Dietary Management of Crohn's Disease

General Principles

The American Gastroenterological Association recommends a Mediterranean diet pattern rich in fresh fruits and vegetables, monounsaturated fats, complex carbohydrates, and lean proteins for all Crohn's disease patients, minimizing ultraprocessed foods, which has demonstrated improved quality of life and lower rates of active disease in patients with inflammatory bowel disease 1, 3.
The European Society for Clinical Nutrition and Metabolism advises against non-evidence-based self-directed exclusion diets, as they lead to limited diet quality and nutrient deficiency, and patients with Crohn's disease are already at high risk for malnutrition 5, 4.

The American Gastroenterological Association suggests that patients with intestinal strictures should cook, steam, mash, or blend mushrooms to achieve a soft, less fibrous consistency, and emphasize careful, thorough chewing of all fibrous foods 1, 2, 4.
The European Society for Clinical Nutrition and Metabolism recommends considering avoiding mushrooms entirely if strictures are symptomatic or if the patient has experienced obstructive symptoms, and high-risk patients with known stenosis should be specifically counseled about the mechanical obstruction risk 6.

The American Gastroenterological Association states that no dietary restriction of mushrooms is necessary for patients without intestinal strictures, and patients with Crohn's disease in remission who do not have intestinal strictures do not need to limit their intake of fibrous, plant-based foods 1, 2.
The European Society for Clinical Nutrition and Metabolism advises ensuring all patients with complicated IBD have access to a registered dietitian for individualized assessment and guidance 3, 7.