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Crohn’s Disease and Colitis: Healing Diets and Other Resources

 

Given my history of diagnosis and healing from Crohn's disease, people frequently message me across platforms seeking guidance, advice or to run their approach by me.  This post is intended to serve as a resource for those of you seeking my input. As I am not in clinical practice and haven't been for over 10 years, it would be professionally irresponsible of me to offer any personalized recommendations.

As with all autoimmune conditions, there is no single approach for every human on the planet to ensure healing and lifelong remission. How I wish there was. And it is for this reason that from the medical perspective, most doctors will tell their patients there is no proof that any of the alternative approaches I outline below will work. It's true. There isn't scientific proof because it would be impossible to conduct an effective double blind placebo study on single diet and lifestyle modifications. When a multi-prong approach is necessary for healing, it is the needs and triggers of the individual that must be considered.

To get an in-depth understanding of this approach to healing, please start by listening to this episode of the Today Is The Day Podcast: Can you Cure An Autoimmune Disease?

Note: This is not medical advice and I cannot provide you with specific answers to your individual situation. This post is intended to function as a resource based on the large volume of questions I receive and to offer you information you can use to ask questions, dig deeper and inspire you on your own road to healing.

Understanding The Scope of The Disease

Suffering from inflammatory bowel diseases like Crohn's disease and ulcerative colitis are never easy to live with or treat. When I was diagnosed with Crohn's disease in 2006, I was told there was basically nothing I could do. Thankfully, I decided to take an alternative approach, one that was not embraced by my gastroenterologist, and I have been living symptom-free since the end of 2006 from a disease I was told was incurable.

I get a lot of messages with questions about how to deal with a Crohn's disease diagnosis, and hope these alternative resources for healing Crohn's disease can help guide the decisions you make for your health. The most important thing to remember is this:

There is no single 'right' approach for every human on the planet. We have to consider the individual, her triggers, her lifestyle, her age, and her unique needs. Healing will also look different. The goal may be to become 100% symptom free, but that may not always be the reality. Moving in the right direction, with less flare-ups, quicker recoveries or less progression of the disease is also part of healing. And remember, if one approach, attempted full on with every effort made fails, this is not the time to give up. It's time to cross that one off the list and try the next. 

Healing

What Is The Best Diet for Crohn's Disease?

This is the most common question I am asked. If there was one single answer, everyone would eat that way and be in remission. Of course, it's not that simple - but that being said, there are some general guidelines that can massively help with symptoms and healing.

Some of the common dietary strategies that are used for Crohn's disease are:

  • Specific Carbohydrate Diet (SCD)
  • Paleo
  • Autoimmune Paleo (AIP)
  • Low FODMAP
  • Gluten-free and Dairy-free Diet
  • Anti-Inflammatory Diet
  • Low Residue Diet
  • Gut and Psychology Syndrome
  • Wahl's Protocol

There isn't a consensus among doctors and researchers about which is best, nor a large body of research on IBD and diet - though there is some. The good news is that many doctors are coming around to the idea that dietary interventions can both help and prevent inflammatory bowel diseases, which is a huge step up from when I was told to try to enjoy life and eat cheeseburgers.

What diet should you try?

If you want my advice, first eliminate 100% (and there is more on these recommendations in the resources outlined at the end of the post):

  • Gluten
  • Dairy
  • Sugar
  • Caffeine
  • Alcohol

100% elimination doesn't mean a little bit here and there, cheat days, etc. To see if you gain benefit, we're going full on. You can then take it further by diving deep into one of the protocols outlined. Which one? First consider your known triggers and eliminate those 100%. No exceptions. Review the above dietary protocols and decide which one you are prepared to take on and adhere to 100%. Follow the recommendations and keep a journal of how you feel.

Tip: It can be easier to pay attention to the bad days than the good. Track all the days and you may just notice that even if you're not completely better, you start to have more good days than bad, and that tells you that you are on the right track.

My General Reco: Start With A Paleo-Style Approach

Again, this is a general guideline I am offering. It's not for everyone and may or may not be for you. But were you to ask my opinion on what seems to have the most positive outcomes, this dietary approach would be it.

One of the promising areas of study is a Paleo-style diet, which eliminates the foods our ancestors theoretically didn't eat thousands of years ago. A Paleo diet focuses on eating specific plant-based foods (mainly vegetables, fruits and nuts/seeds), specific animal-based foods (eggs, poultry, meat, fish) and eliminates major triggers of autoimmune conditions like gluten, dairy, refined sugars, artificial sweeteners, and thickeners/emulsifiers. It also eliminates beans and grains.

This is why the Paleo-style diet can be so effective. Gluten, a protein found in certain grains, can trigger inflammation and the immune system in people with autoimmune conditions. Another paper noted that gluten "increases intestinal permeability, changes composition and diversity of the microbiome/dysbiome ratio, increases oxidative stress, and changes epigenetic processes." One study that involved a self-reported survey from IBD patients found that those on a gluten-free diet experienced fewer and less severe flares.

Conventional dairy products are difficult for all of us to digest, most of us don't have the lactase enzyme required to process lactose, but it can be especially challenging to digest for people with Crohn's disease and ulcerative colitis.

A recent study of the Autoimmune Protocol Diet showed its promising effect on Crohn's disease and remission. This study came to pass when a researcher contacted the team behind Autoimmune Wellness, Mickey Trescott and Angie Alt, asking for connections to patients on the AIP diet. The sample size of the study was small - 15 patients - but the results were remarkable. After 6 weeks on the diet, 73% of patients were in remission and remained so during the following 5-week maintenance phase. You can read the full study here if you're interested.

Why I Don't Recommend A Vegan Diet For Healing IBD

This is a common approach but it's very difficult to find research that supports a vegan diet for regaining health from a disease of inflammation in the gut, or a disease resulting in severe nutrient deficiency. Let me be clear: I fully support (and follow) and plant-based diet, as plants have an incredible array of nutrients that support our health. They are an important part of any dietary philosophy. But plants, at the exclusion of everything else, is not the best approach to healing Crohn's disease.

When suffering from Crohn's, our body needs as much nutrition in the most absorbable forms. Green juices and smoothies can be great, but for many, a lot of fiber can be really challenging. On the vegan diet, the bulk, literally, of the diet often comes from fibrous veggies, and loads of grains and beans. These can be very tough on the intestines for full digestion and can also serve to further an imbalance in the gut microbiome.

In my research, I was only able to find one case study about a man who was able to achieve remission from Crohn's disease after 40 days on a vegan diet (this was in combination with biologic therapies). There was one small 2-year trial of patients on a vegetarian diet (which included milk and eggs) where participants were able to achieve remission in combination with medical therapies.

Summary: Diet Recommendations for Crohn's Disease Healing

These are very, very top level guidelines. It is highly recommended that you follow one of the protocols outlined above, while working with a Certified Culinary Nutrition Expert or Functional Medicine Practitioner to ensure you are getting balanced nutrition.

Avoid

  • Gluten
  • Dairy
  • Processed Foods
  • Processed Oils
  • Refined Sugars
  • Coffee
  • Alcohol

Consume

  • Bone Broth
  • Vegetable juices (strained)
  • Vegetables (steamed during flares)
  • Fruit (steamed during flares, avoid any with small seeds like berries)
  • Nutritious cooking oils
  • Limited (or complete elimination) of grains, beans and legumes
  • Food cooked from scratch
  • Small amounts of animal-based protein

undiet and undiet Cookbook: a maintenance diet

Crohn's Disease

As much as I would love to tell you to get my books, follow them and you'll be healed, this is not the case. UnDiet and The UnDiet Cookbook were not written specifically with people dealing with IBD flare-ups or active IBD. Many people pick up my books, UnDiet and The UnDiet Cookbook, thinking that they are guides to healing Crohn's disease. They are not. These books describe a maintenance diet; the types of recipes you could follow once you are stable.

If you are dealing with a severe flare-up, you may want to consider following some of the specific healing diets designed for those with gut issues.

The Role of Medication

I am not against modern medicine - there is a time and a place for it. Do not feel defeated if, at any point on your healing journey, you need medical intervention. It is lifesaving, especially in emergencies, and for many, is part of the healing journey so that you can become stabilized.

There are many medical therapies for Crohn's disease that are lifesaving - treatments that allow patients to maintain and even improve their health when they cannot do so on food and lifestyle alone. A healthy lifestyle can absolutely work in tandem with medication to help you live your most vibrant and fulfilling life. Please don't ever feel like you've failed by accepting or pursuing medical intervention.

However, I do believe strongly that a nutritious diet is essential for healing Crohn's disease whether or not you choose to go on medications. You can be on meds and still feel awful if you are eating the kinds of foods that are triggering symptoms.

Round-Up of Resources FOr Further Reading/Listening

My Approach and Resources For Healing Crohn's

My Curated List of Resources and Studies on Crohn's Disease and Diet from Around The Web

Want More?

Crohn's Disease

Image: iStock/Lars Neumann

8 Responses to “Crohn’s Disease and Colitis: Healing Diets and Other Resources”

  1. Stephen Katz said… February 4, 2020
    Dear Meghan and Josh, I want to thank you for all the wonderful advice you provide. I am 68 years old and have found the information on your websites invaluable in helping me deal with long-term digestive issues. Thank you, Stephen Oshkosh, Wisconsin
  2. Monica Kalmanovitch said… February 4, 2020
    Thank you. This article has been super helpful -as has your podcast. One question - would these recommendations extend to managing IBS symptoms? Or would you recommend a different protocol for managing IBS?
    • Thank you, Monica! There is certainly overlap between protocols for IBD and IBS, but they are not exactly the same. I always recommend working with a qualified health practitioner who can come up with a specific protocol based on your needs.
  3. Doris said… February 5, 2020
    Meghan, thank you for this well-articulated and comprehensive article. As a nurse who works for pharma in the biologic space for IBD, I wish I could talk to my patients about the research-supported role that diet and lifestyle play in healing and the synergy at play when we bring all the elements of healing together. I look forward to even more research in this field that I know is coming. Thank you for the work you do to remind us all of what’s possible in health.
  4. Chloe said… May 4, 2020
    Your comment about doctors telling you to enjoy your life and eat a cheeseburger has never been so relatable. I literally laughed out loud when I read it because I too have been often frustrated by this comment from doctors. Thank you for your advice, honest commentary, and recommendations. So much power to the truth you’re sharing!
  5. Abigail said… May 17, 2020
    Thank you for this article! I have been thoroughly pursuing the linked materials ad. Especially enjoyed the podcast question, CAN you cite autoimmune diseases? I am curious if you have thoughts on how these recommendations might align with blood-based autoimmune. I’m on the hunt for lifestyle and diet thoughts around those and have found the touch more limited than digestive, or other, autoimmune conditions. Thanks! Always a pleasure to hear your thoughts.
    • A lot of these tips will apply more broadly to autoimmune diseases beyond IBD. If you're looking for specific recommendations that are unique to your health situation, I'd recommend working with a qualified health practitioner to work out the protocol that's best for you.
  6. Thank you for writing this ! I have reversed my ulcerative colitis by going on the Paleo AIP diet and healing leaky gut. I also developed SIBO and I have gotten rid of that, too. It has taken time but I am finally increasing fiber and trying more foods (methodically, as per the AIP diet guidelines). It is going really well, and my bowel movements are improving ! So happy to see a post on IBD that is up to date and doesnt say you have to live with this forever.

Before you post your comment, please note that I am unable to offer nutritional advice or recommendations via my blog.

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