Food.  I enjoy it now, but I was tormented for years by the pain that eating or even smelling foods caused me. These fears meant that I’d often skip meals or stopped eating partway through a meal, and ultimately lead to a very weak, underweight and anemic me.

Unfortunately, I never had a way of coping with this, and the cycle of fear, pain and suffering went on right up until I had my ostomy. Ok, I was able to eat – perhaps too much – while on Prednisone for a few months, but that’s cheating!

I have been fortunate enough to have connected with a Registered Dietitian who specializes in eating disorders, and who has Crohn’s Disease herself, and asked about ways in which people with Inflammatory Bowel Disease can manage this fear of food. I hope that her words of wisdom help if you’re in a similar situation.

Eating is supposed to provide nourishment and pleasure, but when everything makes you sick that’s just not the case. It’s certainly easy and normal to develop food fears and aversions when eating causes you pain. First things first, I would encourage just being understanding and gentle with yourself. Sometimes you just have to do what you have to do to get by for a while. I often recommend using supplements [and meal replacements] when food is just not tolerated; you can live off [them] for a while if you have to. Some people like to use protein shakes and smoothies, which can certainly be helpful, but I would only suggest that if it’s in addition to a greater variety of foods since they can’t meet all of your nutritional needs alone.

To start working through the fear of food and eating, I think one of the most important things would be identifying your trigger foods. That may be a lot harder than it sounds since we’re all different, but there are a few foods that many with IBD find challenging during a flare: popcorn, raw vegetables, nuts, seeds, high fat foods, beans. It’s a great idea to keep a food and symptom diary for a while to see if you notice any patterns. Knowing your personal trigger foods and learning to avoid them can make eating feel a bit safer.

On the other side, it’s also helpful to find foods that you know you can tolerate. On a sick day, or even just a day where you’re feeling a little nervous about eating, sticking to safe foods can help too. Again, this is very individualized, but a few foods that are usually easy for people with IBD include fruit juices, bananas, apple sauce, plain cereals, refined rice and grains, and soy protein. Cooked vegetables are usually easier on the GI tract than raw as well. That food and symptom diary you’re keeping can help you find out which foods are safe for you, too.

Over time, though, you may just have to take some (calculated) risks. When you are not flaring, you may try a new food or reintroduce a food you haven’t had in a while. Start with a small amount and see how you tolerate it, and pair it with foods you know are safe for you. I would only add one new thing at a time; that way if you develop symptoms you can pinpoint exactly what caused them. While you’re at it, let someone you trust and is supportive of you know what you’re doing. This will be a little scary and having support is important!

— Rachael McBride, MCN, RD/LD

Special thanks to Racheal McBride for her time and information. 

Rachael is a Registered Dietitian in Dallas, Texas. She has been vegan for over ten years, which sparked her interest in nutrition and ultimately led her back to school for a Master of Clinical Nutrition at UT Southwestern. During her studies, she was diagnosed with Crohn’s Disease and started paying a lot more attention to Inflammatory Bowel Diseases. Rachael is in private practice and works primarily with individuals with eating disorders, but she also enjoys working with veg*ns, athletes, and those with IBD. Feel free to get in touch if you’d like to work with Rachael or need help finding a Registered Dietitian in your area.

To get in touch with Rachael visit her official site www.rachaelmcbride.com.

Rachael can also be found on the following social media sites:

Twitter: @rachaelmcbRD
FaceBook: /RachaelMcBrideRD

QUESTION: What strategies have you used to overcome the fear of food?