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Kalee Eichelberger, RD,LD/N, CNSC

Specialty Dietitian at the Orlando Health Digestive Health Institute Center for Inflammatory Bowel Disease

Q: After being diagnosed at 78 years old with acute colitis - the hospital and GI Doctor recommended a low fat diet. They did not set me up with a nutritionist or give me a guideline for foods. I still have a lot of gas even with just keeping my diet simple. I know I do fill up with gas if I don't eat every 4/ 5 hours after breakfast/lunch and dinner. Are there some recommendations on diets to follow or go to foods to limit gas?

A: Excessive gas could be due to numerous causes including active inflammatory bowel disease or dietary intolerances. Gas in your stomach can be caused by swallowing air when you eat or drink via drinking through a straw, consuming carbonated beverages (soda, beer), eating too quickly, or chewing gum. Limiting these behaviors and practicing regular, mindful eating may help reduce symptoms. Certain high-fiber foods may also cause gas, including beans/ peas (legumes), raw fruits and vegetables (especially those with intact seeds and skins), and certain whole grains. Sugar substitutes, or artificial sweeteners, such as sorbitol, mannitol and xylitol, found in some sugar-free foods and beverages may also cause excess colon gas. Due to the fact that various medical conditions may increase intestinal gas, bloating or gas pain, I would recommend discussing potential underlying causes with your medical provider that way you can obtain more tailored recommendations for a potential diet plan for your inflammatory bowel disease or food intolerances. For further help finding a qualified registered dietitian nutritionist or food and nutrition practitioner who is right for you, check out: Find a Nutrition Expert (eatright.org) hide answer

Q: Do you have any recommendations on how to help my child get the proper nutrition while also adhering to a special diet? I find it hard to get fruit and veggies in to his diet.

A: Some additional strategies to incorporate fruit and vegetable intake include “sneaking” them into dishes and using preparation strategies that could improve tolerance (as allowed on your child’s special diet): fruit/vegetable smoothies, juicing, pureeing vegetable soups, cooking rice in vegetable broth, baking fruit muffins, etc. When following a limited diet plan, it is key to get tested regularly for vitamin and mineral deficiencies and supplementing as needed. It is oftentimes recommended to take a multivitamin with additional vitamin and mineral supplementation as needed. Additionally, if overall intake and appetite are limited it can also be helpful to find an oral nutrition supplement drink such as Kate Farms or Pediasure to help fill in the gaps. hide answer

Q: Hello, my husband has UC and finds it difficult to adhere to specific diets. Anything that you find helps with people who have to eliminate so much from their diet?

A: Following elimination based diets can be challenging but finding additional recipes, eating out strategies, or meal delivery services that can assist with food prep can be helpful. Below are some helpful resources for structured elimination based diets, a recipe database for those with dietary restrictions/allergies, and meal delivery services. Food Allergies: Safe Eats® Allergy-Friendly Recipes – Kids With Food Allergies IBD- AID: https://www.umassmed.edu/nutrition/ibd/ibdaid/ SCD: https://www.nimbal.org/ https://gikids.org/ FODMAP: Hundreds of Low FODMAP Recipes & Resources | FODMAP Everyday Low FODMAP Diet | IBS Research at Monash University - Monash Fodmap AIP: https://www.thepaleomom.com/start-here/the-autoimmune-protocol/ https://autoimmunewellness.com/ CDED: https://mymodulife.com/ Meal Delivery: Daily Harvest, Hello Fresh, HungryRoot, Epicured hide answer

Q: I have had a full colectomy for my UC. I'm now experiencing some inflammation in my J-Pouch and my lower intestine. I'm currently treating with steroids but would like to also try an anti-inflammatory diet as well. Have other patients had much luck with this diet? Also, I was advised not to eat nuts after my colectomy but opinions vary. Have others been able to digest almonds or cashews post colectomy?

A: Inflammation in the lower intestine (or pouch) is common but really depends on multiple factors or why that is happening. We don’t have the best evidence for diet therapy in people with J-pouches, and there is argument whether there are diets that are truly “anti-inflammatory” to your bowels. While there are foods that people tolerate differently (nuts, seeds, fatty foods), I don’t usually have diet restrictions for my post-colectomy patients. While some things can perhaps cause more diarrhea, they don’t necessarily cause the inflammation. I would recommend speaking to your doctor prior to making any changes. hide answer

Q: I was diagnosed with Crohn’s disease 10 years ago. I’m on my 3rd biologic medication (Stelara). I’ve had a small bowel resection in 2016. I am having trouble keeping my vitamin levels up where they should be. I feel like this is a huge factor in my hair loss. I’m on a daily multi-vitamin, Vit D supplement daily and B12 shot monthly. Looking for ways to get extra vitamins into my diet. Would it be helpful to use dietary supplement drinks such as teami or orgain?

A: While supplement drinks such as Orgain can be a valuable way to receive additional nutrition, depending on the extent of your small bowel resection and current Crohn’s disease inflammation, your ability to absorb nutrients may be limited. I recommend discussing these concerns with your doctor and/or dietitian to have your vitamin/mineral levels checked and what might be best to supplement with (in the dose you need and form that you can absorb and tolerate best). hide answer

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