Inflammatory bowel disease (IBD) affects more than ten million people worldwide. While the exact causes of IBD remain unclear, certain foods are known to trigger symptom “flares.” To better understand the connection between diet and IBD, we spoke with Tufts Medical Center gastroenterologist, Joel Mason, MD to learn more.
What is inflammatory bowel disease?
Inflammatory bowel disease (IBD) is actually a term used to describe two conditions, Crohn’s disease and ulcerative colitis. Both Crohn’s disease and ulcerative colitis are characterized by chronic inflammation of the gastrointestinal system, while Crohn’s disease can affect any part of the GI tract, ulcerative colitis only affects the colon and the rectum. Both conditions commonly cause diarrhea and abdominal pain and can become very serious if left untreated and lead to irreversible bowel damage.
If you experience any of the symptoms of IBD, you should contact your primary care physician. If they suspect inflammatory bowel disease, they’ll refer you to see a gastroenterologist and schedule you for the appropriate tests.
Joel Mason, MD, gastroenterologist
Do diet and nutrition have a role in developing IBD?
Doctors still don’t clearly understand how and why IBD develops, but most agree it results from a complex interaction between the underlying genetics of an individual with various environmental exposures, including microorganisms, diet and antibiotics. To date, we know of no special diet that will lessen an individual's risk of developing IBD.
How can a person identify particular food and diet issues that could be contributing to IBD symptoms?
Although it sounds mundane, in many instances, it requires the patient and health professionals to pay close attention to what foods tend to exacerbate symptoms. Doctors and dietitians need to listen carefully to what their patient tells them, and then combine this detailed history with their knowledge of the physiological response to various food groups, they may be able to sort out what categories of foodstuffs are offenders.
What are some strategies for managing IBD symptoms?
It is very difficult to provide broad recommendations because the disease, its consequences, and the medicines used to treat it vary tremendously from patient to patient. It is very true that what is a beneficial dietary strategy for one patient with IBD might be harmful to another. Nevertheless, it remains true that an appropriate diet can make a big difference in controlling the symptoms of the disease.
There’s no one-size-fits-all diet—it depends on disease location, activity, surgeries and medications, but these are some strategies that seem to help most people:
- Maintain a healthy weight and seek help from your doctor if your weight is dropping.
- With ongoing diarrhea, you should limit caffeinated drinks, stay hydrated with oral rehydration solutions (ORS)—not sports drinks.
- Take a daily multivitamin and mineral, but avoid megadosing unless directed by a doctor.
What should I watch out for when taking IBD medications?
Some medications, foods and supplements can interfere with your IBD treatment or make symptoms worse. Here are a few common interactions to be aware of:
- Avoid aspirin and NSAIDs: Medications like ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin can irritate your digestive tract and make IBD symptoms flare up.
- Skip grapefruit juice with cyclosporin: Grapefruit juice can change the way your body processes cyclosporin, leading to dangerous side effects. Stick with water or other juices instead.
- Take folic acid with methotrexate: If you’re on methotrexate, taking 1 milligram of folic acid daily can lower your risk of side effects like nausea or mouth sores. Talk to your doctor before starting any new supplements.
Always check with your care team before starting a new medication, supplement or even a change in diet. We’re here to help you avoid issues and feel your best.
