Inflammatory bowel disease (IBD) is a term for a group of autoimmune diseases, including Crohn's disease and ulcerative colitis (UC), that inflame the gastrointestinal (GI) tract. Crohn’s and UC are chronic conditions that can cause your digestive tract to malfunction. They are characterized by mild to severe symptoms that may flare, or worsen, at times and get better or go away completely at other times.

Managing IBD symptoms involves reducing inflammation within the GI tract — especially the bowel, or intestines. Inflammatory bowel disease is not curable but is treatable through appropriate diet and lifestyle choices. Read on to find out how you can manage your IBD well. (Source, Source)

What Is Inflammatory Bowel Disease?

Inflammatory bowel disease is an inappropriate immune reaction to gut bacteria, even if it is beneficial. In IBD, the immune system attacks the bowel, causing inflammation that manifests as symptoms including:

• diarrhea
• rectal bleeding
• bloating
• constipation
• gas
• bowel urgency
• cramping
• abdominal pain

You may be at higher risk for developing this chronic condition if you:

• have a genetic predisposition for the development of IBD
• use medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) that disrupt the intestinal barrier, or antibiotics that cause imbalance in the gut microbiome (dysbiosis)
• follow a diet that is high in fat and sugar and low in fiber

(Source, Source, Source)

Managing the symptoms that accompany IBD can help minimize flares and improve your quality of life. Though diet and lifestyle will not cure the disease, the hope is that the flares become fewer and farther between while you experience remission of symptoms for longer periods of time. 

Crohn’s Disease

Crohn’s disease can involve any part of the gastrointestinal tract from the mouth to the anus, but mostly affects the colon and the ileum. The ileum is the last section of the small intestine, which helps to digest food and absorbs nutrients and water from your meal. The colon, or large intestine, is responsible for taking water, nutrients, and electrolytes from your food and turning the waste that remains into feces. Crohn’s disease causes your GI tract to become inflamed and irritated, affecting the digestive process and causing symptoms such as:

• abdominal pain
• diarrhea
• weight loss
• rectal bleeding 

(Source, Source, Source, Source)

Ulcerative Colitis

Ulcerative colitis (UC) inflames the large intestine, causing irritation and ulcers. Inflammation from UC usually begins in the rectum and may spread to the colon, causing mild to severe disease symptoms. About half of those with UC have mild GI symptoms, while the other half may experience more severe symptoms such as:

• frequent fevers
• bloody diarrhea
• nausea
• severe abdominal cramps

(Source, Source)

What Is the Best Diet for IBD?

For IBD, diet is important not only for managing symptoms but also for helping prevent the onset of disease. Research has shown that diet can affect the duration and severity of disease symptoms. Though there isn’t one specific diet to follow for everyone with IBD, there may be an overall plan of foods to eat and to avoid to help lessen your symptoms. Keeping a food diary to track which foods irritate your gut may be useful in eliminating your specific triggers and preventing flare-ups. 

Nutritional deficiencies, dysbiosis, and chronic inflammation each play a role in the onset of inflammatory bowel disease. It’s important to note that malabsorption and malnutrition are common when IBD symptoms are exacerbated during flare-ups. Adding nutrient dense foods to your diet may help restore healing nutrients and gut bacteria, while reducing overall inflammation. (Source, Source)

Foods to Include

As stated previously there’s no one particular diet you should follow, as IBD triggers and symptoms may vary from one person to another. Your practitioner may personalize your eating plan to manage the symptoms you are experiencing and improve your nutritional status. Keeping this in mind, the following foods may be helpful to include in your dietary plan to prevent or manage symptoms:

• banana
• pumpkin
• chicken
• fish
• eggs
• yogurt
• smoothies
• ginger
• cooked potatoes
• turmeric
• steamed foods

(Source)

Foods to Avoid

Everyone’s IBD journey is unique, but common food triggers are pretty clear across the board. Foods that promote inflammation may impair digestion and put you at risk for nutrient deficiencies. If you have IBD, you may want to avoid the following foods to calm intestinal inflammation:

• gluten
• dairy products
• spicy foods
• high fat and fried foods
• high fiber foods, such as raw vegetables
• processed foods
• sugary drinks
• alcohol

(Source)

How Lifestyle Factors Affect Inflammation

In addition to avoiding a standard Western diet with its emphasis on sugary, fatty foods, there are certain lifestyle and environmental factors that can contribute to your inflammatory status. How you live affects your overall health in a big way. 

Movement

Finding the right physical activity is important for reducing your overall inflammation each day. Studies have shown that exercise can reduce the risk of developing IBD, especially Crohn’s disease, and also lessen the frequency of flare-ups. Exercise can also improve your mood and help alleviate symptoms by boosting your immune system. If you struggle with fatigue from IBD, try some slow and gentle, yet effective, aerobic and resistance training movement to increase your energy, such as:

• yoga
• Pilates
• tai chi
• walking

(Source)

Obesity 

Being obese can increase your risk of developing IBD, as well as increasing the occurrence of flare-ups. Research has shown that 50% of those with IBD struggle to get in enough physical movement due to overwhelming symptoms getting in the way, and this lack of movement may increase the risk of obesity. A higher percentage of visceral fat (the fat deep inside your body, wrapped around your organs) may increase your chance of experiencing IBD complications and recurrence of symptoms. To combat weight gain:

• eat a healthy diet to combat nutritional deficiencies
• get consistent exercise
• manage stress
• get adequate sleep

(Source)

Stress 

Managing your everyday stress is key to reducing inflammation, and with IBD managing your stress could grant you longer periods of remission. Although stress does not cause the onset of IBD, it can make symptoms worse. About 60% of Americans report feeling stressed out, and a chronic state of stress is detrimental to your health.

There are many ways to manage stress from the inside out, starting with eating an anti-inflammatory diet that works for your body and your symptoms. Getting adequate rest and sleep, and finding healthy ways to relieve stress daily so it doesn’t become chronic, are also key to your wellness with IBD. Try one of the following stress relievers each day to help keep your symptoms from worsening and manifesting into recurrent flares:

• yoga
• meditation
• mindfulness
• massage
• talking with a friend
• movement
• doing something you love

(Source)

Sleep

Sleep disturbances are a common complaint of IBD sufferers, sometimes due to frequent bathroom visits disrupting nighttime rest. Poor sleep in IBD patients may also look like trouble falling asleep, frequently waking up during the night, only sleeping for short periods of time, and a low quality of sleep overall.

Active disease and poor sleep is a two-way street, as symptoms interrupt sleep and poor sleep worsens symptoms. The greater your inflammation levels, the greater likelihood that your sleep will suffer as well. Limiting disease activity by avoiding dietary triggers can help. In addition, prioritize rest and fight inflammation by:

• creating a bedtime routine 
• turning off electronics a couple of hours before lights out
• leaving early from late-night social situations
• keeping your room cool and dark
• getting outside during daylight hours so the natural light can help regulate circadian rhythms

(Source)

Other Factors

In addition to the above lifestyle factors, smoking and alcohol also play a role in your disease state. Smoking cigarettes may increase your risk of developing Crohn’s disease and increase possible flare-ups, but may actually decrease your risk of developing UC. Research into the role of alcohol consumption in IBD has yielded inconsistent results — we don’t really know if it contributes to disease onset and symptoms or not. Alcohol is a GI irritant for many people, though, and many with IBD choose to avoid it, while others may have no discomfort with moderate alcohol consumption. (Source)

When To Seek Help for IBD

If your quality of life is severely affected by your inflammatory bowel disease, it’s time to seek help to manage and control your symptoms. Depending on the severity, you may find that with the guidance of a health care team or practitioner you can manage your disease through diet and lifestyle alone. More severe symptoms may need supplemental treatments on top of diet and lifestyle changes to manage inflammation appropriately. Seek help from a health care team if you are:

• experiencing any new or unusual symptoms
• having flare-ups that are severe more often than not
• looking to adjust your diet or supplement regime
• thinking about becoming pregnant

(Source)

The Bottom Line on Inflammatory Bowel Disease, Diet and Lifestyle

Inflammatory bowel disease is not curable, but you may be able to manage symptoms and limit flare-ups (and possibly even prevent onset of disease in the first place) by adopting healthy diet and lifestyle habits, such as avoiding inflammatory foods, exercising regularly, and getting good sleep.

If you are considering making changes to achieve a reduction in IBD symptoms, the WellTheory 1-1 coaching membership can help take the guesswork out of a personalized dietary and activity approach. Working with a Nutritional Therapy Practitioner can provide hands-on guidance to help you identify a personalized nutrition and lifestyle plan to support your body and mind while living with IBD.