While fiber can sometimes exacerbate symptoms, this isn’t true for everyone with Crohn’s—research suggests that, in some cases, eating fiber can help you feel better.1 The key to making those foods gut-friendly, says Ashley Hurst, RD, LD, owner of The Crohn’s & Colitis Dietitians, is to “modify the texture,” or make a fibrous food less bulky and therefore easier to move through the GI tract. This might look like blending spinach into a smoothie as opposed to eating it raw in a salad, or snacking on almond butter instead of raw nuts. “Sometimes taking the skins off things—to reduce the amount of fiber a little bit—can be helpful too,” Dr. Feagins says.
If you have Crohn’s, any big change to what you’re eating should always happen under the supervision of a care team—so ask a GI doc or an IBD-focused registered dietitian about any type of elimination diet for Crohn’s before starting one up.
Be aware of nutrient deficiencies.
Between food restrictions and the possibility of frequent diarrhea, a lot of people with Crohn’s are at risk of nutritional deficiencies,2 with vitamin D,3 A, and K4 deficiencies being the most common, Dr. Feagins says. However, if your terminal ileum (the narrowest part of the gut) is the most impacted part of your GI tract (which is common with Crohn’s5), you might be more likely to have a B12 deficiency, Dr. Feagins explains.
You might show signs of a nutrient deficiency, or you might not—it’s not easy to tell on your own! That’s why you should always check with a doctor before taking any over-the-counter supplements. They can screen you for deficiencies—often through a blood test—to determine if you’re low in essential nutrients. If you try to modify your vitamin or mineral levels on your own, you might overdo it, which could lead to even more health complications beyond Crohn’s. But if your doctor decides that certain supplements are needed for your health, taking them in pill form is typically the most approachable option, especially for vitamins D, A, and K.
B12 is a big exception because the deficiency is caused by the small bowel’s inability to absorb the vitamin, so oral supplements often don’t work. Typically, a GI doc will administer B12 vitamins via an intramuscular injection, Dr. Feagins explains. Oral iron supplements can also cause constipation,6 so people can opt for an IV version instead.
The bottom line: If you’re worried about a nutrient deficiency after your diagnosis, check in with your doctor to get your levels tested. If you need more of a particular vitamin or mineral, they (along with a dietitian) can guide you on the next steps to take; perhaps recommending reputable supplement brands to try (since the Food and Drug Administration does not regulate them), helping to determine the best dosage for you, and advising on diet changes that can up your intake.
You might feel weird about food at first, but it probably won’t stay that way forever.
Following a Crohn’s diagnosis, you might feel wary about eating—and that can lead to issues of its own. Without the guidance of a GI doc and IBD-focused dietitian, things can get overwhelming—or even dangerous—fairly quickly. “Disordered eating in someone with a GI disorder looks very different [than in someone without it],” says Hurst, who has IBD herself. “People are dealing with a lot of physical pain, which is what’s driving the restriction.”