What are some suggestions for a low fibre diet for Crohns?

The normal human gut cannot digest certain carbohydrates - the sugar, starches, or fiber found in many foods. Often with Crohn's particularly if the small bowel is involved, you may have more difficulty than others.  Temporarily decreasing FODMAPs in your diet, the hardest-to-digest fermentable carbohydrates, can also stop distressing gut symptoms like nausea, fullness, bloating, wind, abdominal cramps, diarrhoea or constipation. 
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For the two thirds of patients who develop small bowel narrowings (strictures), a low-fiber with low-residue diet or a special liquid diet may be beneficial in minimizing abdominal pain and other symptoms. This means foods that add bulky fibrous residue to the stool. These include raw fruits, vegetables, and seeds, as well as nuts and corn.  Often, these diet changes are temporary and they are followed until the narrowings settle with control of inflammation or surgery. Be careful not to impose too many food restrictions on yourself. These limit variety in the diet and make a balanced intake of foods more difficult. A dietitian working with your doctors can help you with your a diet when needed.

Crohn’s Disease is a condition that causes inflammation of the full thickness of the bowel, which can affect any part of the digestive tract, from the mouth to the anus. The most frequently affected areas are:

• The small bowel, especially the ileum (the last section of the small bowel).
• The large bowel (colon).

 Common symptoms of Crohn’s Disease –

• Diarrhoea
• Passing mucus in your stools
• Abdominal pain/discomfort
• Fatigue, lethargy
• Fever
• Loss of appetite
• Nausea and vomiting
• Weight loss
• Rectal bleeding

These symptoms are a result of the inflammation, thickening and narrowing of the bowel wall. Symptoms and their severity are individual, and depend on the part of the bowel involved and the amount of inflammation. Most people with Crohn’s Disease have intermittent symptoms, with periods of relapses, or ‘flare ups’ and periods of remission, which are completely symptom free. 

Is there a special diet for Crohn’s Disease?

No specific dietary factors have been shown to cause Crohn’s Disease or trigger a ‘flare up’/relapse. Therefore there is no special diet for people with Crohn’s Disease. It is important to consume a healthy balanced diet that provides adequate nutrition to maintain a healthy weight and that promotes normal growth. If you are experiencing gastrointestinal symptoms, your dietitian can recommend dietary modifications to assist in managing these symptoms. Nutritional problems may occur due to poor food intake, reduced absorption of nutrients or loss of protein, blood or fluid from the bowel.

When well, it is important to follow a healthy, balanced diet, incroporating all the core food groups as indicated below:

• Breads and Cereals - at least 5 serves daily
• Meat and protein - at least 1 serve daily
• Dairy - 3 serves daily
• Fruit - 2 serves
• Vegetables - 5 serves
• Fats & oils - 4-6 teaspoons

When is a special diet required?

If you are experiencing gastrointestinal symptoms, certain dietary modifications may be of benefit. If modifications to your diet are required it is best to consult with a dietitian to ensure a nutritionally adequate diet is maintained.

Fibre: A low fibre diet is sometimes helpful in controlling diarrhoea. Reducing dietary fibre may also be recommended to prevent pain and nausea after eating.

 To reduce dietary fibre, choose white breads and cereals instead of wholegrain and wholemeal varieties. Also, limit fruits and vegetables and avoid seeds, nuts, legumes (dried beans and lentils), dried fruit and the skins and seeds of fruits and vegetables.

 Fat: A low fat diet may be recommended for people with fatty diarrhoea. Choose low fat dairy products and lean meats. It is important not to remove these food groups from your diet as they are an important source of protein. Avoid adding fat to foods such as, margarine, butter, oil, lard, cream, mayonnaise, and limit the use of fat in cooking. Also, limit your intake of high fat foods such as, chips, chocolate, pastries, fried foods, cakes and biscuits.

Lactose: Lactose may worsen diarrhoea, therefore a diet low in lactose may be beneficial. Milk and milk products are the only sources of lactose, however these products are important sources of protein and calcium, therefore you should consult with a dietitian before removing these products from your diet.