Can dietary changes help induce IBD remission?

If your child has Crohn’s disease or ulcerative colitis, you may have wondered whether changing their diet could help settle inflammation and bring their IBD into remission.

It is understandable to look for ways to help your child feel better, particularly when they are experiencing a flare. Food can play an important role in managing IBD, supporting growth and maintaining overall health. However, the relationship between diet and remission is more complicated than simply removing certain foods or following an anti-inflammatory diet.

The good news is that some dietary therapies have been shown to help induce remission in children with Crohn’s disease. The evidence is different for ulcerative colitis, and not every dietary approach is effective for every child.

🥗 What does it mean to induce remission?

Inducing remission means bringing active inflammation under control so the bowel can begin to heal.

When a child is in remission, symptoms such as diarrhoea, abdominal pain and urgency may improve or disappear. However, feeling better does not always mean the inflammation has completely settled.

Your child's IBD team may use blood tests, stool tests such as faecal calprotectin, imaging or endoscopy to assess whether inflammation is improving.

This distinction matters because a dietary change might improve symptoms without treating the underlying inflammation.

🔬 Can diet actually help induce remission?

Yes, in some circumstances. The evidence depends on the type of IBD and the dietary approach being considered.

Crohn’s disease

There is good evidence supporting specific nutritional therapies for inducing remission in children with Crohn’s disease.

Two approaches that may be considered are:

Exclusive enteral nutrition (EEN)

EEN involves consuming a nutritionally complete medical formula as the sole source of nutrition, usually for around six to eight weeks. Regular food is temporarily excluded, and the formula supplies the energy, protein, vitamins and minerals a growing child needs.

EEN is an established first-line treatment option for inducing remission in many children with active Crohn’s disease. It can reduce inflammation and support nutritional recovery and growth. For some children, it may offer an alternative to corticosteroids.

However, EEN can be challenging because it requires a temporary liquid-only diet. The formula may be taken orally or, when needed, through a feeding tube.

Crohn’s disease exclusion diet (CDED)

CDED is a structured dietary therapy that limits certain foods while allowing a prescribed selection of other foods. It is generally combined with partial enteral nutrition, meaning a medical formula provides part of the child's nutritional requirements.

Research suggests that CDED combined with formula can help induce remission in some children with mild to moderate Crohn’s disease.

It is not simply a matter of cutting out processed foods or following a general healthy eating plan. The approach has specific stages and nutritional requirements and should be supervised by an IBD dietitian.

Neither EEN nor CDED is suitable for every child. The best option depends on disease severity, nutritional needs, the child's circumstances and the advice of their treating team.

Ulcerative colitis

The evidence for using diet to induce remission in ulcerative colitis is more limited.

Unlike Crohn’s disease, there is currently insufficient evidence to recommend a specific dietary approach as a reliable treatment for active ulcerative colitis.

A balanced diet can support a child's overall health, growth and recovery, but dietary changes alone should not be relied upon to bring an active flare under control.

🌱 What about anti-inflammatory diets?

You may have come across diets promoted as ways to reduce gut inflammation, including:

• Mediterranean-style eating patterns.

• The Specific Carbohydrate Diet (SCD).

• Paleo or autoimmune protocol diets.

• Plant-based diets.

• Low-processed-food or whole-food diets.

These approaches are not all supported by the same level of evidence. Some are being studied for their potential role in managing IBD, but many have not been shown to reliably induce remission.

A Mediterranean-style eating pattern, for example, can provide a variety of vegetables, fruits, whole grains, healthy fats and other nutrient-rich foods. It may be a useful foundation for general health, but it should not be confused with a proven treatment for active inflammation.

Likewise, anecdotal reports of children improving on a particular diet do not establish that the diet will work for other children or that inflammation has resolved.

Before starting a restrictive diet, discuss the potential benefits and risks with your child's gastroenterologist and an IBD dietitian.

🍎 Does removing certain foods help?

Some parents notice that particular foods seem to worsen their child's symptoms. Others wonder whether removing gluten, dairy, sugar or processed foods might reduce inflammation.

It is important to distinguish between foods that trigger symptoms and foods that contribute to intestinal inflammation.

For example, a child may experience bloating, gas or diarrhoea after eating a particular food even when their IBD is in remission. This does not necessarily mean the food is causing an inflammatory flare.

Similarly, a child may have active inflammation without an obvious reaction to any particular food.

There is no universal list of foods that every child with IBD should avoid. Unnecessary restrictions can make it harder for children to get enough energy and nutrients, particularly during periods of rapid growth.

If you suspect a food is causing problems, an IBD dietitian can help you assess the pattern and determine whether a temporary adjustment or further investigation is appropriate.

💚 Can diet help maintain remission?

Although no single everyday diet guarantees that IBD will remain in remission, good nutrition can support your child's health over the long term.

Once inflammation is controlled, the general aim is to provide a varied, balanced diet that meets your child's individual needs.

Depending on what your child tolerates, this may include:

• A variety of fruits and vegetables.

• Whole grains and other sources of fibre.

• Adequate protein from foods such as eggs, fish, meat, legumes or suitable alternatives.

• Healthy fats.

• Sufficient energy to support growth and development.

• Foods rich in calcium, iron and other essential nutrients.

Fibre does not need to be avoided by every child with IBD. However, children with bowel strictures (narrowing of the intestine) or particular symptoms may need individualised advice about fibre and food textures.

During a flare, temporary adjustments may also be needed to help your child tolerate food and maintain adequate nutrition.

The goal is not to create the most restrictive diet possible. It is to find an approach that supports your child's nutritional needs, comfort and quality of life.

📏 Why nutrition is especially important for children with IBD

Children need enough energy and nutrients not only to recover from illness but also to grow, develop bones and muscles, and progress through puberty.

Active IBD can affect appetite, nutrient absorption and the body's nutritional requirements. Some children may develop deficiencies, including low iron, vitamin D or calcium.

Restrictive diets can add to these challenges, particularly if several food groups are excluded or your child is already struggling to eat enough.

An IBD dietitian can help assess your child's growth, dietary intake and nutritional status, and recommend supplements or dietary changes when needed.

💊 Should dietary changes replace medication?

No. Unless your child's treating team has specifically prescribed a dietary therapy as part of their treatment plan, dietary changes should not replace prescribed IBD medication.

For children with Crohn’s disease, treatments such as EEN or CDED may be used as part of a medically supervised plan to induce remission. Other children need medication, or a combination of nutritional and medical treatments.

For ulcerative colitis, medication remains an important part of controlling active inflammation.

If your child is experiencing ongoing symptoms, do not assume that a stricter diet is the answer. Contact their IBD team to discuss whether the disease is active and whether their treatment needs reviewing.

🤝 How to explore dietary changes safely

If you are interested in exploring the role of nutrition in your child's IBD, consider these steps:

1. Talk to your child's gastroenterologist. Ask whether dietary therapy could be appropriate for your child's type and severity of IBD.

2. Request an appointment with an IBD dietitian. They can help you understand the evidence, assess nutritional needs and develop a safe plan.

3. Be clear about your goal. Managing symptoms, correcting deficiencies, supporting growth and inducing remission are different objectives.

4. Avoid making multiple restrictive changes at once. This can make it difficult to identify what is helping and may reduce your child's nutritional intake.

5. Monitor progress with your child's team. Symptoms alone cannot confirm that inflammation has resolved.

6. Consider your child's emotional wellbeing. Food can already be a source of anxiety for children with IBD. Try to avoid making meals feel like a test they must pass to stay well.

   
   

❤️ The most important thing to remember

Diet can be a valuable part of managing childhood IBD, and specific nutritional therapies can help some children with Crohn’s disease achieve remission. However, there is no universal diet that reliably induces remission in every child with Crohn’s disease or ulcerative colitis.

You do not have to find the perfect diet to be a good parent to a child with IBD. Their illness is not caused by a failure to feed them the right foods.

Working alongside your child's gastroenterologist and an experienced IBD dietitian can help you make informed choices, protect their nutritional health and explore dietary options without placing unnecessary restrictions on family life.

📚 Further reading

• Crohn’s & Colitis Foundation — Information about IBD, nutrition and treatment options.

• Crohn’s & Colitis UK — Guidance on living with Crohn’s disease and ulcerative colitis.

• Crohn’s & Colitis Canada — Resources for people living with IBD and their families.

• Crohn’s & Colitis Australia — Information about IBD, nutrition and support.

• European Crohn’s and Colitis Organisation (ECCO) — Evidence-based clinical guidance and research on IBD.

Dietary therapies should be discussed with your child's gastroenterologist and an IBD dietitian. Recommendations may vary depending on your child's condition, nutritional needs and access to specialist care.