Crohn’s disease and ulcerative colitis
Eating in a flare and eating in remission are almost opposite. Confusing them is the most frequent error.
During a flare the bowel is inflamed and the goal is to reduce the mechanical and chemical work demanded of it: less residue, less insoluble fibre, simpler textures, while securing energy and protein intake so tissue is not lost. In remission the goal inverts: progressively reintroduce fibre and variety to care for the microbiota and prevent the next flare.
The silent risk in inflammatory bowel disease is muscle mass loss. Between chronic inflammation, periods of low intake and corticosteroid use, it is very common to reach a normal weight with low skeletal muscle mass. Measuring it changes management.
- Distinct protocols for flare and remission phases
- Progressive, ordered reintroduction of fibre
- Protein intake aimed at halting muscle mass loss
- Iron, B12, vitamin D and zinc monitored
- Phase angle as a nutritional status marker in chronic disease
This page is educational material from a registered dietitian, not a diagnostic tool. Diagnosis and medical treatment are your doctor’s remit; clinical nutrition accompanies that treatment, it does not replace it.
Frequently asked questions
Not from the outset. Lactose intolerance is common during a flare and often transient. Gluten is only removed permanently if confirmed coeliac disease also exists. Removing food groups without reason reduces variety and impoverishes the microbiota.
In remission, yes, and it is strongly advisable to protect muscle mass. In an active flare the load is adapted. The key is that nutritional intake accompanies training, because training in energy deficit in this condition accelerates muscle loss.
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