What You Should Know About a Liquid Diet and IBD

Liquid diets can relieve the worry of managing your diet when you’re in a flare-up. Plus, they can help you get enough nutrients.

Most of us with inflammatory bowel disease (IBD) have probably heard the term “liquid diet.” If you’re anything like me, it likely isn’t your favorite thing in the world.

A liquid diet isn’t just about avoiding all foods or replacing solids for liquefied versions. Some people with IBD may do this temporarily, though, if they find things like soup and broth easier to digest than whole foods during a flare-up.

We usually use the term “liquid diet” in relation to IBD when someone is prescribed elemental nutrition drinks, which are specifically designed to meet the nutritional needs of the body.

These are usually done in conjunction with a dietitian and for a set period of time to help the intestines rest and heal. A healthcare professional may prescribe these if you stop responding to medication or in addition to traditional therapies if a flare-up is particularly severe.

If you’re new to liquid diets, you may be wondering how to navigate them with IBD. Here’s what you need to know.

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Why are liquid diets prescribed for IBD?

To ease symptoms of a flare-up, the bowel often needs to rest in order to heal. The digestive tract has the power to regenerate its lining every 5 to 7 days (hence why 1 week you might feel amazing, and the next you can’t leave the bathroom). But if the digestive tract is inflamed or ulcerated, it may need help doing this.

This is why many of us with IBD sometimes opt for a low residue diet when flaring. This diet restricts the amount of fiber and fat content we consume.

While there’s not much evidence to suggest this is effective long-term, many people find it temporarily eases symptoms, especially as some high fiber foods can irritate an already angry gut.

This is something I personally always do when unwell, relying on low fiber, low fat foods such as rice, potato, steamed fish, and chicken.

Sometimes, total rest of the bowel may be necessary. In this case, your doctor may recommend temporary intravenous (IV) nutrition, since you won’t be able to take any food or liquid by mouth. In other cases, your doctor may clear you for a liquid diet.

Liquid diets massively reduce the amount of work your bowel needs to do. After all, a liquid drink is much easier to digest than a solid meal. This means your digestive tract can focus on resting and repairing from a flare-up.

Have you ever felt like a detective trying to figure out what the heck will make your bowel happier? Liquid diets can relieve the worry of managing your diet when you’re in a flare-up and don’t know what to eat. Plus, they can help you enough nutrients.

Unfortunately, it’s common for those of us with Crohn’s disease to lose our appetite. It’s also common for people with Crohn’s to develop a fear of eating due to pain.

I must admit, when I’m really unwell, it’s easy to think “Why eat?” because I know it’ll trigger pain or a rush to the bathroom. But this is a vicious cycle. My body needs plenty of nutrients to do its job. This can also make my fatigue much worse.

So, elemental nutrition drinks can help meet the nutritional needs of people with IBD. This means that someone who can’t tolerate food can still get the proteins, fat, and vitamins their body needs without any fiber.

How does a liquid diet work?

A liquid diet consists of drinking specially formulated elemental drinks.

Some examples include:

• Modulen IBD
• Ensure
• Boost
• Kate Farms

These drinks often use milk proteins as the main ingredient, but there are dairy-free or lactose-free versions available if, like me, you find dairy hard to tolerate. I often use AYMES ActaSolve, which is vegan.

You’re usually allowed to have additional drinks, like coffee and tea, but typically not any solid food.

The exact amount of drinks you’ll need will depend on your weight and the number of nutrients (calories, carbs, protein, and fat) the drink provides. Most people have around eight of these drinks per day. A dietitian can help you calculate the number of drinks you’ll need.

Typically, people will need to stay on a liquid diet for a set period of time. This is around 2 to 8 weeks to allow for complete bowel repair. It’s important you only drink these and avoid solid food, so the drinks do their job.

Sometimes, we hear the term liquid diet used in a different way. People with IBD who haven’t been prescribed elemental drinks may temporarily avoid solid food for a day or two if they’re feeling unwell.

This is something I personally do every few weeks. During the day, I’ll usually stick to homemade juice, soup, broth, and herbal tea. While I know this can’t achieve the results of an elemental liquid diet, it helps me feel better. Even though this works for me, it’s important to check with your doctor before you make any changes to your diet.

In severe cases, elemental drinks may be given through a feeding tube. This is for people who are unable to get enough calories and protein by drinking.

Do liquid diets work for IBD?

Most of the research regarding liquid diets centers around children with IBD. Studies suggest it leads to remission in up to 80 percent of children with Crohn’s disease.

Many adults drop out of an elemental liquid diet, because it’s much harder to stick to and often due to the taste. But studies do show that liquid diets can lead to significant symptom improvement in adults as well.

In my experience, I’ve never been on an elemental diet long term, but I have tried store-bought elemental drinks for a short period of time. After a few days, my symptoms are much better, and I’m able to introduce food.

I’ve also found elemental drinks ideal if I know I have a trip coming up, or if I’m going somewhere where I can’t easily access the toilet. I was advised by a dietitian to drink them in the morning if I’m particularly anxious about this, and it does usually delay my toilet trip until I’ve eaten solid food later in the day.

There are a few barriers that can make a liquid, elemental diet harder to stick to. A big factor is the taste, but there are now quite a few flavors and brands. Ask your dietitian about your options if you aren’t enjoying the one you currently take.

Another barrier is that following a liquid diet means missing out on certain aspects of life, like going out to eat. But the drinks are usually only a short-term measure, so it’s important to take it one day at a time.

In my experience, it’s still important to keep drinking the drinks regularly. As soon as I get hungry, it’s much easier to just grab food. If you’re sharing a house, try to keep temptations out of sight.

The bottom line

While a liquid diet isn’t for everybody, it can be a useful, medication-free strategy for those managing IBD symptoms.

It’s always important to speak with your care team if you’re considering a liquid diet. Working with a dietitian can help you make sure you’re getting the right amount of nutrients your body needs.