Crohn Disease Diet

What Is It, Foods to Include, Foods to Avoid, and More

Author: Lily Guo

Editor: Alyssa Haag

Editor: Józia McGowan, DO

Editor: Kelsey LaFayette, DNP, RN, FNP-C

Illustrator: Jessica Reynolds

Copyeditor: Stacy Johnson, LMSW

Modified: Jan 06, 2025

What is Crohn disease?

Crohn disease is an inflammatory bowel disease (IBD) that results in chronic inflammation of the gastrointestinal tract, causing abdominal pain and cramping, diarrhea, and malnutrition. Occasionally, there may be blood in the stool. The inflammation in Crohn disease can occur along any portion of the digestive tract, including the small intestine or large intestine (i.e., colon); however, it most commonly affects the end of the small intestine (i.e., ileum) and the beginning of the colon. The inflammation can involve several separate segments, called ‘skip lesions,’ or be continuous along the gastrointestinal tract. Crohn disease often penetrates the deep layers of the bowel resulting in painful and debilitating symptoms.

Crohn disease is most often diagnosed in adolescents and adults between the ages of 20 and 30. Signs and symptoms typically develop gradually and can range from mild to severe. In addition to the gastrointestinal symptoms leading to reduced appetite and weight loss, one may also experience fever; fatigue; sores around the mouth (i.e., cheilitis); iron-deficiency anemia; inflammation of skin, eyes, and joints; and fistulas with pain and drainage around the anus. Additionally, intestinal strictures (i.e., narrowing of the intestines) may develop due to repeated cycles of continued inflammation and healing in the lining of the intestine, causing scar tissue to replace normal epithelial cells.

Crohn disease in children may lead to a delay in growth and development due to malabsorption of necessary vitamins and minerals in the gastrointestinal tract (e.g., vitamin B12, vitamin D). Therefore diet and nutrition are crucial for children with Crohn disease. The individual’s symptoms can often enter remission for periods with proper treatment and therapies.

Currently, the exact cause of Crohn disease is unknown; however, research suggests there are genetic and autoimmune components. While there is no known cure for Crohn disease, there are therapies available to reduce the signs and symptoms, including therapeutic diets; antibiotics (e.g., metronidazole and ciprofloxacin); steroids (e.g., prednisone, hydrocortisone); immunomodulators (e.g., 6-mercaptopurine, azathioprine, methotrexate, cyclosporine); and biologic therapies (e.g., anti-TNF alpha, anti-integrin, anti-interleukin drugs).

Person with inflammation of their GI tract avoiding cruciferous vegetables.

What is a Crohn disease diet?

A Crohn disease diet is a way of eating that helps minimize and reduce the severity of gastrointestinal symptoms associated with Crohn disease and allows for longer periods of remission. The diet can remain flexible and may include a variety of foods from all food groups. Individuals with Crohn disease often find that soft, bland foods cause fewer flares and discomfort compared to spicy, high-fiber foods. An emphasis may be placed on eating foods that are easily digested and increases the hydration of the body, which is particularly important since Crohn disease can often reduce one’s appetite and decrease the absorption of necessary nutrients, resulting in malnutrition.

While the Crohn disease diet is not a strict, regimented diet, studies have shown that eating foods that are part of a Mediterranean or semi-vegetarian diet can allow for the remission of symptoms of Crohn disease and reduce the frequency of symptom relapse.

How does a Crohn disease diet help Crohn disease?

A Crohn disease diet helps mitigate the symptoms of the disease by encouraging the intake of easily digestible foods and maintaining good nutrition. The symptoms of Crohn disease, such as diarrhea, can result in difficulty absorbing protein, fat, carbohydrates, water, vitamins, and minerals. Abdominal pain and cramping can lead to a reduced appetite and a reduced intake of key nutrients. A Crohn disease diet can help individuals maintain a healthy and balanced diet while reducing inflammation caused by certain foods.

What foods are best for a Crohn disease diet?

The foods best to incorporate into a Crohn disease diet include lean protein (e.g., fish, poultry, soy, eggs, nuts, tofu) and non-cruciferous vegetables (e.g., asparagus tips, cucumbers, potatoes, and squash). An individual may remove the peels of vegetables and the seeds and cook them to make them easier to digest. Additionally, foods high in calcium (e.g., collard greens, yogurt, and kefir) and probiotics (e.g., yogurt, kimchi, miso, sauerkraut, and tempeh) are recommended. Recommended grains include sourdough, potato, gluten-free bread, white pasta, white rice, and oatmeal. The role of fiber in a Crohn disease diet is variable. If restrictions are in place, low-fiber fruits such as bananas, cantaloupe, honeydew melon, and cooked fruits are recommended. Otherwise, fiber-rich foods such as oat bran, beans, and barley can help promote bowel movements.

What foods should be avoided on a Crohn disease diet?

The foods to avoid on a Crohn disease diet include insoluble fibrous foods that can be hard to digest, such as cruciferous vegetables (e.g., broccoli, cauliflower), fruits with skin and seeds, whole nuts, and whole grains. Foods that are categorized under the acronym FODMAP, which include Fermentable, Oligo-, Di-, Monosaccharides, and Polyols, can be poorly absorbed by the GI tract and are therefore recommended to be ingested in low quantities. Examples of foods high in FODMAP include fructose (i.e., high-fructose corn syrup), lactose (i.e., found in cow’s milk), sugar polyols (i.e., sorbitol and mannitol), fructans (i.e., found in garlic, leeks, artichokes, and wheat), and galactooligosaccharides (i.e., found in lentils, chickpeas, and green peas). Other non-absorbable sugars include sugar alcohols, sugar-free gum, candy, ice cream, and certain fruit juices like pear, peach, and prune juice. High-fat foods containing butter, coconut, margarine, and cream; fatty, fried, or greasy food; and spicy foods are generally advised to avoid. Alcohol and caffeinated drinks such as beer, wine, liquor, soda, and coffee can further exacerbate the symptoms of Crohn disease.

What are the most important facts to know about a Crohn disease diet?

A Crohn disease diet is a way of eating that can help minimize the symptoms of Crohn disease and increase remission rates. Crohn disease is a chronic inflammatory bowel disease that results in inflammation and destruction of the cells lining the gastrointestinal tract. It leads to symptoms of abdominal pain and cramping, diarrhea, weight loss, and malnutrition. Foods recommended on a Crohn disease diet include lean protein, non-cruciferous vegetables, fruits without peels and seeds, and foods high in probiotics (e.g., soy, eggs, nuts, tofu, cucumbers, potatoes, squash, yogurt, kimchi, and miso). Foods typically avoided on a Crohn diet include foods high in insoluble fiber and foods high in FODMAPS, which include broccoli, cauliflower, garlic, leeks, candy, ice cream, and fruit juices with high sugar content.

References

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