News

March 4, 2025

Nutrition During an IBD Flare: How to Stay Well Nourished

Inflammatory Bowel Disease (IBD) can be unpredictable, with periods of flare-ups where symptoms worsen, often leading to a range of physical challenges. During a flare, maintaining proper nutrition can become especially difficult due to symptoms like diarrhea, abdominal pain, nausea, and a reduced appetite. However, it’s crucial to ensure that your body receives the nutrients it needs, even when you’re not feeling your best.

In this article, we’ll explore practical tips and strategies to help you stay well-nourished during an IBD flare, drawing from the latest research on managing nutrition in this condition.

Why Nutrition Matters During an IBD Flare

Proper nutrition during a flare is vital because IBD can interfere with the body’s ability to absorb nutrients, leading to deficiencies in key vitamins, minerals, and macronutrients. If you don’t eat enough during a flare, it can worsen fatigue, weaken your immune system, and make it harder for your body to heal. On the other hand, consuming the wrong foods can exacerbate inflammation and symptoms. Therefore, it’s important to adopt a tailored approach that supports both the digestive system and overall health.

1. Focus on Easily Digestible Foods

During an IBD flare, the gut is already under stress, and foods that are hard to digest may make symptoms worse. Opting for easy-to-digest, low-fiber foods can help minimize irritation. Here are some examples of suitable options:

  • Cooked vegetables (instead of raw) like carrots, squash, and spinach.
  • Lean proteins, such as chicken, turkey, or fish, which are less likely to irritate the digestive system compared to red meats.
  • Refined grains like white rice, plain pasta, and white bread, which are lower in fiber and gentler on the stomach compared to whole grains.
  • Low insoluble fibre fruits such as bananas, applesauce, and melons, which are easier to digest.

Focusing on a bland, low insoluble fibre diet for a period during a flare can give the GI tract a much-needed rest.

2. Stay Hydrated

Dehydration is a common concern during an IBD flare, especially if diarrhea is one of your symptoms. The loss of fluids and electrolytes can lead to dehydration, which can make you feel more fatigued and worsen the symptoms of a flare. To ensure adequate hydration:

  • Drink plenty of water throughout the day. Aim for at least 8 cups, but more may be needed if you’re experiencing diarrhea.
  • Electrolyte-replenishing drinks like oral rehydration solutions (ORS) or electrolyte-infused waters can help replace lost sodium, potassium, and other essential minerals.
  • Avoid sugary and caffeinated drinks, which can irritate the digestive tract and increase fluid loss.

Staying hydrated helps maintain energy levels and ensures that your body functions optimally, even under stress.

3. Incorporate Anti-Inflammatory Foods

While the focus during the flare is often on foods to avoid; it’s important to prioritize foods that make us feel good as well. There are plenty of anti-inflammatory foods such as:

  • Omega-3 fatty acids found in fatty fish (like salmon and mackerel), chia seeds, flaxseeds, and walnuts may help reduce inflammation.
  • Curcumin, the active compound in turmeric, has been shown to have anti-inflammatory properties and may be beneficial for individuals with IBD. Consider adding turmeric to smoothies or meals for a mild flavor and its health benefits. Curcumin can also be taken at higher doses via supplementation.
  • Probiotics, found in foods like kefir, yogurt (with live cultures), and sauerkraut, may help balance the gut microbiota and improve gut health during a flare.

Always consult your doctor or dietitian before adding any new supplements, especially during an active flare, to ensure they’re appropriate for your condition.

4. Monitor for Nutrient Deficiencies

During an IBD flare, the body’s ability to absorb essential nutrients can be impaired, especially if there’s active inflammation in the gut. Deficiencies in key vitamins and minerals are common in individuals with IBD. Some of the most common deficiencies include:

  • Vitamin B12: Especially in people with Crohn’s disease, vitamin B12 deficiency can occur due to malabsorption in the small intestine. B12 is essential for energy production and nerve function.
  • Iron: Chronic blood loss, which is common in IBD, can lead to iron deficiency anemia. If you’re feeling fatigued and pale, it may be due to low iron levels.
  • Calcium and Vitamin D: Bone health is another concern in IBD, as malabsorption can lead to low levels of calcium and vitamin D, which are crucial for bone strength.
  • Magnesium: Magnesium plays an important role in muscle and nerve function and may be depleted due to diarrhea.

Including foods rich in these nutrients or taking supplements under the guidance of a healthcare provider can help prevent deficiencies. For example:

  • B12-rich foods: Lean meats, fish, fortified cereals, and dairy products.
  • Iron-rich foods: Poultry, beans, and leafy greens (though the latter may be problematic if fiber is a concern during a flare). Red meat is a great source of iron as well; however, it’s not recommended given its pro-inflammatory nature.
  • Calcium-rich foods: Dairy products, fortified plant-based milks, and leafy greens.
  • Magnesium-rich foods: Nuts, seeds, and leafy greens. Nut and seed butters can be used in place of whole nuts/seeds if tolerance is low.

5. Small, Frequent Meals

If your appetite is reduced during a flare, try eating smaller meals throughout the day instead of large ones. This can make it easier for your body to absorb nutrients and reduce the risk of feeling overly full or bloated. It can also prevent overeating at a single sitting, which could exacerbate discomfort.

Focus on nutrient-dense, easy-to-digest foods that you can eat in smaller portions. Smoothies made with protein powder, nut butters, and bananas, for example, are an excellent option to get nutrition without overwhelming your digestive system.

6. Avoid Trigger Foods

While there’s no one-size-fits-all list of “trigger foods” for IBD, certain foods are commonly known to exacerbate symptoms during a flare. These include:

  • High insoluble-fibre foods like fruits and vegetables with skins, peels, seeds; whole nuts/seeds. Remove seeds, peels, skins to make these easier to digest.
  • Spicy or fried foods
  • Alcohol and caffeine
  • Artificial sweeteners, which can irritate the gut
  • Lactose (if you have lactose-intolerance)

Keep a food journal to track which foods seem to worsen your symptoms, and work with your dietitian to customize a nutrition plan that works for you.

Conclusion: Navigating Nutrition During an IBD Flare

Managing nutrition during an IBD flare requires a careful balance of foods that support healing while minimizing gut irritation. By focusing on easily digestible foods, staying hydrated, incorporating anti-inflammatory options, and monitoring for nutrient deficiencies, you can help support your body during a challenging time.

Always work with your healthcare team to make the best decisions for your health. An individualized approach, which may involve supplementation or dietary modifications, will help you stay nourished and better equipped to manage flare-ups.

 

By Alexandra Haggis, RD.

 

References:

  1. Marton LT, Goulart RA, Carvalho ACA, Barbalho SM. Omega Fatty Acids and Inflammatory Bowel Diseases: An Overview. Int J Mol Sci. 2019 Sep 30;20(19):4851. doi: 10.3390/ijms20194851. PMID: 31574900; PMCID: PMC6801729.
  2. Lin Y, Liu H, Bu L, Chen C, Ye X. Review of the Effects and Mechanism of Curcumin in the Treatment of Inflammatory Bowel Disease. Front Pharmacol. 2022 Jun 20;13:908077. doi: 10.3389/fphar.2022.908077. PMID: 35795556; PMCID: PMC9250976.