Early in my career, I made the rookie mistake of overloading new patients with information—so much so that some said it felt like drinking from a fire hose. 😳
I quickly realized that more isn’t always better.
What matters is giving patients clear, practical takeaways they can actually use.
After seeing thousands of people with IBD, these are some recommendations that have made the biggest impact on my patients’ quality of life:
✅ Set a daily hydration goal. Many people with IBD are at increased risk for dehydration. They know they need to drink more water, but without a specific goal, they fall short. Consider an oral rehydration solution for those with a J-pouch, active disease, an ileostomy, or short bowel syndrome.
✅ Focus on eating behavior. Patients often admit to eating too fast but need extra reminders and specific tips to slow down (e.g., eating with their non-dominant hand). How they eat matters as much as what they eat. Not only can chewing better and eating slower reduce symptoms, but it can minimize risk of bowel obstruction in at-risk individuals.
✅ Think “roughage” over fiber. People with active IBD or strictures are often told to follow a low-fiber diet. Instead of fixating on grams of fiber, help them focus on the texture and consistency of their food, choosing softer textures.
✅ Check for and correct micronutrient deficiencies. Micronutrient deficiencies are common in the IBD population, and they’re going undiagnosed because of a lack of testing and monitoring. Some labs don’t flag deficiencies as abnormal until levels are alarmingly low. For a list of labs to monitor, check out page 3 of my 2025 IBD Nutrition Assessment Form.
✅ Set a limit for added sugar. Patients know they should cut back, but having a concrete target—like <25g per day—makes it easier to follow through. See these practical tips for eating less sugar.
✅ Incorporate a daily mind-body practice. Stress is a known IBD trigger. Even 10 minutes of yoga, meditation, or breathing exercises can make a real difference.
✅ Avoid artificial food colorings and sweeteners. Research links these additives to dysbiosis, increased intestinal permeability, and inflammation. Since they provide no nutritional benefit and are easy(ish) to spot on food labels, limiting them can help shift the diet toward more whole, minimally processed foods.
