For people with Crohn's disease, one of the most persistent and important questions is “What can I eat?”
That's because research suggests that food choices can play a significant role in triggering symptoms, which means selecting the right options may help you stay in remission and make your everyday life more comfortable. But it gets tricky when the food doesn't come from your own kitchen.
"Eating at a restaurant when you have Crohn's can be more challenging because all of the ingredients are not always listed on the menu, so there may be hidden triggers like dairy, gluten, and spicy seasonings that can impact symptoms," says Adiana Castro, RDN, owner of Compass Nutrition in New York City and a specialist in gut health. "If you're in the middle of a flare, it can be very anxiety producing to eat somewhere you're not cooking your own food and choosing your own ingredients."
That doesn't mean you have to skip the pleasures of dining out, but it does help to follow some general tips for making a restaurant experience fit your needs. Here are five top strategies for going out to eat when you have Crohn's disease.
1. Plan Ahead
When considering what and how to eat at a restaurant when you have Crohn's disease, the key is to plan in advance when possible, so you know which foods are problematic and which are beneficial, says Ronen Arai, MD, a gastroenterologist with Baptist Health in Coral Springs, Florida. Then you can go into the meal feeling more confident and comfortable that you're not risking a flare, so you can enjoy your meal instead of bracing yourself for symptoms.
Most restaurants have their menus online, making it easier to choose appropriate options in a leisurely way, says Castro. This is also useful if you're trying to decide on a restaurant, because you can assess which one will have more choices for you.
"Looking at menus in advance can prepare you for talking to your server about possible modifications, like getting steamed vegetables instead of salad, since raw vegetables can be more difficult to digest," she says. "Most restaurants are very accommodating when you need food substitutions for health reasons."
2. Choose the Right Vegetables
While all vegetables have vitamins and minerals, not every veggie is a good choice for people with Crohn's, says Castro. Raw vegetables can be challenging for people with Crohn’s, and high-fiber options may be hard on your digestive system as well, she says. Because of this, she suggests aiming for cooked, low-fiber vegetables:
Peeled potatoes
Butternut squash
Peeled yams or sweet potatoes
Carrots
Baby spinach
Asparagus tips
Vegetables like these have been shown to decrease inflammation when eaten regularly.
Castro recommends staying away from gas-producing vegetables like broccoli, cauliflower, onions, and Brussels sprouts.
3. Stick to Low-Fiber Options
It's a good idea to reduce fiber-rich foods if you have Crohn's, especially if you have strictures, a common complication of the condition that involves the narrowing of the intestine due to scar tissue. Research suggests that up to 70 percent of those with Crohn's may have strictures within a decade after diagnosis.
"With these strictures, foods that are high in fiber can get lodged in the small intestine and lead to abdominal pain and nausea, and sometimes even vomiting," says Dr. Arai. Because of that, it may be helpful to avoid high-fiber options like raw nuts, dried fruits, mushrooms, and salads.
Berries with seeds can be especially challenging because they can irritate an inflamed gut, says Castro.
4. Go for Fish
If you're a fan of seafood, a choice like salmon, tuna, or mackerel can be a good way to get more omega-3 fatty acids, which are an important part of reducing inflammation — and why these fish are promoted for reducing the effects of arthritis and other inflammatory conditions. Some freshwater fish such as rainbow trout and walleye can also be a source of these beneficial fats.
"Keeping inflammation in check is a very important part of Crohn's management, and that's done through a combination of medications, stress management, sleep, and lifestyle changes like physical activity and diet," says Arai. Choosing a known anti-inflammatory food like fish can fit in with those efforts.
5. Stick With Familiar Choices
Although restaurant dining is often a stellar opportunity to try new dishes, that can present a risk when you have Crohn's because you don't know how you'll react, says Arai.
"Generally, it's a good idea to experiment with new foods in the comfort of home, in case an unexpected symptom occurs," he says. "Food effects can be highly individual, so something that doesn't bring on any symptoms in a friend with Crohn's can worsen your symptoms. That's why it's crucial to keep track of which foods are problematic for you personally."
The Takeaway
Because restaurants rarely list every ingredient in every dish, going out to eat can cause anxiety for someone with Crohn's disease because they may be concerned about eating a food that triggers a flare.
Looking at menus in advance and knowing if you need modifications can help you choose a restaurant and specific dishes before you visit.
If you have strictures, a common complication of Crohn’s, limiting or avoiding high-fiber foods is important.
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Resources
Cappello M et al. Food triggers in inflammatory bowel disease from the patients' and doctors' perspective. Journal of Crohn's and Colitis. May 2021.
Levine A et al. Dietary Guidance From the International Organization for the Study of Inflammatory Bowel Diseases. Clinical Gastroenterology and Hepatology. May 2020.
Lynn Grieger is a registered dietitian-nutritionist, certified diabetes care and education specialist, certified personal trainer, and certified health and wellness coach. She completed requirements to become a registered dietitian at Valparaiso University in 1987 and completed a dietetic internship at Ingalls Memorial Hospital in Harvey, Illinois, in 1988.
Lynn brings her expertise in nutrition, exercise, and behavior change to her work in helping people reach their individual health and fitness goals. In addition to writing for Everyday Health, she has also written for websites and publications like Food and Health Communications, Today's Dietitian, iVillage.com, and Rodale Press.She has a passion for healthy, nutrient-dense, great-tasting food and for being outdoors as much as possible — she can often be found running or hiking, and has completed a marathon in every state.
Elizabeth Millard is a freelance writer based in northern Minnesota. She focuses on health, wellness, and fitness, and has written for Runner's World, Bicycling, Self, Women's Health, Men's Health, Prevention, Experience Life, and more. She is an American Council on Exercise–certified personal trainer and a Yoga Alliance-registered yoga teacher. She graduated from Harvard University with a bachelor's degree in English.
