Download dietary advice for crohns disease and ulcerative colitis

DIETARY ADVICE FOR
CROHNS DISEASE AND
ULCERATIVE COLITIS
Information Leaflet
Your Health. Our Priority.
www.stockport.nhs.ukNutrition and Dietetics, Inpatient Integrated Therapies | Stepping Hill Hospital
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What is Crohn’s disease/ Ulcerative Colitis?
Crohn’s disease and Ulcerative Colitis, known as Inflammatory Bowel Disease, are disorders
affecting the gastrointestinal tract (gut). Crohn’s disease can affect any part from the mouth to
the anus, whereas Ulcerative Colitis affects only the large bowel.
Symptoms can include:
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Diarrhoea
Abdominal pain
Tiredness
Nausea (feeling sick) and vomiting
Weight loss
Anaemia
Both conditions can have periods of relapse (when symptoms are present) and remission (when
symptoms are reduced and you are feeling well).
The nutritional treatment of inflammatory bowel disease therefore changes, according to what
stage you are in, i.e. active stage or in remission.
Dietary Advice for Active Stage of Crohn’s Disease/Ulcerative
Colitis
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You may find that limiting foods that are high in fibre helps to relieve your symptoms, as they
can irritate the bowel. Examples of low fibre foods are shown in the following table. However,
in times of remission aim to slowly increase the number of high fibre foods consumed
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Avoid highly spiced foods which may also irritate the bowel
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Fatty foods may increase symptoms. Try to have a smaller portion of fatty foods e.g. fish
and chips and spread fats evenly through the day rather than have in one meal
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When reintroducing foods it is important to do this slowly, introducing one new food at a time
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Aim to still eat a wide variety of foods from all the different food groups shown in the low fibre
dietary advice table
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It is important to remember that everyone is individual. Foods that cause problems with one
person may not necessarily have the same effect on somebody else
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Low Fibre Dietary Advice
Breads and
Cereals
Fruit
Vegetables and
Salad
Meat, fish, eggs,
and cheese
Dairy Produce
Fats
Miscellaneous
FOODS TO CHOOSE
FOODS TO AVOID
White bread
White pasta and rice
Cornflakes, Rice Krispies
Biscuits and cakes made from
white flour (e.g. cream
crackers, rich tea, sponge and
madeira cake)
Wholemeal, granary or seeded bread
Wholemeal pasta and brown rice
Digestive and fruit biscuits
Fruit cake
High fibre cereals e.g. Allbran, Weetabix,
bran flakes and muesli
Small quantities of stewed fruit
(max of 2 portions per day)
Tinned soft fruits (without
skins)
Fresh fruit juice (no bits)
All fresh and dried fruits
Avoid pips, seeds, skins and stringy fruit
e.g. rhubarb
Fruit juice with “bits”
Boiled (no skins) and mashed
potatoes
Soft cooked carrots,
cauliflower,
butternut squash, swede,
sieved tomatoes (without
pips/skins)
All other vegetables and salads
Any lean meat
Any fish
Cheese, eggs
Tough fibrous meats with gristle
2-3 servings per day – choose
lower fat varieties if better
tolerated
Avoid yoghurt with fruit pieces
Fat spreads/oils - in
moderation
Only limit these if you cannot tolerate fats
Bovril, Oxo, Marmite
Tea, coffee
Squash, fizzy drinks
Boiled sweets, mints
Jam jelly, clear marmalade
Honey, syrups
Nuts, chocolates, jams with seeds,
marmalade with rind, crisps
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Sample Low Fibre menu
Breakfast
Cornflakes or Rice Krispies with milk, sugar if desired
White bread or roll (can be toasted)
Thin spread margarine/butter
Marmite, seedless jam, jelly marmalade or honey
Tea or coffee
Snack
Tea/coffee or fruit juice
Plain cake or biscuits/crackers
Lunch
Clear soup
White bread, barm cake or bread rolls
Lean meat, fish, chicken, egg, cheese
Spreads (e.g.: mayonnaise, margarine)
Smooth fruit yoghurt
Fruit juice
Snack
Tea/coffee or fruit juice
Plain cake or biscuits/crackers
Stewed fruit or tinned fruit (without skins)
Dinner
Lean meat, fish, chicken, cheese or eggs
Boiled/mashed potato, white pasta/rice or white bread
Soft-cooked carrot or cauliflower florets
Gravy/sauce
Ice-cream/jelly or Plain sponge or Milk pudding/custard
Supper
Horlicks or Ovaltine or tea/coffee
Plain biscuit or white toast/spread
What If My Appetite or Intake is Poor and I am Losing Weight?
If your appetite is poor, this can affect your food intake and you may lose weight. During this
time, healthy eating is not a priority. Here are some points to help you some extra nourishment.
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Choose higher fat and/or sugar foods, for example, full cream milk; ‘thick and creamy’
yoghurts; creamy/condensed soup etc. Avoid ‘diet’ versions of foods
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High fibre foods are bulky and can be very filling – chose low fibre alternatives (for example,
white bread/pasta/rice; cornflakes/rice krispies), and restrict your intake of salad, fruit and
vegetables – refer to low fibre food list
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Try to follow a little and often eating pattern and include 5-6 small meals rather than three
large meals. If you still feel hungry- you can always have second helpings
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Encourage yourself to have a nutritious drink between meals e.g. full-cream milk, milk
shakes, hot milky drinks (Malted drinks, hot chocolate or milky coffee)
Sample Meal Plan for a High Protein, High Calorie and Low Fibre
Diet
Breakfast
Fruit juice
Cereal, e.g. corn flakes, rice krispies or porridge with full fat milk.
Egg/bacon/fish
White bread, pancakes, English muffins with butter or margarine and/ or honey, jelly jam or
marmalade (shreddless)
Milky tea or coffee or full fat milk
Snack
Glass of full fat milk and tea biscuits, e.g. rich tea/ morning coffee or a thick and creamy yogurt
Lunch
Meat/fish/eggs/cheese with white bread and butter/margarine
Ham and/ or cheese omelette
Snack
Glass of full fat milk or milky coffee and plain or chocolate biscuit/ piece of sponge cake
Dinner
Meat/fish/eggs/cheese
White bread or potatoes – boiled (no skin/mashed) or chips
Carrots, swede, parsnip or turnip – well cooked
Milk pudding/ice cream/jelly and cream/mousse/sponge pudding/jam tart and
custard/meringues, double cream/toffee /chocolate sauce
Supper
Cream crackers/Crispbread and cheese
Toast with butter and jam or honey
Pancakes with butter/jam
Plain crisps or breadsticks with dips (taramasalata, sour cream, prawn marie rose, cheese dips)
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Dietary Advice for Remission Stage of Crohn’s Disease/Ulcerative
Colitis
Only follow this advice when you have achieved a normal weight and are not continuing to lose
weight. Do not follow this advice if you are still having symptoms of Crohn’s disease or
ulcerative colitis.
During times of remission (i.e., when you are well) you should try to follow a healthy diet that
includes a higher fibre, lower fat intake with a variety of foods. This will provide you with all the
calories (energy) and nutrients (protein, carbohydrates, fat, vitamins and minerals) you need.
The following will give you advice on how to do this.
Protein foods: Examples include: Lean red meat, poultry, eggs, fish, nuts and pulses. Aim to
have at least two servings daily
Dairy products: Examples include: cheese, milk and yogurts. Aim to have three servings daily.
One serving is 1 pot yoghurt (125g), one-third pint/190 ml milk (low fat versions) or 25g cheese.
Starchy Carbohydrates: Examples include: Bread, potatoes, cereal, pasta, rice, noodles
(preferably wholemeal versions) Try to have one serving at each main meal.
Fruit and vegetables (as tolerated) This can include fresh, tinned or frozen. Aim for five
servings daily
Fats and Oils: Examples include: Butter, margarine, sunflower oil, olive oil. Use in moderation
in cooking and meal preparation
Others: Examples include: Cakes, biscuits, chocolate, sweets. Small amounts can be taken as
part of a balanced, varied diet.
Useful Contacts:
Crohn's and Colitis UK
4 Beaumont House
Sutton Road
St Albans
AL1 5HH
01727 830 038
http://www.crohnsandcolitis.org.uk
Contact us
Acute Dietitians
Inpatient Therapies Department
Stepping Hill Hospital
Tel: 0161 419 5087
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If you would like this leaflet in a different format, for example, in large print, or on
audiotape, or for people with learning disabilities, please contact:
Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: 0161 419 5678
Information Leaflet. Email: [email protected].
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Leaflet number
Publication date
Review date
Department
Location
MED115
June 2015
June 2017
Nutrition and Dietetics, Inpatient Integrated Therapies
Stepping Hill Hospital
www.stockport.nhs.ukNutrition and Dietetics, Inpatient Integrated Therapies | Stepping Hill Hospital