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Nutrition Tips for Inflammatory Bowel Disease (IBD)

For Older Adults Living with Crohn’s Disease or Ulcerative Colitis

Understanding IBD

Inflammatory Bowel Disease (IBD) includes:

  • Crohn’s Disease – Can affect any part of the digestive tract.
  • Ulcerative Colitis – Affects the large intestine (colon) and rectum.

Both conditions cause inflammation in the digestive tract, which can make it harder for your body to absorb nutrients.

Why Nutrition Matters More After 65

As we age, we are at higher risk for:

  • Unintentional weight loss
  • Muscle loss
  • Vitamin and mineral deficiencies
  • Dehydration
  • Medication side effects

Good nutrition helps maintain strength, energy, and healing — especially during flare-ups.

Eating During a Flare (Active Symptoms)

If you have:

  • Diarrhea
  • Abdominal pain
  • Cramping
  • Fatigue

Your digestive system may tolerate lower-fiber, softer foods better.

Foods That Are Often Easier to Tolerate During a Flare

Grains

  • White rice
  • White bread or toast
  • Plain pasta
  • Cream of wheat or grits
  • Saltine crackers

Protein Foods

  • Baked or boiled chicken
  • Turkey
  • Fish
  • Eggs
  • Tofu
  • Smooth nut butters

Vegetables (Well-Cooked, No Skins)

  • Carrots
  • Green beans
  • Zucchini
  • Potatoes without skin

Fruits

  • Ripe bananas
  • Applesauce
  • Canned peaches or pears (in juice, not syrup)
  • Melons

Dairy (If Tolerated)

  • Lactose-free milk
  • Yogurt with live cultures
  • Aged cheeses (in small amounts)

Foods That May Worsen Symptoms During a Flare

  • Raw vegetables
  • Whole grains and bran
  • Nuts and seeds
  • Popcorn
  • Fried or greasy foods
  • Spicy foods
  • Alcohol
  • Caffeine
  • High-sugar beverages
  • Artificial sweeteners (sorbitol, xylitol)

Eating During Remission (When Symptoms Are Controlled)

When inflammation is low and you feel better, you may slowly reintroduce more fiber and variety — with guidance from your healthcare provider.

Focus on:

  • Lean proteins to prevent muscle loss
  • Adequate calories to maintain weight
  • Colorful fruits and vegetables (as tolerated)
  • Healthy fats (olive oil, avocado)
  • Whole grains if tolerated

Important Nutrients for Adults 65+ with IBD

Because IBD and some medications affect absorption, you may be at risk for:

  • Vitamin B12 deficiency
  • Vitamin D deficiency
  • Iron deficiency
  • Calcium loss
  • Protein deficiency

Ask your provider whether you need blood testing or supplements. Do not start any new supplements without consulting with your healthcare provider first.

Medication Considerations

Some medications used for IBD (such as steroids like prednisone) may:

  • Increase appetite
  • Raise blood sugar
  • Cause bone thinning
  • Increase risk of infection

Nutrition strategies may need to adjust depending on your medication plan.

Sample Gentle 1-Day Meal Plan (During Mild Symptoms)

Breakfast

  • Scrambled eggs
  • White toast
  • Ripe banana
  • Decaffeinated tea

Morning Snack

  • Lactose-free yogurt

Lunch

  • Chicken and rice
  • Cooked carrots
  • Applesauce

Afternoon Snack

  • Saltine crackers
  • Smooth peanut butter

Dinner

  • Baked fish
  • Mashed potatoes (no skin)
  • Cooked green beans

Evening Snack

  • Rice cake
  • Herbal tea

Preventing Unintended Weight Loss

Older adults with IBD should:

  • Eat small meals every 3–4 hours
  • Include protein at every meal, or as directed by healthcare provider
  • Use oral nutrition supplements if recommended
  • Monitor weight weekly

Notify your provider if you lose weight unintentionally - ask your healthcare provider if there is a specific amount of unintentional weight loss you should be watching for.

Hydration Matters

Chronic diarrhea can increase dehydration risk.

Aim for:

  • 8–10 cups of fluid daily (or, as directed by your healthcare provider)
  • Electrolyte beverages if recommended
  • Limit caffeine and alcohol

When to Call Your Healthcare Provider

Contact your provider if you experience:

  • Persistent diarrhea
  • Blood in stool
  • Fever
  • Severe abdominal pain
  • Unintentional weight loss
  • Weakness or dizziness
  • Always ask your healthcare provider for specific advice on when to call to report symptoms, and when to seek urgent/emergency care.  

Key Takeaway

IBD affects everyone differently. During flares, choose gentle, low-fiber foods. During remission, focus on balanced nutrition to maintain strength and prevent deficiencies.

Nutrition is a powerful tool — but it should be personalized.

Medical Disclaimer

This resource is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. Nutritional needs for individuals with Crohn’s disease or ulcerative colitis vary depending on disease severity, medications, and other medical conditions. Always consult your physician, gastroenterologist, or registered dietitian before making significant dietary changes. Do not delay or disregard professional medical advice based on this information. Call 911 if you are experiencing a medical emergency.

Sources:

This handout is for educational purposes only and is not a substitute for professional medical advice. Always follow your healthcare provider’s instructions.

This content was created with the assistance of AI. Any AI-generated content was reviewed by a Nurse Practitioner.