Crohn's disease diet: eating in flares and remission

By the DieticiansWorldwide.com editorial team · 17 October 2026 · Clinical nutrition

Why diet and Crohn's disease are so confusing

Crohn's disease is a lifelong inflammatory condition that can affect any part of the gut, from mouth to anus, most often the end of the small intestine and the start of the colon. Because it lives in the digestive tract, food feels like it must be the cause or the cure. Many people with Crohn's are told by friends, websites or social media to cut out gluten, dairy, sugar, grains or whole food groups.

The evidence is more modest. The UK charity Crohn's & Colitis UK states that "there is no evidence that any particular food causes Crohn's or Colitis" and "no evidence that following a particular diet can cure Crohn's or Colitis" (Crohn's & Colitis UK, food). It also notes that most people living with Crohn's or Colitis feel certain foods can trigger flare-ups, "but so far, there is very little scientific evidence to prove this".

That gap between experience and evidence is real, and both sides matter. Food can genuinely change symptoms such as pain, wind and diarrhoea, especially when the bowel is inflamed or narrowed. But changing symptoms is not the same as changing inflammation, and over-restricting food carries its own risks. This guide sets out what the evidence supports in each phase of the disease.

Diet is part of treatment, not a replacement for it. Never stop or reduce prescribed medicines because you are trying a new diet; talk to your IBD team first.

Crohn's diet at a glance: flare versus remission

Eating in remission: the Mediterranean pattern

When the disease is quiet, the aim is the same as for anyone else: a varied, nutritious diet that supports overall health. The American Gastroenterological Association's 2024 clinical practice update put this plainly. Its first best-practice statement is that, unless there is a contraindication, "all patients with IBD should be advised to follow a Mediterranean diet rich in a variety of fresh fruits and vegetables, monounsaturated fats, complex carbohydrates, and lean proteins and low in ultraprocessed foods, added sugar, and salt" (AGA Clinical Practice Update, Gastroenterology 2024). Our guide to the Mediterranean diet explains the pattern in practical terms.

The AGA was careful about what this does and does not promise. It noted that "no diet has consistently been found to decrease the rate of flares in adults with IBD", and that a diet low in red and processed meat may reduce flares in ulcerative colitis but has not been found to reduce relapse in Crohn's disease. In other words, the Mediterranean recommendation is about general health and wellbeing, not a proven way to stop Crohn's from coming back.

Crohn's & Colitis UK gives similar practical advice: include a wide variety of fruit, vegetables, nuts, seeds, proteins and wholegrains, and limit high-fat, high-sugar and high-salt foods, especially animal fats and processed meats.

What about ultra-processed foods?

Ultra-processed foods are a live area of research. Crohn's & Colitis UK says they "might increase the risk of developing Crohn's", and the AGA links a Mediterranean diet with lower intake of ultra-processed foods to a lower risk of developing IBD. Both statements are about developing the disease, mostly from observational studies, rather than about controlling it once you have it. Cutting back on ultra-processed food is sensible for many reasons; treating every additive as dangerous is not supported by current evidence.

Do you need to avoid fibre?

Usually not. Crohn's & Colitis UK says, "You do not need to limit how much fibre you eat, unless you have a narrowing (stricture) in your bowel", and adds that most people with Crohn's or Colitis have a low fibre intake. Fibre feeds gut bacteria and supports bowel and heart health. If fibre is not a problem for you, keep eating it.

Eating during a flare

A flare often brings pain, diarrhoea, reduced appetite and tiredness, and the priority shifts from the ideal diet to getting enough food and fluid. Crohn's & Colitis UK suggests:

• trying protein-rich foods such as eggs, dairy, meat, fish, pulses, beans or nut butters;
• choosing fibre that is easy to digest, like well-cooked, peeled vegetables, bananas or melons;
• trying soups or smoothies if full meals are hard to manage;
• using dairy alternatives with added calcium if dairy makes symptoms worse;
• drinking plenty of fluid, especially with frequent diarrhoea.

It lists caffeine, alcohol, artificial sweeteners and liquorice among the foods and drinks that might make diarrhoea worse. Small, frequent meals often feel easier than three large ones.

The most important instruction comes afterwards: when you feel better, gradually return to a balanced diet, and reintroduce foods you avoided during the flare one at a time.

The low-residue diet: what it is and what it is not

A low-residue diet limits high-fibre foods that are hard to digest, such as fruit and vegetable skins, nuts, seeds and wholegrains, and sometimes foods like milk that can leave residue in the bowel. People often follow one during a flare. Crohn's & Colitis UK is candid: "there is no high-quality evidence that it works", and if you choose to follow one, it is important to increase fibre gradually again when you are better.

The situation is different if you have a stricture, a narrowed section of bowel. Here texture matters, because tough or fibrous food can lodge at the narrowing. The AGA notes that people with symptomatic strictures "may not tolerate fibrous, plant-based foods (ie, raw fruits and vegetables) due to their texture", and that careful chewing and cooking or processing fruit and vegetables to a soft consistency may let them keep a wider variety of plant foods and fibre in their diet. In practice, that can mean peeled, well-cooked vegetables, smooth soups, blended fruit and smooth nut butters rather than skins, seeds, whole nuts and stringy vegetables.

A stricture diet should be set up with your IBD team or dietitian, because the right level of restriction depends on how narrow the bowel is and how you are eating overall.

Is there a specific Crohn's disease diet?

There is no diet that suits everyone with Crohn's. But there are two specific nutritional therapies with good evidence for inducing remission, both delivered by specialist teams.

Exclusive enteral nutrition

Exclusive enteral nutrition (EEN) means taking all of your nutrition from a nutritionally complete liquid formula for several weeks, with no ordinary food; in the children's trial described below, the EEN phase lasted six weeks. It is one of the oldest dietary treatments for Crohn's and is particularly important in children. NICE advises considering enteral nutrition as an alternative to steroids to induce remission in children in whom there is concern about growth or side effects, and in young people in whom there is concern about growth (NICE NG129).

The AGA describes EEN as "an effective therapy for induction of clinical remission and endoscopic response in Crohn's disease, with stronger evidence in children than adults", and says it may also help malnourished patients before elective surgery. The main drawback is adherence: drinking only formula for weeks is hard, socially and physically. Our explainer on enteral nutrition covers how liquid and tube feeding work in general.

What is the Crohn's disease exclusion diet?

The Crohn's disease exclusion diet (CDED) was designed as a more tolerable alternative. It combines a structured whole-food diet, which removes foods and additives thought to affect the gut barrier and microbiome, with partial enteral nutrition: a proportion of daily energy from formula. It runs in phases, with a stricter early stage and gradual reintroduction of foods.

The key trial was in children. In a 12-week randomised study of 78 children with mild to moderate Crohn's, CDED with partial enteral nutrition was tolerated by 97.5% of children, against 73.6% for exclusive enteral nutrition (Levine and colleagues, Gastroenterology 2019). At week 6, remission rates were similar: 75% versus 59%, a difference that was not statistically significant. At week 12, sustained steroid-free remission was 75.6% with CDED against 45.1% in the group that had EEN and then returned to a free diet with some formula.

The AGA concludes that CDED "may be an effective therapy for induction of clinical remission and endoscopic response in mild to moderate Crohn's disease of relatively short duration", and recommends that anyone on CDED is co-managed with a registered dietitian. It is not a do-it-yourself plan: the formula, phases and food lists need supervision, and the diet is not designed to be followed indefinitely.

Popular diets: SCD, gluten-free and low FODMAP

Specific carbohydrate diet

The specific carbohydrate diet (SCD) removes most grains, many sugars and some dairy. It has a devoted following. In the DINE-CD trial, 194 adults with mild to moderate Crohn's symptoms were randomised to the SCD or a Mediterranean diet for 12 weeks, with prepared meals for the first six weeks (Lewis and colleagues, Gastroenterology 2021). Symptomatic remission at week 6 was 46.5% on the SCD and 43.5% on the Mediterranean diet, with no meaningful difference, and inflammation markers rarely improved on either. The authors suggested that, because the Mediterranean diet is easier to follow and has wider health benefits, it may be preferred for most people.

Gluten-free

Crohn's & Colitis UK says there is no evidence that gluten is bad for Crohn's or Colitis. Some people feel better without it, but because a gluten-free diet is also low in FODMAPs, the improvement may come from fewer fermentable carbohydrates rather than from removing gluten. If you suspect a problem with gluten, ask your GP about testing for coeliac disease before you cut it out.

Low FODMAP for IBS-type symptoms

Crohn's & Colitis UK reports that IBS-like symptoms "affect more than 30 in 100 people with Crohn's or Colitis", which means gut symptoms can continue even when inflammation is controlled. In that situation, a low FODMAP diet may help identify trigger foods. It is not designed to be followed long term and should be supervised by a trained dietitian.

What foods trigger a Crohn's flare?

No food has been proven to trigger flares for everyone. Commonly reported culprits include spicy food, high-fat or fried food, caffeine, alcohol, fizzy drinks, artificial sweeteners and, for people with strictures, tough, fibrous or seedy foods. These can worsen symptoms such as pain, wind or diarrhoea. Whether they increase inflammation is much less clear.

A food and symptom diary, kept for a few weeks when the disease is reasonably stable, is more useful than guessing. Crohn's & Colitis UK suggests it may be easier to identify triggers when symptoms are under control, and advises discussing possible triggers with your IBD team or dietitian before making big changes. It also notes that symptoms after eating do not necessarily mean the disease is active.

Nutrient gaps to watch

Crohn's raises the risk of malnutrition and specific deficiencies, through reduced eating during flares, malabsorption, blood loss, surgery and restrictive diets. The AGA recommends regular malnutrition screening for everyone with IBD, looking for unintended weight loss, fluid retention and loss of fat and muscle, followed by a fuller assessment by a registered dietitian if problems are found.

• Iron. Crohn's & Colitis UK says around 1 in 3 people with Crohn's or Colitis have low iron levels, from poor intake, blood loss or poor absorption. The AGA recommends monitoring all patients with IBD for iron deficiency. Our guide to iron supplements explains the options, but take them only when blood tests show you need them.
• Vitamin D. The AGA also recommends monitoring vitamin D in everyone with IBD.
• Vitamin B12. Vitamin B12 is absorbed at the end of the small intestine, the area Crohn's often affects. The AGA advises monitoring B12 in people with extensive ileal disease or previous ileal surgery. Our article on B12 deficiency covers symptoms and testing.
• Calcium. Important if you cut out dairy; Crohn's & Colitis UK suggests choosing dairy alternatives with added calcium.
• Energy and protein. During and after flares, many people need more than usual to rebuild weight and muscle. Our guide to oral nutrition supplements explains when prescribed drinks help.

Crohn's & Colitis UK points out that a general multivitamin may not give you enough of the specific nutrient you are low on, which is why blood tests should guide supplements.

How strict does the diet really need to be?

For most people with Crohn's in remission, not strict at all. The evidence points towards a varied, inclusive, Mediterranean-style diet, with restriction reserved for specific reasons: a stricture, a supervised therapy such as EEN or CDED, or a time-limited trial to identify a trigger.

Long-term elimination diets have costs. Each food group removed narrows the diet, increases the risk of deficiency and can make eating stressful. Crohn's & Colitis UK warns that diets which restrict foods or food groups for a long time may mean you miss out on important nutrients, and advises not to cut foods out without talking to your dietitian or IBD team. Fear of eating can become a problem in its own right; restrictive eating driven by fear of symptoms can resemble ARFID, which needs specialist support.

A useful rule: restrict only what you have a clear reason to restrict, for as short a time as possible, and plan how you will reintroduce it.

Generic diet sheets or an individual plan from a dietitian?

Generic "Crohn's diet" sheets, whether low-residue lists or online meal plans, cannot account for where your disease is, whether you have a stricture or stoma, what surgery you have had, how much weight you have lost, which medicines you take, or what you like to eat. The AGA states that registered dietitians are "an essential part of the interdisciplinary team", suggests that all newly diagnosed patients with IBD have access to one, and recommends co-management with a dietitian for anyone with complicated disease, malnutrition, a fistula, short bowel or on EEN or CDED.

An IBD dietitian can:

• assess your nutritional status and screen for deficiencies;
• design a flare plan and a remission plan, so you know what to do before symptoms start;
• set up and supervise EEN or CDED when your gastroenterologist recommends them;
• adapt food textures for strictures without losing nutrients;
• separate inflammatory symptoms from IBS-type symptoms and guide a low FODMAP trial if needed;
• help you regain weight after a flare, or later, if needed, manage weight sensibly with a dietitian for weight loss approach that protects muscle.

NICE guidance for England says people with Crohn's should be given information on diet and nutrition when appropriate. In the UK, "dietitian" is a protected title; our United Kingdom country guide explains how to check registration. Before an appointment, our free healthy eating check can give you a quick picture of your current diet to discuss.

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