“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.
When your Crohn’s is under control, you can keep fiber on your menu by choosing high-fiber foods with naturally soft textures and modifying high-fiber foods that have rough or stringy textures to make them softer. If you haven’t eaten much fiber recently, it’s best to increase your intake gradually, under the guidance of a registered dietitian who specializes in inflammatory bowel disease (IBD).
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 Health’s 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.
How soft is soft enough? Foods should be fork-tender and soft enough to mash or squish against the roof of your mouth, Collins says. Some good examples include:
- 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 aren’t soft to begin with can be made softer, so they’re 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 Crohn’s & Colitis Dietitians in Sugar Land, Texas.
You can modify a food’s texture by peeling, steaming, boiling, roasting or baking, mashing, or blending it. “You’re physically breaking down those tough, woody fibers,” Leelasinjaroen says.
According to Hurst and Collins, that might look like:
- Roasting, steaming, or sautéeing firm vegetables until they’re 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.
Make sure to chew your food thoroughly too; smaller food particles will pass through strictures more easily. “You should chew to applesauce consistency, no matter what you’re eating,” Collins says.
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.
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