People with IBD can have a love/hate relationship with food. But everyone has different foods that can make them feel better or worse, cause symptoms or provide relief. However, there are different types of food that commonly help or hinder many with IBD, due to the way they interact with the body. When food is broken down in the gut, the byproducts are the fuel for our microbiome (the bugs that live in our gut and directly interact with the immune system). These different foods can be described as pro-inflammatory, anti-inflammatory or trigger foods.

Pro-inflammatory foods

There are some foods that can increase the chance of having a flare by triggering inflammation in the gut – there are called pro-inflammatory foods. Pro-inflammatory foods typically decrease the variety and number of ‘good’ gut bacteria. Some of the components of foods may also directly affect the lining of the gut. Together, these effects can contribute to increased inflammation in the gut. Ultra-processed foods that are low in dietary fibre, high in saturated or trans-fats, contain emulsifiers, additives and preservatives and are low in micronutrients are key pro-inflammatory foods that are relevant in both CD and UC. Examples of these foods are packaged biscuits, brightly coloured snack foods, and fizzy drinks. Generally, these foods should be avoided or at least eaten rarely.

Anti-inflammatory foods

In good news, there are other foods known to be anti-inflammatory: these foods decrease the chance of a flare by maintaining stability or decreasing inflammation in the gut. These foods provide the ideal fuel sources for our gut bugs to be abundant and thrive. As a result, there is harmony between the bugs, the gut lining, and the immune responses. Examples of anti-inflammatory foods for both CD and UC are foods high in dietary fibre such as fruits and vegetables, legumes and lentils, and wholegrains. Other examples are foods that are rich in omega-3 fatty acids such as fatty fish, and fermented foods such as yoghurts, miso soup, kimchi, and sauerkraut. Generally, these sorts of foods should be encouraged and preferred.

Trigger foods

A trigger food is one that may cause symptoms such as cramps, pain, diarrhoea, bloating or gas. Trigger foods do not usually increase the level of inflammation in your gut, are not associated with increased disease activity, and are more commonly considered to cause ‘functional’ symptoms. The effects of these foods can vary substantially between people: not everybody has the same trigger food. Many of these belong to a group known as FODMAPs [Fermentable, Oligosaccharide, Disaccharide, Monosaccharide and Polyols]. The most common trigger foods are those eaten raw (nuts, seeds, fruit), lactose containing dairy products, fatty/greasy foods, sweeteners and added sugars, spicy foods, and those high in fibre (among others).

Sometimes it can be hard to identify trigger foods. When you do identify a trigger food, then maybe try eating it less frequently, in a smaller portion, or skip it entirely. Some trigger foods also have anti-inflammatory effects, which can mean striking a balance or working out alternative choices.

Summary

The main take-home message here is that everyone with IBD has a different relationship with food. However, if you’re experiencing increased symptoms after eating certain things it would be a good idea to keep a symptom and food diary to get to the bottom [😉] of what may be causing them. Similarly, exploring foods that may help your symptoms could provide some welcome relief and also taste good! Don’t forget that if you have any concerns about how foods may be affecting your IBD, speak to your consultant next time you see them, or contact your dietitian to discuss them. 

Finally, prior to making any major change to your diet, it is essential to talk with your dietitian to ensure that you have an adequate and healthy diet that suits you.