Food and IBD: what kids and teens need to know

Food can sometimes feel complicated when you have inflammatory bowel disease (IBD). You might wonder what you should eat, whether certain foods can make your symptoms worse, or why your friends can eat things that don't always agree with you.

The good news is that there is no single diet that works for everyone with IBD. Your body is unique, and what works for you might be different from what works for someone else.

Understanding how food affects your body can help you feel more confident about eating, getting the nutrients you need and enjoying meals with family and friends.

🥗 What is the connection between food and IBD?

Crohn's disease and ulcerative colitis are types of IBD that cause inflammation in your digestive system. Food doesn't cause IBD, and you haven't done anything wrong to develop it.

However, what you eat can sometimes affect how you feel. Certain foods might make symptoms such as tummy pain, bloating, diarrhoea or wind worse, even when your inflammation hasn't increased.

It's important to know that making your symptoms worse doesn't necessarily mean a food is causing inflammation or making your IBD worse. Your healthcare team can help you understand the difference.

🍎 Do I need to follow a special diet?

Not everyone with IBD needs a special diet. Some people can eat a wide variety of foods, while others need to make changes depending on their symptoms, treatment or nutritional needs.

Your diet may also change over time. You might be able to enjoy foods during remission (when your IBD is under control) that are harder to tolerate during a flare.

If your healthcare team recommends a particular diet, they should explain why you need it and how to make sure you're still getting the nutrients your body needs.

Don't feel that you have to follow a strict diet just because someone online says it helps IBD. Always speak to your IBD team or dietitian before making big changes to what you eat.

🍞 Why do some foods upset my tummy?

Living with IBD can mean that your digestive system reacts differently to certain foods.

For example:

• High-fibre foods, such as raw vegetables or wholegrains, might be harder to tolerate for some people during a flare.

• Fatty or fried foods might make diarrhoea or tummy discomfort worse.

• Spicy foods might trigger symptoms in some people.

• Milk and other dairy products can cause bloating, wind or diarrhoea if you have difficulty digesting lactose.

• Fizzy drinks might increase bloating or wind.

But these foods don't cause problems for everyone! You might be able to eat them without any trouble, and that's completely normal.

Try to notice how you feel after eating different foods rather than assuming that certain foods are automatically bad for you.

🔥 Does food cause IBD flares?

Food doesn't cause Crohn's disease or ulcerative colitis, and avoiding particular foods won't necessarily prevent a flare.

During a flare, inflammation in your digestive system can make eating and digesting food more difficult. You might notice that your appetite changes, you feel full quickly or certain foods don't agree with you.

Your healthcare team might recommend temporarily changing the texture or type of food you eat to help you manage symptoms and maintain your nutrition.

If your symptoms are getting worse, tell your parent or carer and contact your IBD team. Don't try to manage a flare by cutting out lots of foods or skipping meals.

💪 Why is nutrition so important when I have IBD?

Your body is still growing, developing and changing, especially during your teenage years.

It needs enough energy and nutrients to help you:

• Grow taller and develop normally.

• Build strong bones and muscles.

• Have energy for school, sports and everyday activities.

• Concentrate and learn.

• Repair body tissues and support your immune system.

• Recover from illness and treatment.

IBD can sometimes make it harder for your body to absorb certain nutrients, and inflammation can increase your nutritional needs.

Your healthcare team may check your growth, weight and blood tests to see whether you're getting what you need. If you have low levels of particular nutrients, they might recommend supplements or changes to your diet.

🥛 What if I can't eat certain foods?

If a food regularly makes you feel unwell, it's worth discussing it with your parent or carer and your IBD team.

Sometimes, you might need to change how you prepare a food or try a different version of it. For example, cooked vegetables might be easier to tolerate than raw ones, or lactose-free milk might suit you better than regular milk.

However, cutting out whole food groups can make it harder to get enough nutrients, particularly when you're growing.

Your dietitian can help you find alternatives so that you can still enjoy a varied diet and get the nutrition you need.

📝 Should I keep a food diary?

A food diary can help you notice patterns between what you eat and how you feel.

You could record:

• What you ate and drank.

• Any symptoms you noticed.

• When your symptoms started.

• Whether you were having a flare or feeling well.

• Any other things that might have affected how you felt, such as stress or poor sleep.

You don't need to record every single thing you eat forever. A short diary can sometimes provide useful information for your dietitian or IBD team.

Remember that one episode of tummy pain doesn't automatically mean a food caused it. IBD symptoms can have lots of different causes.

🍽️ What if eating feels stressful?

It's understandable if food sometimes makes you feel worried, especially when you don't know whether something will upset your tummy.

You might feel nervous about eating before school, going out for a meal or trying something new. You might also feel frustrated when you have to think about food more than your friends do.

Here are a few things that might help:

• Eat foods you know you tolerate well when you need to feel comfortable.

• Plan ahead for school trips, parties or days out.

• Ask your parent or carer to help you find foods that work for you.

• Talk to your IBD team if worrying about food is affecting your life.

• Remember that you don't have to explain your food choices to everyone.

If food worries are making you skip meals, avoid social activities or feel frightened about eating, let someone you trust know. Your healthcare team can help you find support.

🧑‍🤝‍🧑 What about eating with friends?

Having IBD doesn't mean you have to miss out on meals, parties, sleepovers or going out with friends.

You might need to plan a little more than other people, but there are ways to make eating out easier.

You could check a menu beforehand, bring a snack you know you tolerate or ask whether a restaurant can make a small change to a meal.

You also don't have to tell everyone about your IBD if you don't want to. You can simply say that certain foods don't agree with you.

Most importantly, food should be about more than managing symptoms. It's also about enjoying yourself, sharing experiences and spending time with people you care about.

🩺 When should I ask for help?

Talk to your parent or carer, IBD nurse, doctor or dietitian if:

• You are losing weight without meaning to.

• You aren't growing as expected.

• You feel tired or weak a lot of the time.

• You are struggling to eat enough.

• Lots of foods seem to upset your tummy.

• You're worried about eating or avoiding more and more foods.

• You want to try a special diet or take nutritional supplements.

Your IBD team can help work out what's happening and find a plan that suits your needs.

💚 Remember

You don't need to eat perfectly to manage IBD. There isn't one magic food that will cure it, and you don't have to avoid every food that might trigger a symptom.

Learning what works for your body, getting enough nutrition and asking for help when you need it can make eating feel less stressful.

You deserve to enjoy food, feel good about eating and have the energy to do the things you love.

This article is for general information only and is not a substitute for medical advice. Every child and teen with IBD is different, and dietary needs can vary. Always speak to your IBD team or a qualified dietitian before making significant changes to your diet or taking nutritional supplements.