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I m a Dietitian With IBD Here s What I Eat During a Flare

When in the throes of an IBD flare, eating can be challenging, but maintaining your nutrition is critical. Rachel Dyckman, a dietitian specializing in gastrointestinal health, has had inflammatory bowel disease for almost 20 years. Here’s what she recommends. By Rachel Dyckman, RDNFor My Health StoryReviewed: December 14, 2021Everyday Health BlogsFact-Checked

What I Eat During A Flare as a Dietitian With IBD

Try these four favorite types of flare-friendly foods and learn the best methods to prepare them to reduce inflammation and speed up your recovery.A question I’m frequently asked by fellow inflammatory bowel disease (IBD) patients is “What should I eat when I’m in a flare?” For those with IBD, “flares” unfortunately come with the territory. They’re periods of active gastrointestinal (GI) inflammation that result in painful and often disruptive symptoms, making it challenging to figure out what to eat without further exacerbating things. While every IBD patient’s nutritional needs, disease course, and tolerance to different foods is unique, there are certain easily digestible foods that are generally well tolerated, may help lower inflammation, and will promote a healthy gut microbiome and provide nutrients the body needs to heal. RELATED: The Link Between Your Gut Microbiome and Your Health

Smoothies and Pureed Soups

Rather than avoiding fibrous foods altogether, I blend fruits, vegetables, beans, and legumes into smoothies and soups. Modifying the texture of high-roughage foods allows me to reap the benefits of their vitamins, minerals, and gut microbiome–feeding fiber, while minimizing mechanical irritation to my intestines. Smoothies and soups also help me stay hydrated when I’m not absorbing fluids as effectively. During IBD flares, it’s common to have a reduced appetite, due to painful GI symptoms and elevations in pro-inflammatory molecules called cytokines, which tend to reduce appetite as a side effect. Additionally, fatigue that often accompanies flares can make eating feel like a chore. I find that during these times, it’s easier to drink some of my meals, rather than eat them.

Soft Lean Proteins

Protein needs increase during flares, due to increased protein loss, increased metabolic rate, nutrient malabsorption, and certain commonly prescribed medications that promote protein breakdown, like corticosteroids. Since protein plays an important role in maintaining muscle mass and facilitating tissue repair, it’s important to incorporate a protein source at most meals. Soft (tender foods that don’t require a lot of chewing), lean proteins are easiest to digest and best tolerated. Some of my go-tos include tofu, fish, lean ground turkey or chicken, plain Greek yogurt, and eggs. When preparing tofu, fish, poultry, and eggs, I use cooking methods with minimal added fat, such as sautéing, baking, or boiling, rather than frying.

Ripe Peeled Fruits

Soft, ripe fruits like bananas, melons, and peeled peaches and nectarines are easy to digest and are great sources of soluble fiber. Soluble fiber is particularly beneficial to those with IBD because it absorbs water, forming a viscous gel in the GI tract. This gel slows GI transit time, helping us absorb more nutrients and fluids from our food. Many types of soluble fiber double as “prebiotics,” meaning they selectively feed good gut bacteria. In addition to soluble fiber, fruit is an excellent source of vitamin C. Vitamin C is a commonly underconsumed nutrient among those with IBD, according to a study published in January 2021 in Crohn’s and Colitis 360. Many IBD patients avoid vitamin C–rich produce during flares out of fear that these foods will worsen symptoms. While certain whole fruits are high in roughage and may need to be avoided during flares, there are plenty of soft fruits that are likely to be well tolerated. Soft fruits also help replenish electrolytes like potassium. This is particularly important for those taking corticosteroids like Prednisone, which can increase potassium loss.

Fermented Foods

Yogurt, kefir, kombucha, and miso are fermented foods that I consume often, both when I’m experiencing a flare and when I’m in remission. These foods contain probiotics, live microorganisms that provide a variety of health benefits. Research published in July 2021 in the journal Cell suggests that eating more fermented foods may alter the gut microbiome in a way that lowers inflammation. Since IBD is an inflammatory disease associated with fewer beneficial bacterial strains and less overall microbial diversity in the gut, eating foods that repopulate the gut with good bacteria can help promote remission. RELATED: Fermented Foods Decrease Inflammation and Improve Gut Diversity, Study Finds

Foods Rich in Omega-3 Fatty Acids

Fish and seafood, ground chia seeds, ground flaxseeds, and shelled hempseeds are all easy-to-digest ways to incorporate more omega-3 fatty acids into your diet. Omega-3s oppose inflammatory processes in the body, and most of us aren’t getting enough of them. To meet my requirements during flares, I try to incorporate at least two servings of fish into my weekly meal rotation. I also add ground chia seeds, ground flaxseeds, and shelled hempseeds to smoothies and soups. As a bonus, these seeds happen to be rich in prebiotics. RELATED: Crohn’s Disease: Fats You Should Eat, Enjoy, or Avoid

Smooth Nut and Seed Butters

Whole nuts and seeds are high in roughage and tricky to break down when your GI tract is inflamed, but smooth nut and seed butters are an entirely different story. I always keep jars of peanut butter, almond butter, and tahini in my pantry as tasty and easy-to-digest sources of healthy fat, protein, and vitamins and minerals. Nuts and seeds are high in monounsaturated fats, which are thought to be protective against ulcerative colitis. I’ll have a spoonful of nut or seed butter as a snack, or add it to other well-tolerated foods like bananas, plain Greek yogurt, smoothies, oatmeal, and rice cakes.

Bone Broth

Bone broth has been consumed for centuries and is made from boiling collagen-rich animal bones, often with herbs and spices. I like to use bone broth as a soup base to give it extra protein, or I’ll drink it on its own as a warm, comforting beverage. Preliminary research suggests that collagen protein may also promote healing of the gut’s mucosal lining. And since bone broth contains sodium, it’s a great way to replenish lost electrolytes too.

Moving Toward Remission

At the end of the day, it’s important to remember that flares are only temporary, and nourishing your body properly can help you get through them. While diet alone cannot necessarily cure IBD, making certain dietary adjustments can significantly improve your quality of life, aid in symptom management, and promote remission. As symptoms improve, it’s important to gradually reincorporate foods like whole fruits and vegetables with skins back into your diet, as well as whole grains. The wider the array of whole, plant-based foods in your diet, the more you can improve your good gut bacteria and decrease the chance of relapse. Important: The views and opinions expressed in this article are those of the author and not Everyday Health.See More NEWSLETTERS

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