8 Tips for Eating Out With Crohn's Disease

Crohn's disease is an inflammatory bowel disease that recurs unpredictably and has no cure.It can lead to uncomfortable symptoms like diarrhea, abdominal pain, rectal bleeding, fever, weight loss, and fatigue.

If you have Crohn's disease, you probably already know all that. You also are likely aware that you must be picky about what you put in your mouth because eating trigger foods can cause or worsen your symptoms. Choosing the right dish can be challenging when you go out to eat —particularly if you're flaring.

"Crohn's patients have anxiety about eating, period," said Tamara Duker Freuman, a registered dietitian in New York specializing in digestive disorders. "But, when you're not in your own home and bathroom, it can cause a lot of anxiety."

However, if you feel up for eating out, check out these eight tips to make the most of your dining experience.

Pick Your Meal Before You Go

If you're planning a meal out, check out the menu before you go. Search online for the restaurant menu. Or, if you live in a metropolitan area, check out menupages.com. And don't be shy about calling the restaurant.

"It's exactly the same thing that people with food allergies do," explained Martha Rosenau, a Colorado Springs, Colorado, registered dietitian and owner of Peak Nutrition.

Many restaurants will modify their dishes—swap heavy cream for low-fat milk in their soup or mashed potatoes, for example—especially if you ask them beforehand. (Tip: Keep foods to avoid in mind when asking for swaps.)

If you're in remission, the Crohn's and Colitis Foundation suggests focusing on these foods:

• Fiber-rich foods such as oat bran, beans, nuts, and whole grains (but check with your healthcare professional first if you've had surgery or complications)
• Protein like lean meats, fish, eggs, nuts, and tofu
• Fruits and vegetables (colorful ones), with the peel and seeds removed if they bother you.
• Calcium-rich foods such as collard greens or yogurt, kefir, and milk (if you can tolerate dairy)
• Food with probiotics like yogurt, kimchi, miso, sauerkraut, and tempeh

If you are having a flare-up, the foundation suggests these instead:

• Low-fiber fruits like bananas and melon
• Lean protein, including fish, lean cuts of pork, white meat poultry, soy, eggs, and firm tofu
• Refined grains such as sourdough, potato or gluten-free bread, white pasta, white rice, and oatmeal
• Fully cooked, seedless, skinless, non-cruciferous vegetables like asparagus tips, potatoes, and squash
  

Keep It Simple To Avoid Triggers

Although everyone tolerates food differently, certain food groups are common problems: dairy products, deep-fried or fatty foods, high-fiber foods, and some raw fruits and veggies. Caffeine and alcohol also increase your risk of a flare.

Simpler foods like white bread, bananas, white rice, and white meat like poultry can be easier to tolerate. Consider sandwiches with lean meat like turkey and avocado instead of lettuce and tomato. Or, you might try well-cooked foods like mashed potatoes, rice, and veggies.

Chain restaurants with extensive menus are more likely to offer something you can eat.

Look for a restaurant with a lot to choose from.

Skip Spicy Cuisines

People with Crohn's tend to tolerate some cuisines better than others.

Spicy foods like a hot madras curry or jalapeno-loaded chiles toreados may not go down as well as blander meals. And because steakhouses focus on fatty red meat, which can be a trigger, they may not be the best option.

However, Japanese food like miso soup, sticky rice, or salmon can be good choices. So can restaurants that offer other types of soup, a warming comfort food.

Freuman suggested figuring out what agrees with you.

"Eat to your limit of tolerance for quality of life and also for nutrition," Freuman said.

Fast Food Is an Option

Sometimes, food that can be helpful to a Crohn's flare-up seems counterintuitive. A case in point: fast food.

Some research indicates that during a flare-up, people do best with simple foods like white flour, white meat, and cooked potatoes. Many fast food chains offer those in spades. There are some downsides: Fast food fare can be high in fat, sometimes trans fat, and pack many calories per square inch of food.

That said, Stephen Hanauer, MD, professor of medicine at Feinberg School of Medicine in Chicago, didn't object to it during a flare-up.

"It gives you the calories you want, and it's tasty," Hanauer said.

However, Hanauer pointed out that high levels of fat may aggravate symptoms. For lighter fare, try chains that allow you to choose lower-fat ingredients, such as made-to-order sandwiches or burrito shops.

Bring A Friend (or Several)

Grabbing lunch or meeting for dinner is often the best chance to catch up with friends and family. You don't have to miss out just because you don't feel well enough to eat a full meal.

Plus, socializing has many health benefits, including getting sick less frequently.

"Even if you just went and had a hot tea or a glass of juice or chicken broth, you can be with the people you want to be with," Rosenau said. "Just be there for the sheer enjoyment of each other's company."

Rosenau recommended carrying some granola or a bottled nutrition shake in case you get hungry. Also, consider having a bite beforehand.

Spend Less Time Waiting

Simple steps like going to a restaurant outside peak lunch and dinner times can make dining out less stressful. And research has found that stress can trigger abdominal pain and flare-ups in inflammatory bowel diseases such as Crohn's. It's best to avoid it if you can!

See if your friends or family could meet for a late lunch or early dinner. You'll probably have more control over how long you wait and spend in the restaurant. You might also consider asking for a table near the bathroom because flares can make your need to go unpredictable.

Be Mindful, Try To Relax, and Enjoy Your Meal

As mentioned, managing stress is critical to managing Crohn's. Being as relaxed and stress-free as possible helps you better digest your food. (So will chewing your food well).

Having a positive attitude about eating is an excellent way to begin. So is practicing mindful eating. Mindful eating is eating while being in a state of non-judgmental awareness, shifting one's attention to the food and mind-body connection.

The American Heart Association offers the following tips for mindful eating:

• Ponder: Before you eat, ask yourself how hungry you are.
• Appraise: When your food is in front of you, take a moment to appreciate how it looks and smells.
• Slow: Slow way down and put your fork down between bites. Really chew your food and taste it.
• Savor: Enjoy your food. How does the texture feel in your mouth? What are all the complex flavors you can taste? Take a moment to savor the satisfaction of each bite.
• Stop: Stop when you're full. You may avoid unnecessary calories and indigestion by noticing when you're full and stopping.

Be a Regular

Finding restaurants with good food, reasonable prices, and a friendly atmosphere can be challenging. It can be an even taller order if you have dietary restrictions because of Crohn's disease. Once you find one that you enjoy and makes you comfortable, don't hesitate to suggest going back.

"Just finding the restaurant that works for you is a great strategy," Rosenau said.

Some restaurants might even show you their appreciation for being a regular by remembering your preferences or offering discounts and special dishes. And it's an excellent way to establish a relaxing routine you can enjoy with friends and family.

A Quick Review

Going out to eat when you have Crohn's or another inflammatory bowel disease can be challenging. That's because the chronic condition can cause flare-ups with uncomfortable symptoms such as abdominal pain or frequent running to the restroom.

Some strategies to make eating out easier include learning what foods to eat in remission and during a flare, checking out the menu before you go, going during a less busy time, and focusing on the experience.