Eating With IBD During a Flare vs. Remission: What Changes and Why

Your gut at different stages

When you are managing Crohn’s disease or ulcerative colitis, the way your gut responds to food can change depending on whether you are in a flare or remission. Foods that feel manageable during a calm period may suddenly become harder to tolerate when inflammation is active. Understanding why this happens, and what may help at each stage, can make day-to-day eating feel less confusing and more manageable.

What is happening in the gut during a flare

During a flare, the lining of the bowel becomes inflamed and damaged. This thin protective layer is normally responsible for absorbing nutrients and acting as a barrier. When it is inflamed, it becomes swollen, more fragile, and less able to do its job properly. The normal movement of the bowel may speed up or slow down, and the gut may become more sensitive to certain types of food.

At the same time, the immune system is more active. This can lead to increased production of immune signals that contribute to swelling, discomfort, and other symptoms such as diarrhoea, cramping, or urgency. The combination of inflammation and immune activity means the gut is less resilient during a flare.

Why food tolerance changes during a flare

When the gut lining is inflamed, it becomes less able to handle foods that are rough in texture, high in fibre, or difficult to digest. Foods that pass through quickly or that ferment in the gut may cause more gas, bloating, or discomfort. This does not mean these foods are harmful, but they may be harder to tolerate temporarily.

Foods that are easier to digest and gentler on the gut lining are often better tolerated during this time. This might include well-cooked vegetables, white rice, soft fish, or smooth soups. The aim is to reduce the physical and digestive load on the gut while it is healing.

What happens during remission

Remission means that inflammation in the gut has settled down, and the gut lining has had a chance to repair. The bowel is functioning more normally, and the immune system is less active. During this time, many people find they can tolerate a wider variety of foods, including those with more fibre, texture, or variety.

Remission is also an opportunity to focus on nourishing the body with a balanced and varied diet. This may help support long-term health, maintain energy, and reduce the risk of nutrient gaps that can develop over time in people with IBD.

Why variety matters in remission

During remission, the gut is better able to handle different types of food. This is important because a varied diet supports the balance of bacteria in the gut, provides a wider range of nutrients, and may help keep inflammation stable over time.

Including sources of omega-3, such as oily fish, may be helpful. Omega-3 has been studied in IBD for its role in supporting the body’s response to inflammation, and some research suggests that regular intake may support long-term gut stability.

The role of fibre at different stages

Fibre is an area where advice often changes depending on disease activity. During a flare, high-fibre foods such as raw vegetables, nuts, seeds, and wholegrains may increase symptoms because they are harder to digest and can irritate the inflamed gut lining.

In remission, fibre becomes more important again. It helps feed beneficial gut bacteria, supports normal bowel movements, and may play a role in reducing inflammation over time. Gradually reintroducing fibre during stable periods, and choosing softer or well-cooked sources, can help the gut adjust without triggering symptoms.

Symptoms versus inflammation

It is important to remember that feeling well does not always mean inflammation is fully controlled, and having symptoms does not always mean a flare is starting. Symptoms can be influenced by many things, including stress, food choices, gut bacteria balance, and bowel sensitivity.

Equally, it is possible to have low-level inflammation without noticeable symptoms. This is why monitoring with your healthcare team, including regular blood tests or scans when needed, is important even during remission.

Practical takeaways

• During a flare, choose foods that are easy to digest, such as well-cooked vegetables, white rice, eggs, or smooth soups. Avoid raw or high-fibre foods temporarily.
• In remission, gradually reintroduce variety, including sources of fibre, healthy fats such as oily fish, and a wider range of fruit and vegetables.
• Keep a simple food and symptom diary if you are unsure which foods help or hinder at different stages.
• Stay in touch with your dietitian or IBD team. They can help tailor your diet to your current disease activity and nutritional needs.
• Remember that nutrition supports your treatment, but does not replace it. Medication remains the primary way to control inflammation in IBD.

Conclusion

Eating with IBD is not the same all the time. What works during a flare may be different from what supports your health in remission. By understanding how your gut changes at each stage, and adapting your diet accordingly, you can support your body while reducing unnecessary discomfort. Always discuss changes in symptoms or diet with your healthcare team, especially if you are unsure whether inflammation is active or controlled.

References

1. Hashash JG, Elkins J, Lewis JD, Binion DG. AGA Clinical Practice Update on Diet and Nutritional Therapies in Patients With Inflammatory Bowel Disease: Expert Review. Gastroenterology. 2024;166(3):521-532. doi:10.1053/j.gastro.2023.11.303

1. Scaioli E, Sartini A, Bellanova M, Campieri M, Festi D, Bazzoli F, Belluzzi A. Eicosapentaenoic acid reduces fecal levels of calprotectin and prevents relapse in patients with ulcerative colitis. Clin Gastroenterol Hepatol. 2018;16(8):1268-1275.e2. doi:10.1016/j.cgh.2018.01.036

1. Verma B, Manik KA, Verma S, et al. Dietary Strategies for Gut Barrier Integrity in Inflammatory Bowel Disease: The Impact of Fiber and Beyond. Cureus. 2026;18(1):e101355. doi:10.7759/cureus.101355

1. Opstelten JL, de Vries JHM, Wools A, et al. Dietary intake of patients with inflammatory bowel disease: a comparison with individuals from a general population and associations with relapse. Clin Nutr. 2019;38(4):1892-1898. doi:10.1016/j.clnu.2018.06.983

This article is intended for informational and educational purposes only. It does not constitute medical advice and should not be used as a substitute for professional medical guidance, diagnosis, or treatment.