People living with inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, often wonder what foods they should eat. You’ve probably heard of avoiding spicy food, Brussels sprouts, legumes, and lactose, but what about lettuce? As one MyCrohnsAndColitisTeam member asked, “Foods like lettuce make me feel sick. Is this normal?” Another asked, “I had C. diff colitis, and now lettuce seems to bother me. Has anyone else had a similar experience?”
Here, we explore how lettuce, salad, and raw greens can trigger IBD symptoms and affect Crohn’s flares. It is important to note that your IBD experience will be unique. Speak with your health care provider, a nutritionist, or a dietitian before making changes to your diet.
Should You Avoid Lettuce During a Flare?
Generally, people living with Crohn’s disease are told to stick to a low-fiber diet during a flare. Raw, green vegetables are thought to worsen gastrointestinal symptoms like bloating, gas, diarrhea, cramping, and pain. Gastroenterologists recommend avoiding high-fiber, raw fruits and vegetables during Crohn’s flares.
Fiber is especially problematic for those who have been diagnosed with a stricture (a narrowed bowel). If you have a stricture, avoid insoluble fiber. This kind of fiber can irritate the colon. Insoluble fibers include those found in nuts, raw fruits and vegetables, and whole-grain breads, cereals, and bran.
While lettuce is a raw, green vegetable, it’s not considered as harmful to your intestine as vegetables like raw broccoli and cauliflower or vegetables with skin and seeds. However, lettuce is a bit more risky than vegetables like asparagus tips, cucumbers, potatoes, and zucchini — especially when they are cooked, seedless, and skinless.
It may be a good idea to avoid lettuce, raw greens, and other high-fiber foods when experiencing a flare-up. If you do incorporate lettuce into your diet, do so after your flare has passed. Eat small amounts and closely monitor your IBD symptoms.
Can You Eat Lettuce When in Remission?
When you are not experiencing active Crohn’s symptoms, it is crucial to eat a diverse diet packed with nutrition. Getting vitamins like iron and vitamin B12, found in certain vegetables, can lower your risk for complications of Crohn’s disease like malnutrition and anemia.
Keep in mind that how you prepare certain foods can impact how your body tolerates them. It’s best to eat cooked vegetables without peels and seeds. However, your body may still tolerate low-fiber vegetables like certain types of lettuce. Be sure to pay attention to how your body reacts to small amounts of lettuce to avoid triggering a Crohn’s relapse.
Are Certain Types of Lettuce Better Than Others?
Different kinds of lettuce and other leafy greens have different nutritional properties. These properties can make some varieties easier on your digestive tract than others. For example:
- Iceberg and butter lettuce — These soft, light green lettuces are considered safe in small amounts for most people with Crohn’s. They are low in fiber and high in water content. When you are in remission, slowly introduce butter lettuce or other soft greens into your diet for valuable nutrition.
- Cabbage — The impact of cabbage on your IBD can vary greatly depending on how it’s prepared. For example, kimchi (a fermented dish that contains cabbage) is a probiotic that doctors recommend for gut health. However, raw cabbage is high in indigestible fiber and leads to gas and bloating.
- Cooked collard greens — This dish is high in calcium, a crucial nutrient to replenish after a flare. Make sure to remove the stems to reduce as much insoluble fiber as possible.
- Baby spinach and kale — In their raw forms, these greens are hard to digest. However, when cooked or blended into a smoothie or purée — without their stems — these greens are good sources of iron that are easier on your digestive system.
Takeaway Messages
Ingredients that trigger your Crohn’s may not trigger someone else’s. To understand what foods improve and worsen your IBD symptoms, keep a food journal to track your symptoms. Eat small, simple meals that you prepare at home to have full control over what goes into your food. If you have any questions about your Crohn’s symptoms, consult your health care team.
Talk With Others Who Understand
MyCrohnsAndColitisTeam is the social network for people with IBD and their loved ones. On MyCrohnsAndColitisTeam, more than 161,000 members come together to ask questions, give advice, and share their stories with others who understand life with IBD.
What are your experiences with lettuce and IBD? Has eating lettuce reduced or increased your symptoms in the past? Share your tips and experiences in the comments below or on your Activities page.
References
- What Not To Eat If You Have Crohn’s Disease — Cleveland Clinic
- Eating and Drinking With IBD — Crohn’s and Colitis Canada
- What Should I Eat? — Crohn’s & Colitis Foundation
- Anti-Inflammatory Diet for IBD (IBD-AID) — UMass Chan Medical School
- Inflammatory Bowel Disease (IBD) — Mayo Clinic
- The Role of Diet in Inflammatory Bowel Disease — Gastroenterology and Hepatology
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