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Tips for eating pasta with Crohn's & colitis

Written by
Brittany Rogers, MS RDN
January 13, 2023
pasta for crohns and colitis

Many people with Crohn’s disease, ulcerative colitis, or microscopic colitis report having symptoms after eating pasta. This could be due to the acidity of the sauce, the fat content or type of protein, the type of pasta used, or some of the ingredients added to the dish. 

Trigger foods are very personalized, so not all of the tips in this article may be applicable to you. If you do experience symptoms after eating certain pasta dishes, here are a few tips to try to make your meals more tolerable and enjoyable.

Know your options for dealing with trigger foods in pasta recipes

1. Have less red sauce

If red sauce causes acid reflux, try having less of it rather than eliminating it all together. That way you still get the satisfaction and taste while it’s less likely to cause symptoms.

2. Swap out the red sauce completely

Try an alternative pasta sauce idea like a pumpkin-based sauce or use garlic and olive oil to dress your pasta (recipe ideas down below).

3. Swap out the meat

Sometimes meat with high fat content can cause symptoms, so swapping the meat out for 99% fat free ground turkey or chicken instead of beef can improve tolerability.

4. Swap out the gluten

If you notice symptoms after having gluten, try a gluten-free pasta made with simple ingredients like brown rice, or try a vegetable-based noodle like zucchini noodles.

5. Eat the dish as-is

Sometimes the symptoms are worth it!

Gluten and IBD

Is gluten inflammatory?

Researchers don’t currently know if gluten is inflammatory or not in people with Crohn’s and colitis. Gluten-fed mice seem to end up with ileitis1. But we don't know whether these studies in mice will translate into humans. If gluten is inflammatory for Crohn’s disease patients, we don't know whether it'll also be inflammatory for those with ulcerative colitis.

What about celiac disease & IBD?

People with IBD are 2.2 times more likely to have Celiac disease compared with the general population2. Talk to your doctor if you haven’t yet been checked for celiac disease.

Does gluten trigger symptoms?

In a study with over 300 IBD patients, 65% of those who tried a gluten-free diet saw an improvement in their symptoms and about 38% reported fewer or less severe flares3. More studies need to be conducted before any conclusions can be drawn though.

Practical Advice

Whenever we have a lack of data, we usually recommend adding in more variety into that category because what we do know is that the best diet for the microbiome appears to be one that contains the highest variety of plant-based foods. So, instead of restricting gluten, we recommend adding in more variety of well-tolerated grains into the diet such as gluten-containing grains, rice, buckwheat, polenta, millets, sorghum, teff, oatmeal, etc. 

Alternative pasta sauce ideas

1. Creamy pumpkin sauce

Canned pumpkin puree, olive oil, tahini, tomato paste (optional), non-dairy milk, garlic, salt, and pepper to taste, blended to desired consistency

2. Butternut squash sauce

Use the same recipe as above but swap the pumpkin puree for boiled or roasted butternut squash prior to blending

3. Olive oil with garlic and fresh herbs

Drizzle pasta with your choice of olive oil, fresh garlic, and herbs

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. Shah A, Walker M, Burger D, Martin N, von Wulffen M, Koloski N, Jones M, Talley NJ, Holtmann GJ. Link Between Celiac Disease and Inflammatory Bowel Disease. J Clin Gastroenterol. 2019 Aug;53(7):514-522. doi: 10.1097/MCG.0000000000001033. PMID: 29762265.
  3. 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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