Nourishing Liquids

In certain scenarios, some individuals with inflammatory bowel disease may benefit from having a liquid diet. This resource will go over when this diet may be indicated, types of liquids to consume, and tips for tolerating this diet.

When only having liquids may be warranted:

• Significant narrowing/stricturing in the bowel; if narrowing is not severe than soft, low insoluble fibre foods can usually be consumed as well.
• Severe Crohn’s disease flare-up; some patients may choose to try complete enteral nutrition (only taking nutrition supplements either orally or by a feeding tube).
• Post gastrointestinal surgery until a solid diet can be resumed.

For those who don’t need to restrict solid foods, consuming liquids can supplement food intake to help with malnutrition and weight gain and meeting nutrition needs.

Making your own smoothies and soups:

Below is a guide that gives examples of things you could put in a smoothie and soup. By adding foods from the fibre, protein, and energy columns, you will increase the nutritional value of them and it will help you to stay full for longer.

If you have narrowing in your bowel, you may need to blend your smoothies and soups until they are very smooth and strain out any larger pieces of fibre and seeds.

 

Sweet smoothies

Liquid (1 -2 cups)	Fibre (1/2-1 cup)	Extra Protein (1-4 tbsp)	Extra Energy (1-2 tbsp)	Flavourings (optional)
Cow’s milk Lactose free cow’s milk Goat’s milk Soy milk Coconut milk Cream Oral nutrition supplements Oat milk* Almond milk*	Banana Berries Mango Pineapple Kiwi Peaches Applesauce Pears Spinach Kale Cucumber	Greek yogurt Silken/soft tofu Peanut butter Almond butter Sunflower butter Pumpkin seed butter Protein powder Mascarpone cheese Hemp seeds** Chia seeds** Ground flaxseeds**	Avocado Avocado oil Hemp seed oil Flaxseed oil Coconut cream	Ginger Cinnamon Nutmeg Cocoa powder Vanilla extract Lemon Lime Maple syrup Honey

*Plant based milks like oat milk and almond milk can be used as the liquid base of smoothies and soups but they are lower in protein and calories than soy milk and animal milks.

**Hemp seeds, chia seeds, and ground flaxseeds should be avoided if you have narrowing in your bowel.

 

Savoury soups

Liquid (1 -2 cups)	Fibre (1/2-1 cup)	Extra Protein (1-4 tbsp)	Extra Energy (1-2 tbsp)	Flavourings (optional)
Cow’s milk Lactose free cow’s milk Goat’s milk Soy milk Coconut milk Cream Bone broth Vegetable broth Canned soup	Carrots Sweet potatoes Peas Broccoli Cauliflower Spinach Kale Pumpkin Parsnip Squash Onion	Chickpeas Lentils Legume pasta Silken/soft tofu Salmon Chicken Beef Lamb Cheese Almond butter	Avocado Avocado oil Olive oil Coconut cream Sour cream Butter Rice Noodles	Ginger Cumin Curry powder Salt Pepper Green onion Leeks Garlic Dill Parsley Cilantro

 

Oral nutrition supplements:

There are many different types of oral nutrition supplements on the market. Many patients will benefit from having high protein and calorie options, especially if liquids are their sole source of nutrition. Others may choose to buy formulas that may be slightly better tolerated (if FODMAPs are an issue) or restrict animal ingredients. Listed below are some brand recommendations that fit these criteria.

• High Calorie and Protein: Resource 2.0® (Nestle), Ensure Protein Max® (Abbott), Boost Plus Calories® (Nestle), Ensure Plus Calories® (Abbott).
• Low FODMAP/easier to digest: Sperri Complete 1.0
• Vegan/organic options: Sperri Complete 1.0, Compleat® Organic Blends (Nestle)
• Clear fluids (if needed in preparation for surgery or scope): Boost® Soothe (Nestle)

Tips to make a liquid diet better tolerated:

• If narrowing/stricturing is severe and you are experiencing nausea and vomiting, you may need thin the smoothies and soups by adding additional liquid and straining them.
• Drink small amounts at a time spread out throughout the day.
• Chew your smoothies and soups; the physical motion of chewing can support digestion.
• For nutrition supplements, you may need to trial various types to see what your body tolerates.
• If you have significant gastrointestinal symptoms like gas, bloating, diarrhea, it may be helpful to work with a dietitian who can modify and tailor the above recommendations to your needs.

Resources for additional recipes/information:

• http://www.bccancer.bc.ca/nutrition-site/Documents/Patient%20Education/Nourishing-liquids.pdf
• Blenderized Tube Feeding Recipes | Vancouver | Natural Tube Feeding (can be taken orally)

Gina Almasan, RD