Lorraine Maher, specialist Gastroenterology Dietitian

Lorraine is a dietician, who works in the Blackrock Clinic, with a special interest in gut health. 

There are different approaches to diet during a flare and during remission. Regardless of disease, try not overly restrict your diet. Severe restrictions in your diet are the number one cause of weight loss in IBD and weight loss is the number one cause of malnutrition. Support from a dietician is warranted if you struggle identifying food intolerances and/or are losing weight.

?Diet in Active Disease State (during a flare):

The advice changes, but depends on the person:

Diet Progression following a Flare

When you know the inflammation has reduced, the guide would be to continue to eat what you can tolerate and slowly add back any foods you were omitting so as to diversify your diet. It best to take it slowly, Ultimately, how you will progress depends on you and your particular circumstances.

If you were particularly restricted in the flare up, begin with soft solids (well cooked food that doesn’t need a lot of chewing and has no hard pieces) and then progress to solid food.

You might take a systematic approach, by introducing one or two items every few days to avoid any foods that worsen symptoms. If you ate something one day that made things worse, maybe just eliminate that food (or maybe try again with a smaller portion) or leave and retry a few months down the road again. Don’t think of it as being cut out of your diet forever.

A sensible long term approach would be to increase fibre in your diet as tolerated. Fibre comes from a variety of plant based food – whole-grains (for example bread, rice, potatoes) beans and lentils, fruit, vegetables, nuts and seeds. You may find introducing more soluble fibre sources is better tolerated for example, oats, linseeds, orange, passionfruit, carrots, beans and pulses.What you tolerate tends to be very individual, and that’s where a gut health dietitian can be of much assistance!

If you unintentionally lost weight during the flare up, you should aim to increase total calorie and protein intake following a flare, until you get back to your desired weight. Overall between flares, when you’re in remission, the best approach is to eat as wide a variety of foods as you can tolerate, including fruit, vegetables, whole grains, lean protein, oily fish and moderate intake of dairy products. That will positively impact your overall nutrition status and enhance gut health.

These are some suggestions for first foods that you can have during a flare: