If you have any form of inflammatory bowel disease (IBD) I recommend my 2 weeks online nutrition coaching to help you get your condition under control and start to heal your gut or at least get your condition into remission.
A word of caution: if you have one of the two most serious types of IBD, namely Crohn’s disease (the most severe type) or ulcerative colitis, my advice is not a substitute for getting medical advice, diagnosis and treatment from a fully qualified doctor. These two conditions require medical attention, and constant vigilance with your diet throughout your lifetime. However, I can help alongside your doctor.
Inflammatory bowel disease is an umbrella term for a range of conditions which are essentially the chronic inflammation of the gastrointestinal tract. These conditions (from least severe to most severe) include IBS (irritable bowel syndrome), Celiac disease, diverticulitis, ulcerative colitis, and Crohn’s disease.
Irritable Bowel Syndrome (IBS)
This common condition is mainly diet and lifestyle related. Certain foods and drinks can trigger this condition, and stress can also trigger IBS. Stress and poor diet often go together, which exacerbates the condition. The main symptoms are stomach cramps, stomach ache, bloating, diarrhoea (and sometimes constipation). This condition is reversible by cutting out inflammatory foods and consuming more anti-inflammatory foods. More on this below.
Stress can also be managed. Meditation, mindfulness, deep relaxation, walking in nature, deep-breathing exercises, and good quality sleep all have the effect of activating your parasympathetic autonomic nervous system, which is the physiological state in which your body and mind repairs itself and recharges.
This is an auto-immune disease where your immune system attacks your own healthy gut tissue, triggered by the consumption of foods containing gluten. If you continue to eat gluten, your health is compromised because you no longer absorb nutrients optimally.
The simple cure for Celiac disease is to eliminate gluten from your diet. The foods with the highest gluten content include bread, baked foods, cakes and pastries, cereals, biscuits and crackers, beer, commercially manufactured soups and gravies and sauces. There are now gluten-free versions of some of these foods.
This is a disease of the large intestine (also known as the colon), where small bulges (diverticula) in the lining of the colon become inflamed. Left untreated, these inflamed bulges may turn into abscesses and require surgery. The chief symptom is pain in the lower left side of your stomach, accompanied by nausea and vomiting. See your GP immediately, or if the pain becomes excruciating dial 999 and get immediate medical treatment.
However, in around 95% of cases, diverticulitis is less severe and can be treated by cutting out inflammatory foods/drinks and eating a healthy diet of anti-inflammatory foods.
This is a chronic disease characterized by inflammation of the colon and sometimes also the rectum. The most common symptom is diarrhoea and the constant need to go to the toilet. It is incurable, but with proper medication and diet it can be managed to the extent that you can keep the disease in remission (ie – a substantial reduction of symptoms) for the most part. However, flare-ups are possible if you eat inflammatory foods or go through a period of stress.
Ulcerative colitis is diagnosed by a colonoscopy, as the ulcers are clearly visible on the surface of the inner lining of the colon.
This is the most serious and debilitating form of IBD. The main symptoms are diarrhoea, stomach cramps/pains, blood in the stool. The exact cause is unknown, but thought to be a combination of genetics and problems with your immune system.
Crohn’s disease is incurable, but it can be managed into remission with medication and good diet. Occasionally colon surgery is necessary in severe cases. Unlike ulcerative colitis which only affects the colon, Crohn’s disease can flare up anywhere in the digestive tract.
Long term symptoms of IBD
In addition to diarrhoea, stomach cramps and bloating, a serious long term consequence of IBD can be nutritional deficiencies that result from decreased appetite and impaired absorption of nutrients. Particularly in the more severe types of IBD, you can over time develop deficiencies in iron, vitamin D, vitamin B12, zinc and calcium. In the case of Crohn’s disease, Crohn’s anemia (iron deficiency) and osteoporosis (from lack of vitamin D and calcium) are issues to be addressed with supplements prescribed by a doctor.
In the case of Crohn’s, fat absorption can be a problem, leading to an unhealthy degree of weight-loss and deficiencies in fat-soluble vitamins A, D, E and K.
If you have any form of IBD, avoid the following inflammatory foods:
Wheat and grains, particularly those high in gluten (bread, pizza bases, pasta)
High-sugar junk food/drinks
Artificial sweeteners or any manufactured foods/drinks that contain them.
Too much insoluble fibre (especially raw fibrous vegetables) can also irritate the gut.
Different foods can trigger different symptoms in different people, depending on the type of condition and the individual’s sensitivity to particular foods.
Low FODMAP Diet
If symptoms persist, even after eliminating the above inflammatory foods, eliminating FODMAP foods (certain short-chain carbohydrate foods) is the next step:
Fermentable oligosaccharides: wheat, onions, garlic
Disaccharides: lactose in milk (many people are lactose intolerant), dairy products.
Monosaccharides: fructose, foods containing high fructose corn syrup, apples, honey
Polyols: compounds such as sorbitol and mannitol, found in fruits with stones (such as peaches and plums) and certain vegetables such as mushrooms and cauliflower.
Once these foods have been eliminated, monitor your condition and then slowly reintroduce these foods one by one, to see which food is triggering a flare-up.
Eat more anti-inflammatory foods, particularly the following:
Bone broth (highly nourishing to the gut-lining)
Nuts & seeds (almond butter is soothing in the case of Crohn’s disease)
Green tea and mint tea
Soft-cooked broccoli and sprouts
Extra virgin olive oil
Salmon and mackerel
Eggs (not fried)
Healthy Gut Microbiome
The healthier your gut microbiome (your ecosystem of gut bacteria) the better, so eat plenty of prebiotics (foods which feed healthy bacteria) and probiotics (foods containing healthy bacteria such as Kefir, live natural yoghurt). At the same time, eliminate foods which feed harmful bacteria (for instance beer, and junk foods/drinks containing high levels of sugar).
(Dominic Londesborough is a personal trainer in London and also an online nutrition coach)