Nutrition and Inflammatory Bowel Disease

Important information:

Good nutrition for children with inflammatory bowel disease (IBD) supports their growth and development and can lead to better disease outcomes. Symptoms such as loss of appetite, abdominal pain, mouth sores, diarrhea, or difficulty absorbing nutrients can lead to poor nutrition in children with IBD. This can contribute to:

  • Poor disease outcomes

  • Decreased adult height

  • Poor bone health

  • Low weight

Good nutrition can help:

  • Decrease symptoms

  • Improve vitamin and mineral balance

  • Improve growth, weight, and development

Food as medicine

Although no specific diet can cure IBD, certain diets can help manage the disease. Your child’s nutritional needs will depend on age, gender, activity level, and disease status. If symptoms increase, a modified diet with well-cooked vegetables and peeled fruits may be recommended. Research on nutrition and IBD is ongoing at Children's Hospital of Philadelphia (CHOP) and other organizations.

Patient instructions:

  • Aim for a balanced diet that includes all food groups:

    • Fruits and vegetables

    • Whole grains (such as whole wheat, brown rice, quinoa, and oatmeal)

    • Lean proteins (such as yogurt, eggs, chicken, fish, nut butters, and beans)

    • Dairy (as tolerated)

    • Water

  • Limit the following foods:

    • Processed and smoked meats (such as deli meats, hot dogs, and sausages)

    • Frozen meals and microwavable dinners

    • Red meat

    • High-fat, greasy foods (such as fast food)

    • Packaged foods with long shelf lives

    • Added sugars (such as high fructose corn syrup)

    • Artificial sweeteners, including sugar alcohols (such as erythritol, maltitol, sorbitol, Stevia, and xylitol)

    • Sugar-sweetened beverages (such as juices and sports drinks)

  • Children with a narrowing of the intestines (stricture) should avoid whole nuts, large seeds, and popcorn. Small seeds, such as those in strawberries and cucumbers, are safe to eat. Consult with your healthcare provider if you're unsure whether your child has a stricture.

  • Choose fresh, whole foods instead of processed. Processed foods have been changed from their natural state. These foods often contain additives that preserve shelf life.

  • Ensure your child is getting enough calcium and speak to your healthcare provider about any additional nutrient needs, such as vitamin D, iron, or folic acid.

  • Have your child eat slowly, chew food well, and pay attention to which foods are tolerable and which may cause discomfort.

  • If needed, consider nutritional formula drinks or smoothies to provide extra energy and calories.

  • Tube feedings may be required to provide additional calories and help your child gain weight. Discuss this with your healthcare provider if necessary.

  • When reading food labels, look for foods with fewer ingredients, avoid added sugars, high amounts of sodium, artificial preservatives, and food dyes. Avoid ingredients you do not recognize or are difficult to pronounce.

  • Label reading practice: below are two Nutrition Facts labels of different brands of vanilla bean ice cream. If you had the option to pick between the two brands, we recommend Brand #2 because it contains fewer ingredients.

To schedule an outpatient nutrition appointment:

  • To see a dietitian at the Buerger Center in Philadelphia, call the Center for Pediatric IBD at 215-590-7423.

  • To see a dietitian at satellite locations, call central scheduling at 267-425-3310. We will try to coordinate visits with your child’s gastroenterologist and dietitian when possible.

 

Reviewed February 2025 by Jamie Scaramuzzi, BSN, RN, CPN and Natalie Stoner, RD