Many people with IBD eat even less fiber than the rest of Americans, because people with IBD purposely stop eating foods with fiber. I know this to be true because of
1) my clinical nursing experiences
2) my clinical research experiences
3) my long-term study of scientific literature about fiber/IBD
4) my review of social media interactions among people with IBD.
I spent 15 years working as a nurse with gastroenterology patients, some of whom had IBD. It was my job to complete a health history form for each of my patients, and during the interview I always asked my patients with IBD what they knew about fiber. Many of them had acquired the idea that fiber was harmful and should be avoided. Some of the patients had in the past undergone intestinal surgery and were instructed to avoid fiber (as is necessary after abdominal surgery); however, these patients were never instructed to resume fiber, and they continued to avoid fiber as a precaution.
After leaving clinical practice, I found the same low-fiber mindset in people with IBD who participated in my dissertation research studies. In one of my IBD diet studies, 10 of the 11 participants were actively avoiding fiber when they entered the study.1 None of these participants were instructed by their health care provider to avoid fiber, and none had a contraindication regarding fiber. All 11 participants tolerated a high fiber diet during the 4-week intervention study.
I again saw a low-fiber mindset among people with IBD in a study using data from the Crohn’s and Colitis Foundation of America Partners Internet Cohort.2 We included in our analyses data collected from individuals with IBD who were in remission at the beginning of the study.2 Approximately 30% of these individuals reported that they avoided eating dietary fiber.2
Also, fewer than 1% of the individuals in the analysis reported eating All-Bran or similar high-fiber cereals. 2
VIEWS REGARDING IBD DIET AND FIBER ONLINE
Throughout my doctoral program I monitored posts to online IBD-related patient forums, and the overwhelming sentiment I saw toward fiber was negative.
In January 2016, I became active on Twitter and began searching on #Crohn’s, #IBD, and #fiber. At that time, I noted that many people with IBD were tweeting about the woes of having to maintain a low fiber diet. In the same Twitter search, I noted many tweets about the findings from the Partners data that revealed greater risk of flare associated with a low-fiber diet. For further documentation of contrasting views of fiber/IBD, please see two of my articles listed under the Research References tab:
1) Clashing Paradigms: Low Fibre or High Fibre Diets for Non-Infectious Gut Inflammation? or click HERE
2) Continued Disconnect Between Biomedical Research and Dietary Fiber Recommendations Regarding Inflammatory Bowel Diseases.
- Brotherton C, Taylor A. Dietary Fiber Information for Individuals With Crohn Disease: Reports of Gastrointestinal Effects. Gastroenterol Nurs 2013;36:320-327. http://www.ncbi.nlm.nih.gov/pubmed/24084130
- Brotherton CS, Martin CA, Long MD, et al. Avoidance of Fiber is Associated with Greater Risk of Crohn’s Disease Flare in a 6 Month Period. Clin Gastroenterol H 2015. http://www.ncbi.nlm.nih.gov/pubmed/?term=brotherton+AND+sandler