Self-care | Eating and Drinking with IBD

Eating and drinking with IBD. Confusing right?! Unfortunately, there is no one-size fits all guide that will tell you what you can and can’t eat and drink with IBD. It’s one of the biggest issues that many of us have to contend with. Some IBD patients don’t react well to dairy, whereas others have dairy products on their “safe foods” list. Fruits and vegetables with insoluble fibre are one of the biggest culprits for causing problems, but still, some patients can eat them with no issue.
Eating:
What you CAN eat and drink will likely be dependent on whether you’re flaring or in remission, and what your main symptoms are. For example, if you have pain caused by strictures (narrowed parts of the intestine), you’ll probably want to avoid food that may make these symptoms worse, such as nuts, beans and popcorn. These could also cause an obstruction if not chewed completely. If one of your main symptoms is diarrhoea, you will want to avoid foods which usually increase stool output and frequency such as fruit, vegetables and spicy food.

If you're trying to combat weight loss, high calorie "junk food" may actually be the answer; biscuits and cakes and carbs such as potatoes and pasta could help sustain weight. If you're losing weight because you are struggling with solid food, speak to your IBD team to see whether they can prescribe weight management nutritional drink supplements. In the meantime, protein shakes, Complan, yoghurt drinks and milkshakes may help.

Some will find it useful to follow a low fibre or low residue diet. This does NOT mean cutting out all fruit and vegetables! This will do your body far more harm than good in the long term! To learn more about a low fibre diet, visit the Mayo Clinic. ANY diet should be discussed with your IBD team or dietician first.

If you are unable to eat fruit and vegetables, try drinking juice, as it can count as one of your 5-a-day. You may not be able to tolerate juice either, but it's worth trying to split the portion in two, or even 3 and drinking them throughout the day to see if this helps.

Whatever restrictions you are working with, you do need to have as healthy a diet as possible, which means eating the correct amount of food from each food group and drinking lots of water. As every patient is different, keeping a food diary to monitor how your body reacts to each food is a good idea. You will need to log things such as frequency, urgency, pain, blood, consistency and the amount of gas created. You can download these from the World Wide Web or find lots of different trackers in your app store! Just because something doesn’t agree with you one time, doesn’t mean you shouldn’t try it again a few weeks later. If you are trying to introduce new foods, do this a small amount at a time.

B12 and Vitamin D deficiency are common amongst Crohn’s and Colitis patients, and you may be lacking in other vitamins and minerals due to dietary restrictions or your bodies inability to absorb them properly. You can buy over the counter supplements for most of these and your IBD team can arrange for injections or infusions if you have difficulty absorbing certain things still.

Herbal medications may be taken to help some symptoms or help with things like sleep. Be aware that it is not only prescribed medications that can interact with each other! This is the most comprehensive list I have found about these interactions.

For further advice on food and supplements, check out a balanced belly by Jenna Farmer. Jenna is a qualified nutritional therapist and IBD sufferer.

Drinking:
You should monitor which types of drink work for you and which don't, just like you should with food. Some people find that alcohol, carbonated drinks, fruit juice or caffeine affect symptoms, whilst others can drink anything they like. The key is to figure out what works for you, and not assume you are the same as everyone else.

Staying hydrated is really important. How much water YOU should drink is actually based on a number of factors such as your health, weight, the local climate and how physically active you are. Drinking too much water can actually flush out the electrolytes which you need to stay hydrated (but you would have to drink an awful lot to do this).

You don't need to rely solely on water to meet your fluid needs. Beverages such as juice and herbal teas are composed mostly of water and can contribute to your daily water intake. What you eat also provides a significant portion, so fruits and vegetables, particularly watermelon and spinach, are almost 100% water by weight. That said, water still IS your best bet.

Many people like to add fruit to water, which is fine, but be aware that drinking too much lemon water can actually dehydrate you (because lemon is a natural diuretic). It may also cause other problems such as heartburn and tooth erosion because of its high acid content.

Staying hydrated may be more difficult if you have had part of your intestine removed, especially during the summer months. If you have had your colon (large intestine) removed, you will need to increase your daily salt intake too. It can feel very confusing, so do quiz your IBD team about it if you feel the need – that is what they are there for! If you have a short bowel, high output stoma or a jpouch, a homemade oral rehydration solution (ORS) will be beneficial when you’re feeling dehydrated. Check out this St. Mark’s PDF which includes the ORS recipe! Those that have their whole digestive system intact can use this recipe.

If you are dehydrated you may experience:
Dry, sticky mouth
Increased thirst
Light headedness or feeling dizzy especially when going from sitting to standing
Tiredness
Headache
Passing less urine which is dark or strong smelling
Muscle cramps

Your fluid intake is probably adequate if:
You rarely feel thirsty
Your urine is colourless or light yellow

Medication:
Follow the rules! Medication is not given to us for fun. People may feel like they should be able to stop taking medication once they are in remission, but sustaining remission is just as important. Take all of your medications as directed on the packet. If you are confused by something and can’t contact your IBD team straight away, talk to a pharmacist as they are qualified to deal with queries about medications and interactions.

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