6 tips for eating with a Crohn’s stricture

By focusing on [modifying] texture rather than eliminating entire food groups, many patients can keep their diets diverse, palatable, and nutritious while reducing their obstruction risk, says Pornchai Leelasinjaroen, MD, a gastroenterologist with Gastro Health in Kennewick, Washington.

Other strategies, such as eating smaller, more frequent meals and chewing your food thoroughly, can help, too. Here are six tips you can try in your own kitchen.

1. Be Smart About Fiber

It feeds the good bacteria in your gut, which in turn produce compounds that soothe inflammation and keep your intestinal lining healthy, Dr. Leelasinjaroen says.

People with more severe strictures, those with active inflammation, and those who are preparing for or recovering from surgery may also need to temporarily stick with a low-fiber diet or avoid fiber altogether until their inflammation is under control, says Stacey Collins, RDN, a clinical dietitian at the University of Colorado Healths Crohn's and Colitis Center in Aurora. Your care team can help you figure out what to do in your specific situation.

2. Choose Foods With Naturally Softer Textures

But the risk is much lower with softer foods. They are highly flexible and can pass through narrowed areas of the intestines much more easily, greatly reducing the risk of friction, pain, or blockages, Leelasinjaroen says.

• Scrambled eggs
• Yogurt or cottage cheese
• Applesauce
• Avocado or guacamole
• Soft fruits like banana, melons, papaya, and peeled peaches
• Hummus
• Instant oatmeal
• Pasta or noodles
• White rice
• Polenta
• White or sourdough bread
• Nut or seed butters
• Chia pudding
• Tahini

3. Modify Textures to Make Food Softer

Many fruits and vegetables that arent soft to begin with can be made softer, so theyre less likely to cause issues. Modifying texture and blending or breaking down food further is a central part of preventing a bowel obstruction, says Ashley Hurst, RD, a registered dietitian and the owner of the Crohns & Colitis Dietitians in Sugar Land, Texas.

According to Hurst and Collins, that might look like:

• Roasting, steaming, or sauteing firm vegetables until theyre easily pierced with a fork, like peeled carrots, yams without the skin, green beans, seeded peppers, peeled and seeded winter squash, or baby spinach
• Pureeing bean or vegetable soups
• Peeling and cooking firm fruits like apples or pears
• Blending fruits and vegetables into a smoothie

4. Avoid Very Tough Foods

• Fruits or vegetables with skins, seeds, or stalks
• Salad or raw, leafy greens
• Whole grains, including popcorn
• Nuts and seeds (though smooth nut and seed butters are okay)
• Steak or other tough, gristly meat
• Dried fruit
• Dried meat
• Mushrooms

5. Eat Smaller, More Frequent Meals (and Chew Them Well)

Think about how you eat in addition to what you eat. Have smaller, more frequent meals rather than large portions, says Leelasinjaroen. This lowers the food load passing through the stricture at any one time, he says. That can reduce the risk of obstructions or discomfort.

6. Stay Hydrated and Try to Walk After You Eat

Collins recommends that her clients with strictures aim to drink 80 to 100 ounces of water per day to support good digestion. To help keep foods moving along, drink during meal times, rather than [always] separating drinking from meals, she says.

If you develop symptoms of a bowel obstruction, seek urgent medical care. Symptoms include: severe or worsening abdominal pain and cramping, a bloated or distended abdomen, persistent nausea or vomiting, or being unable to pass gas or stool. An obstruction is a medical emergency go to the emergency room.

The Takeaway