Crohn’s and Colitis Awareness Week: Dec. 1–7

Inflammatory Bowel Disease (IBD), predominantly Crohn’s Disease (CD) and Ulcerative Colitis (UC), affects about 4 in 1,000 people in developed countries. There’s still no identified cause or cure for these conditions, but there are ways to manage symptoms through diet.

“It is always important to be mindful of nutrition, but it’s especially important for people with IBD,” said Amy Melton, MS, RD, LDN, lead clinical dietitian at Memorial Medical Center. “Some may not digest and absorb all the nutrients they eat and some may even have an increased need for certain nutrients, vitamins and minerals.”

Vitamin/Mineral Considerations for IBD Patients

  • Iron deficiency can be common due to blood loss. An iron supplement may have enhanced absorption with a simultaneous vitamin C source.
  • Check for folate deficiency annually. Medications such as methotrexate or sulfasalazine block folate absorption.
  • Check for vitamin D deficiency every 1–2 years. It is common with long-term steroid use, genetic or environmental factors.
  • Check vitamin B12 levels every 1–2 years. B12 may be altered after surgical resections of the stomach or terminal ileum.
  • Monitor zinc levels, since they are commonly low in the presence of Crohn’s.

Some of these levels should be monitored more frequently depending on presence and severity of a confirmed deficiency. Also, consider the form of vitamin or mineral supplements. For example, a chewable may be better absorbed than a tablet. Always check with your physician before starting any supplements.


There is no one-size-fits-all diet for IBD. Some foods may be better tolerated than others at different times, so it’s important to speak with a physician and a registered dietitian to identify what works best for you. Sometimes during a flare of symptoms, fiber is restricted. Then, it can be gradually increased back into the diet with the guidance of a medical professional.

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A Low-FODMAP (Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols) diet has been shown to reduce symptoms in IBD patients. When consumed in certain amounts, foods high in FODMAPs may cause gastrointestinal discomfort. A registered dietitian will provide guidance with elimination and reintroduction of foods per this diet. It is not recommended to practice an elimination diet without medical supervision.

Keep it Simple

In general, always maintain adequate hydration, aiming for at least 8 cups of water per day, and limit caffeinated and sugary beverages. Limit processed foods with additives–strive for more whole-food sources with fewer ingredients.

Amy Melton, MS, RD, LDN, CNSC, has been a registered dietitian since 2011. and she recently became a certified nutrition support clinician. She has worked at Memorial Medical Center as a clinical dietitian since 2012, and her areas of primary focus are general surgery, where she sees many patients with IBD, and medical intensive care. She works with acute care patients who have a wide variety of nutrition risk factors.

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