Four Essential Steps for Managing IBD Long-Term

If you’ve been diagnosed with Inflammatory Bowel Disease (IBD), such as Crohn’s disease (CD) or Ulcerative Colitis (UC), there are crucial steps you can take to manage your condition and maintain long-term remission. Here’s what you should be focusing on:

1. Achieving and Maintaining Remission with Your Gastroenterology Team

The first priority after an IBD diagnosis is bringing active disease or flare-ups into remission. This requires working closely with your gastroenterologist, who will guide your treatment plan, and a dietitian experienced in IBD care. Active Crohn's disease can cause inflammation throughout the digestive tract, from the mouth to the anus, while ulcerative colitis specifically affects the large intestine. When inflammatory bowel disease (IBD) is active, it can lead to malnutrition due to poor absorption of nutrients.

Your dietitian plays a critical role in supporting your treatment by creating a tailored nutrition plan that helps heal the inflamed gut and restores your body’s nutrient balance. This comprehensive care approach helps manage inflammation and keeps you on the path to remission.

2. Identifying and Managing Trigger Foods

Certain foods and lifestyle habits can trigger IBD flare-ups. Your dietitian will help you identify these triggers and work with you to make any necessary lifestyle changes. Together, you’ll create a slow, steady plan to reintroduce foods, allowing your digestive system to gradually adapt. This approach can help your body tolerate a wider variety of foods that support gut health and help maintain remission.

3. Supporting Your Body with Nutrient-Rich Meals

Once your disease is in remission, your dietitian will reassess your nutritional needs. At this stage, the goal is to transition from a gut-healing diet to one that supports your overall health with balanced, nutrient-rich foods. This steady shift helps maintain remission, prevents malnutrition, and reduces the risk of future flare-ups. Regular check-ins with your dietitian—at least once or twice a year—ensure that your diet evolves as your condition changes, helping you stay in remission long-term.

4. Adopting a Gut-Friendly Dietary Pattern

A gut-friendly diet is key to keeping inflammation at bay. The Mediterranean diet, known for its anti-inflammatory properties, can be beneficial once active disease has settled. Additionally, a high-fibre diet is crucial for maintaining long-term remission. Your dietitian can guide you through incorporating these dietary patterns in a way that works for your specific needs and preferences.

By including a dietitian as part of your IBD care team, you ensure that your nutrition supports your long-term health and remission.

Massironi S, Viganò C, Palermo A, et al. Inflammation and malnutrition in inflammatory bowel disease. The lancet. Gastroenterology & Hepatology. 2023 Jun;8(6):579-590. DOI: 10.1016/s2468-1253(23)00011-0. PMID: 36933563.

Balestrieri P, Ribolsi M, Guarino MPL, Emerenziani S, Altomare A, Cicala M. Nutritional Aspects in Inflammatory Bowel Diseases. Nutrients. 2020 Jan 31;12(2):372. doi: 10.3390/nu12020372. PMID: 32023881; PMCID: PMC7071234.