Crohn’s Disease

The dietary treatment for Crohn’s disease varies from patient to patient. When in remission, and without a significant narrowing in the intestine, a general healthy diet, including foods high in fiber, is generally recommended. During a flare, a low fiber, lactose-free and low-fat diet may be recommended, depending on the individual case. If there is a narrowing in the bowel, then a low undigestable fiber diet may help prevent blockages (obstructions) of the bowel. Some patients may need to stay on a low fiber, lactose-free and low-fat diet even while in remission. Two diets have been increasingly recommended for Crohn’s patients who find that certain foods increase their symptoms:

-The Low FODMAP Diet, for patients who have increased gas from the difficulty of digesting complex carbohydrates. This diet avoids foods that are high in FODMAPs (fermentable oligosaccharide, disaccharide, monosaccharide and polyols), such as some fruits, vegetables, nuts, seeds, grains and grain-based products, dairy and dairy alternatives, sugars and sweeteners. The low digestibility of FODMAPs results in their poor absorption in the small intestine. In this case, when eaten, the food passes undigested from the small intestine to the large intestine, where it is fermented by bacteria. This can lead to IBS-like symptoms including gas, bloating, abdominal discomfort, pain and altered bowel function. The low FODMAP diet includes foods such as some fruits (for example, bananas, blueberries, and pineapple), vegetables (for example, tomatoes, green beans, and potatoes), some nuts, seeds, grains and grain-based products, some dairy and dairy alternatives, and sugars and sweeteners that are low in fermentable oligosaccharide, disaccharide, monosaccharide and polyols.

-The Specific Carbohydrate Diet (SCD), which restricts complex carbohydrates, such as sugars, in the diet. Complex carbohydrates are not easily digested and when eaten, the food passes undigested from the small intestine to the large intestine, where it is fermented by bacteria. This can lead to IBS-like symptoms including gas, bloating, abdominal discomfort, pain and altered bowel function. The carbohydrates that are allowed in the SCD are monosaccharides that can be easily absorbed by the intestinal wall, such as apples, apricots, bananas, peppers and broccoli. This diet has been successful for many Crohn’s patients and has been reported to be beneficial in a small number of pediatric patients. However, it has not, been confirmed in large or placebo controlled scientific studies published in the medical literature.