What is your assessment of her diet?
The diet is excellent; she is getting in three meals per day and is avoiding dairy and gluten, which may worsen her symptoms.
Incorrect! There is no data to support the use of a gluten free diet in patients with IBD who do not have concurrent celiac disease. There is also no data to support the notion that dairy is “inflammatory” or that it will worsen IBD symptoms or disease. Therefore, if IBD patients do not have lactose intolerance (symptoms of diarrhea, pain and/or bloating) after consuming dairy, dairy products are encouraged as they increase dietary diversity and non dairy alternatives tend to be lower in protein.
The diet could use some improvement; she should re-introduce dairy, gluten and fruits/vegetables.
Good choice!
The diet could use some improvement; she could re-introduce dairy and gluten but should continue to avoid fiber from fruits and vegetables given her history of obstructions
Incorrect!
In the past, many patients with history of bowel obstruction were recommended to follow a “low fiber” which resulted in avoidance of fruits and vegetables. In the last decade, the guidance on fiber and IBD has really changed. In particular soluble fibers, are actually quite beneficial for overall gut health in patients with IBD and encourage healthy short chain fatty acid production in the bowel.
In addition, fruit/vegetable avoidance may cause micro nutrient deficiencies. Therefore, it is important that we do NOT restrict all fruits/vegetables in the diet for patients with IBD (even those with strictures) and instead practice texture modification of these foods
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