Nutrition is an important part of Inflammatory Bowel Disease (IBD) treatment. Our nutritionist can help create an IBD diet, or make dietary modifications, that may be required in the individual management of each patient.
A number of nutritional modifications have been shown to improve symptoms in patients with Inflammatory Bowel Disease. Different nutritional adjustments may help during various stages of disease. For example, some interventions may work to prevent flares, while others may work to reduce symptoms during a flare. Below are some nutritional guidelines that have been shown to be beneficial for patients with IBD.
Asymptomatic patients may benefit from:
- Eating small frequent meals
- Eating a varied and nutritious diet
- Avoiding weight loss
- Removing starches from the diet. There is some evidence to suggest that removing starches helps inhibit the growth of microorganisms in the intestine, thereby reducing gas, bloating and abdominal pain.
Improving symptoms during an IBD flare
Those patients who find themselves in the middle of a Inflammatory Bowel Disease flare can reduce symptoms of gas, bloating and abdominal discomfort by following these dietary modifications:
- Avoiding fiber: bran, beans, nuts, seeds, popcorn, brown rice, wild rice, raw fruits and vegetables
- Reintroducing whole grains, fruits and vegetables one at a time
- Limiting dairy, especially for patients with small bowel disease
- Limiting excess fat (limit to 8 teaspoons per day)
- Avoiding high sugar drinks, sweet juices, caffeine, alcohol
Vitamin and mineral supplements
The following vitamin and mineral supplementation is important for patients with IBD:
- Zinc, Potassium and Magnesium in patients with diarrhea
- Calcium with Vitamin D, especially for patients on steroids
- Vitamin B12
A wide variety of bacteria are present in the intestinal tract of healthy individuals. These bacteria serve important roles that range from digestion, absorption and storage of nutrients to protection against disease-causing bacteria through competition for nutrients and secretion of anti-microbial substances. A disrupted microbial equilibrium, characterized by lower numbers of protective bacteria and larger numbers of disease-causing bacteria, is observed in IBD patients. There is evidence to suggest that IBD flares may be brought about by an overactive immune system triggered by changes in intestinal bacterial composition. The idea behind probiotic supplementation in IBD is to increase the diversity of bacteria in the intestine that would compete for nutrients with disease-causing bacteria.
There is evidence to suggest that VSL#3 (a combination of Sterptococcus thermophiles, four lactobacilli and three bifidobacteria species) helps maintain remission in UC patients and reduces flares of pouchitis.
Bowel Rest/Nothing by mouth
Bowel rest should not be used as primary therapy but rather in conjunction with other modalities. Parenteral nutrition (nutrition through the vein) is usually reserved for those who:
- Do not tolerate food by mouth
- Have fistulous complications (abnormal communications between the gut and other organs in the body)
- Need perioperative nutrition support, usually in cases of severe malnourishment
To learn more about IBD nutritional guidelines or to schedule an appointment with our nutritionist, contact us today.