Recurring bowel trouble, including diarrhea, pain and abdominal cramping, reduced appetite and weight loss, fever and fatigue may be indicative of inflammatory bowel disease (IBD).

Inflammatory Bowel Disease

Diseases of the bowels can really limit an active lifestyle. Not to be confused with the less severe irritable bowel syndrome (IBS), inflammatory bowel disease (IBD) is a group of diseases where the gastrointestinal (GI) tract are chronically inflamed. People with IBD can suffer from episodic or persistent symptoms that make it hard to carry out everyday activities. The most common forms of IBD are Crohn’s disease (CD) and ulcerative colitis (UC).1

Prevalence of IBD is highest in North America and Europe. In North America, UC affects 238 out of 100,000 people, while CD affects 201 out of 100,000.2 Asia has much lower rates of IBD than Western countries, though prevalence is increasing.2 Studies conducted in Singapore showed that the rates of CD rose dramatically from 1.3 in 100,000 in 1992 to 7.2 in 100,000 in 2003.3,4 Of the main ethnic groups in Singapore, the Indians are most susceptible to the condition, followed by Chinese and Malays.3,5

The cause of IBD is not known but genetics, the immune system and the environment all play a role. IBD symptoms can be affected by diet and stress, so lifestyle and nutritional changes might be able to help. At Nestlé Health Science, we devote a significant proportion of our research efforts to nutritional therapies for GI disorders, including IBD. In this way, we aim to help people manage their condition better.

Some people with IBD may be aware that certain foods aggravate symptoms. Commonly, symptoms can be made worse by dairy, fatty foods, spicy foods, caffeine and alcohol, and even too much fiber. Since IBD can cause restrictions in the GI tract, eating easy-to-digest foods is important. Following the dietary instruction for any medication is also crucial, as drug-food interactions can affect symptoms. And because undesired weight loss can occur, especially when symptoms flare up, people with IBD should ensure adequate nutritional and fluid intake through more frequent, smaller meals or nutritional supplements, if necessary.

  1. Mayo Clinic. Inflammatory bowel disease (IBD). Available at: Accessed: March 2016.
  2. Ng SC. Epidemiology of inflammatory bowel disease: focus on Asia. Best Pract Res Clin Gastroenterol. 2014;28:363-72.
  3. Tan CC, Kang JY, Guan R, et al. Inflammatory bowel disease: an uncommon problem in Singapore. J Gastroenterol Hepatol. 1992;7:360-2.
  4. Thia KT, Luman W, Jin OC. Crohn's disease runs a more aggressive course in young Asian patients. Inflamm Bowel Dis. 2006;12:57-61.
  5. Lee YM, Fock K, See SJ, et al. Racial differences in the prevalence of ulcerative colitis and Crohn's disease in Singapore. J Gastroenterol Hepatol. 2000;15:622-5.


*Listed symptoms are not all-inclusive; actual patient symptoms may vary. 

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Triggers of IBD include stress, smoking, various kinds of foods, missed medication and certain other kinds of medicines.1

1.University of California San Francisco Medical Center. Nutrition Tips for Inflammatory Bowel Disease. Available at Accessed March 2016.

What to eat during or after a flare


During or after experiencing an IBD flare, generally bland foods with low residues such as oatmeal, chicken, turkey or fish, cooked eggs, mashed potato, rice or sourdough bread are well tolerated. Spicy or high residue foods such as raw vegetables and popcorn may be quite problematic for some. A balanced nutritional supplement may be beneficial to help meet the increased nutritional needs.

Food doesn't cause IBD in the first place, but it can make symptoms worse. Different food can affect patients differently. To know which foods to avoid, it is helpful to keep a diary or daily log of what is eaten, along with descriptions of symptoms. This will help link problem foods that worsen the symptoms so that they can be avoided in the future. It will also help a doctor or dietitian plan an individual diet better tailored to patient needs.
IBD is not irritable bowel syndrome (IBS)


Despite some overlapping symptoms, IBD and IBS are two different conditions. IBS is often episodic, that is, the symptoms wax and wane, but it is a not associated with any identifiable disease in the GI tract. IBD is marked by inflammation of some part of the GI tract, and is a more serious condition. In either case, diet can play a role in alleviating symptoms.1

  1. Crohn’s&ColitisFoundation of America. ManagingFlares – Crohn’sColitis. Available at: Accessed March 2016.