4 Keys to Managing IBD

by Elizabeth Roberts Patient Expert

If you have IBD, then you know there is no quick fix, nor is there a one-size-fits-all treatment plan. But, in the nearly 20 years that I've been living with IBD, writing about it, and working with other IBDers in my cooking and nutrition career, I've realized that in addition to medical intervention there are 4 Keys to Managing IBD:

Adequate Sleeroper Hydratiotress Managemenourishing DieDEQUATE SLEEP means you should be getting at least 8 hours of restorative sleep every night. Simply put, your body (and that includes your gut) cannot and will not heal without enough sleep. This is when cells regenerate, energy is stored, and healing takes place. Adequate sleep is not an option for a person living with IBD, it is a medical necessity, like a medication prescribed by your doctor.

To prepare for sleep, turn off your computer, TV, and cell phone a minimum of one hour before going to bed. This allows your mind to become quiet and your body to relax. Drinking a cup of chamomile, valerian, or passionflower tea can help to calm and relax you. Practice deep breathing to help you relax and fall into a restful sleep.

HYDRATION, and by that I mean water, fruits and vegetables, and non-caffeinated tea, are necessary to keep the cells in the body working properly. Since our body is nearly 70 percent water, we need to drink (and eat) an adequate amount of water each and every day. Water also helps to flush toxins from body tissues and prevent further health issues.

The general rule of how much we should drink is found by dividing your weight in half. This is how many ounces of water you should drink each day. For example, if you weigh 120 lbs., divide by two, and that equals 60 ounces of quality, non-caffeinated fluids you should drink each day.

While water is the main source for hydration, there are a number of fruits and vegetables that are high in water content as well. These include: grapefruit, cucumber, celery, radish, tomato, carrot, cantaloupe, bell pepper, cauliflower, watermelon, spinach, strawberry, and broccoli.


Stress can be felt or experienced on four levels: physical, environmental, emotional, and spiritual. Stress from all these levels is cumulative and it is very helpful to reduce or remove the largest sources of stress, whether they be at the physical, environmental, emotional, or spiritual levels. Physical and environmental stress can come at us as illness, toxins in air, food, perfumes, noise, etc. Emotional and mental stressors seem the most pervasive coming at us from family, work, friends, traffic, email, cell phones, and the like. While we cannot control all stress in the fast-paced, smart phone crazed, hectic world in which we live, we can attempt to control our own thoughts and behaviors and, therefore, how we react to stress.

Mental stress is one of the greatest challenges to the immune system. So, for us IBDers, learning to manage stress is not an option, but mandatory treatment for healing and optimal health to take place.

Three things you can do to lessen stressors include:

  • change your situation

  • change yourself and/or your mindset to adapt to the situation

  • leave the situation

Also know that some stress is okay, even beneficial (feeling nervous before a meeting or event, for example). It's when stress becomes overwhelming and all-encompassing and doesn't leave that the body reacts and breaks down.

Learning the skill of 'reframing' is also beneficial. Reframing teaches us to look at a situation or person that we cannot change in a different way or from a different viewpoint. It alters not only how you see something, but also how your body responds to it. Realizing life is not black or white, right or wrong, provides a lot of gray space and more options.

Learn to relax. This can be achieved most easily by learning belly breathing or rhythmic breathing. These teach us how to slow down our breath, which can help us to relieve tension and stress. This can also help us to unwind before going to bed.

Learn to have and enjoy unstructured time (this includes vacations) in your life, by yourself or with non-stressful friends and family.

Laugh every single day. This is one of the best stress relievers we have. It's easy, free, and it is contagious.


There seem to be two camps when it comes to food and IBD. One camp says food has no effect upon IBD and its outcome. The other camp says different foods do have a positive effect on IBD symptoms.

If you've read my previous posts then you know I'm from camp two. For the first 10 years I lived with IBD, I didn't pay much attention to what I ate. But when my symptoms got worse, not better, and I was at the maximum dosage of the medication I was taking and was still living in my bathroom and had lost my job, is when I decided changing my diet simply couldn't hurt. Five years later I have a new career, I sleep in my bed instead of on the bathroom floor, I take a small maintenance dose of medication, and I'm back to living my life much as it was before IBD.

I won't tell you which diet is right for you. But I will suggest that every IBDer should seriously look into:

There are plenty of support groups for each of these on Facebook, private internet websites, and the like. There are people who have eaten according to the diets and say they are healed. There are many, many more of us who live a virtually symptom-free life, and there are those who experience a lessening of symptoms with infrequent flares.

The one thing I do know is that if you have IBD you may also have leaky gut, which leads to malabsorption, which can lead to malnutrition. Without proper, healthy foods it is nearly impossible for the body to heal. And the typical standard American diet (SAD) just isn't going to do the job at helping to heal a leaky gut so you can properly absorb nutrients so you don't get sicker from malnutrition.

I eat according to the SCD diet. When I started this new lifestyle, just looking at a green vegetable set my gut into a flare. And healing my gut took time and patience and dedication. Now, 3+ years later nearly 75% of my daily food intake is made up of fresh vegetables and fruit, some of those leafy, green, and raw. I have more energy and focus, and I live my life without thinking about where the next bathroom is.

But, even if one of these diets doesn't seem right for you, do try to eat more nourishing whole foods and fewer processed, boxed, and fast foods. Your gut will thank you for it.

Elizabeth Roberts
Meet Our Writer
Elizabeth Roberts

Elizabeth wrote for HealthCentral as a patient expert for Digestive Health.