Dietary Guidance for Patients with Inflammatory Bowel Disease

Publication Date: February 14, 2020
Last Updated: March 14, 2022

Recommendations

Fruit and Vegetables

In CD, it is prudent to recommend moderate to high consumption of fruits and vegetables.

(L)
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In patients with symptomatic or significant fibrostricturing disease, insoluble fiber intake should be restricted.

(VL)
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In UC, there is insufficient evidence to recommend any specific change or restriction in intake of fruit and vegetables.

(VL)
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Refined Sugar and Carbohydrates

In CD, there is insufficient evidence to recommend any specific change of intake of complex carbohydrates or refined sugars and fructose.

(L)
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It may be prudent to use a low FODMAP diet for patients with persistent symptoms despite resolution of inflammation and absence of strictures.

(L)
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In UC, there is insufficient evidence to recommend any specific change of intake of complex carbohydrates or refined sugars and fructose.

(VL)
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It may be prudent to use a low FODMAP diet for patients with persistent symptoms despite resolution of inflammation.

(L)
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Wheat and Gluten

In CD, there is insufficient evidence to recommend restriction of wheat and gluten.

(L)
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In UC, there is insufficient evidence to recommend restriction of wheat and gluten.

(L)
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Red Meat, Processed Meat, Poultry, and Eggs

In CD, there is evidence that it is unnecessary to restrict moderate consumption of unprocessed red meat, lean chicken meat (breast of chicken), and eggs.

(H)
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In UC, it is prudent to reduce intake of red and processed meat.

(L)
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Dairy

Consensus was not obtained for CD or UC for pasteurized dairy products. Consensus was obtained that unpasteurized dairy products should not be consumed..

()
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Fat

In CD, it is prudent to reduce exposure to saturated fats

(L)
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and avoid trans fat.

(VL)
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In UC, it is prudent to reduce consumption of myristic acid (palm oil, coconut oil, dairy fats).

(L)
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It is prudent to increase dietary consumption of omega-3 fatty acids (DHA and EPA) from marine fish,

(L)
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but not from supplements.

(H)
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It is prudent to avoid trans fat.

(VL)
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Alcohol

In CD, there is insufficient evidence to recommend changes in low-level alcohol consumption.

(L)
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In UC, there is insufficient evidence to recommend changes in low-level alcohol consumption.

(L)
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Maltodextrin and Artificial Sweeteners

In CD, it may be prudent to limit intake of maltodextrin-containing foods and artificial sweeteners.

(VL)
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In UC, it may be prudent to limit intake of maltodextrin-containing foods and artificial sweeteners.

(VL)
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Emulsifiers and Thickeners

In CD, it may be prudent to reduce intake of processed foods that contain carrageenan, carboxymethylcellulose, and polysorbate-80.

(VL)
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In UC, it may be prudent to reduce intake of processed foods that contain carrageenan, carboxymethylcellulose, and polysorbate-80.

(VL)
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Nanoparticles and Sulfites

In CD, it may be prudent to reduce exposure to processed foods containing titanium dioxide and sulfites.

(L)
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In UC, it may be prudent to reduce exposure to processed foods containing titanium dioxide and sulfites.

(VL)
324190

Recommendation Grading

Overview

Title

Dietary Guidance for Patients with Inflammatory Bowel Disease

Authoring Organization

International Organization for the Study of Inflammatory Bowel Diseases

Publication Month/Year

February 14, 2020

Last Updated Month/Year

February 5, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Adolescent, Adult, Child, Infant, Older adult

Health Care Settings

Ambulatory, Hospital, Operating and recovery room, Outpatient

Intended Users

Dietician nutritionist, nurse, nurse practitioner, physician, physician assistant

Scope

Counseling, Assessment and screening, Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D003424 - Crohn Disease, D043183 - Irritable Bowel Syndrome

Keywords

irritable bowel syndrome (IBS), ulcerative colitis, Crohn's disease

Source Citation

Levine, A., Rhodes, J. M., Lindsay, J. O., Abreu, M. T., Kamm, M. A., Gibson, P. R., … Lewis, J. D. (2020). Dietary Guidance for Patients with Inflammatory Bowel Disease from the International Organization for the Study of Inflammatory Bowel Disease. Clinical Gastroenterology and Hepatology. doi:10.1016/j.cgh.2020.01.046

Supplemental Methodology Resources

Data Supplement