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Is it safe to eat grains with Crohn's or colitis?

Is it safe to eat grains with Crohn's or colitis?

Updated on
July 21, 2023
Medical reviewer
Medically reviewed by
Brittany Rogers, MS, RDN
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Written by
Romanwell Dietitians

We get a lot of questions from current and prospective clients about grains and whether they’re safe to eat with Crohn’s or colitis. In this post we share what the research says about the safety of grains so you can make more informed choices about what you eat based on how you want to feel. 

What are grains?

Examples of grains include wheat, rice, oats, cornmeal, bulgar, barley, quinoa, millet, and farro. 

Are grains pro-inflammatory or anti-inflammatory?

  • The diet guidelines say there’s insufficient evidence to recommend changes to carbohydrate intake (including grains).ď‚Ž
  • In a study with almost 700 participants with IBD, those following a plant-based diet with a high intake of cooked grains were significantly less likely to flare than those who consumed a westernized diet with processed foods.ď‚Ž
  • In another study with 100 IBD participants, grain consumption did not increase the risk for a flare.ď‚Ž

Is gluten inflammatory?

  • The guidelines mention emerging evidence that gluten appears to be inflammatory to mice with Crohn's disease.ď‚Ž
  • We don’t currently know whether this research will translate to human studies, so we can’t say yet whether gluten is inflammatory for people with Crohn’s or colitis. 

Could certain grains trigger symptoms?

  • Trigger foods are any food or beverage that causes a symptomatic response when consumed.
  • In a study with over 2,300 participants, grains, and in particular rice, were frequently reported to improve symptoms.ď‚Ž
  • In another study with 233 participants, gluten-containing bread was frequently identified as a trigger food.ď‚Ž
  • Finally, a third study with over 300 IBD patients found that 65% of those who tried a gluten-free diet saw an improvement in their symptoms with about 38% reporting fewer or less severe symptom flares.ď‚Ž

Practical tips from an IBD registered dietitian

  • We have insufficient evidence to definitively say whether grains are inflammatory or anti-inflammatory at this time, so we don’t recommend completely restricting them from your diet.
  • When you’re experiencing symptoms, choose grains that may be easier to digest such as rice, buckwheat groats, polenta, and plain instant oats. 
  • You may want to trial a gluten-free diet if you notice gluten-containing foods increase your symptoms

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References

  1. Levine A, Rhodes JM, Lindsay JO, Abreu MT, Kamm MA, Gibson PR, Gasche C, Silverberg MS, Mahadevan U, Boneh RS, Wine E, Damas OM, Syme G, Trakman GL, Yao CK, Stockhamer S, Hammami MB, Garces LC, Rogler G, Koutroubakis IE, Ananthakrishnan AN, McKeever L, Lewis JD. Dietary Guidance From the International Organization for the Study of Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol. 2020 May;18(6):1381-1392. doi: 10.1016/j.cgh.2020.01.046. Epub 2020 Feb 15. PMID: 32068150.
  2. Limketkai BN, Hamideh M, Shah R, Sauk JS, Jaffe N. Dietary Patterns and Their Association With Symptoms Activity in Inflammatory Bowel Diseases. Inflamm Bowel Dis. 2022 Nov 2;28(11):1627-1636. doi: 10.1093/ibd/izab335. PMID: 35092268.
  3. Tasson L, Canova C, Vettorato MG, Savarino E, Zanotti R. Influence of Diet on the Course of Inflammatory Bowel Disease. Dig Dis Sci. 2017 Aug;62(8):2087-2094. doi: 10.1007/s10620-017-4620-0. Epub 2017 May 26. PMID: 28550491.
  4. Cohen AB, Lee D, Long MD, Kappelman MD, Martin CF, Sandler RS, Lewis JD. Dietary patterns and self-reported associations of diet with symptoms of inflammatory bowel disease. Dig Dis Sci. 2013 May;58(5):1322-8. doi: 10.1007/s10620-012-2373-3. Epub 2012 Aug 26. PMID: 22923336; PMCID: PMC3552110.
  5. Morton H, Pedley KC, Stewart RJC, Coad J. Inflammatory Bowel Disease: Are Symptoms and Diet Linked? Nutrients. 2020 Sep 29;12(10):2975. doi: 10.3390/nu12102975. PMID: 33003341; PMCID: PMC7650696.
  6. Herfarth HH, Martin CF, Sandler RS, Kappelman MD, Long MD. Prevalence of a gluten-free diet and improvement of clinical symptoms in patients with inflammatory bowel diseases. Inflamm Bowel Dis. 2014 Jul;20(7):1194-7. doi: 10.1097/MIB.0000000000000077. PMID: 24865778; PMCID: PMC4331053.

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