Inflammatory Bowel Disease (IBD), including Crohn’s Disease (CD), is a lifelong condition that often requires dietary, medication, medical and sometimes surgical treatment.

Dietary manipulation plays an increasingly important role for managing Crohn’s Disease and IBD. There is a lot of information out there about the best diet for Crohn’s disease. Some dietary manipulations are backed by strong evidence, some not so much.

Here’s a breakdown of the key diets often discussed, what they involve, and what the research actually says.

1. Exclusive Enteral Nutrition (EEN)

What is it?
EEN involves consuming only a liquid enteral feed for 6–8 weeks, with no other food or drinks except water. This can be delivered orally or via a nasogastric tube, using nutritional supplements or enteral feed. Examples of these products are Modulen, Fortisip, or Ensure.

Does it help?
✅ Yes — the evidence is strong.
EEN is effective at inducing remission in Crohn’s Disease and promotes superior mucosal healing compared to steroids alone. It’s underused in adult populations despite strong evidence.

Supporting Evidence:

• A Cochrane meta-analysis (2018) found similar remission rates between EEN and steroid therapy (around 70%).
• Lomer et al. (2022) highlighted EEN’s benefits in inflammatory strictures and in reducing post-surgical infection risks.

Plant based consideration:

There are growing number of nutritional supplements that are now plant based. Which is great for making sure those following dairy free or vegan diets have options. However, it is important to note that the research surrounding EEN has been on nutritional supplements or enteral feed that was dairy based.

Therefore, we are not sure whether their plant-based equivalent would be effective at treating Crohn’s Disease flares.

2. Crohn’s Disease Exclusion Diet (CDED)

What is it?
CDED is a phased diet combining partial enteral nutrition with a whole-food exclusion diet. It limits red meat, emulsifiers, preservatives, and insoluble fibre.

• Phase 1: 50% enteral nutrition + 50% exclusion diet (6 weeks)
• Phase 2: 25% enteral nutrition + less restrictive exclusion diet (6 weeks)

Does it help?
🟨 Maybe — the evidence is promising.
RCTs suggest CDED may be as effective as EEN, though more studies are needed, especially in adults.

Supporting Evidence:

• Levine et al. (2019) found CDED equally effective as EEN in children.
• Yanai et al. (2022) showed CDED alone induced remission in 57% of adults, and 68% when combined with partial enteral nutrition.

Plant based consideration:

Similar to EEN, these studies have been done using dairy based nutrition supplements or dairy based enteral feed. Therefore, we do not yet know if the plant based equivalent would be effective.

3. Low FODMAP Diet

What is it?
A phased diet that limits fermentable short-chain carbohydrates (FODMAPs) temporarily, which can trigger IBS-type symptoms (bloating, diarrhoea, gas, and pain). It involves strict FODMAP elimination followed by gradual reintroduction to identify the individuals triggers.

Does it help?
❌ No — not for inducing remission in IBD.
The low FODMAP diet can help manage IBS symptoms in IBD patients not in active flare, and it does not induce remission.

This is useful for the IBD population that also have IBS, when not in a flare.

Supporting Evidence:

• Pedersen et al. (2017) found no significant difference in remission between the low FODMAP and normal diets in people with IBD.
  

4. Semi-Vegetarian Diet (SVD)

What is it?
This diet starts with 3-7 days of enteral nutrition, followed by the 1^st infliximab infusion.

A mostly plant-based diet that includes occasional fish and dairy (weekly), and minimal meat (fortnightly). This study was alongside infliximab treatment.

Does it help?
🟨 Maybe — more research needed.
One small-scale study suggest that semi-vegetarian diet in combination with infliximab can induce remission of Crohn’s Disease.  

Supporting Evidence:

• Chiba, M. et al. (2017) found that the combination the plant based diet and infliximab after 6 weeks, 94% of adults & 100% of children were in remission. Mucosal healing was seen in 46% of all cases

Plant based consideration:

Similar to EEN and CDED, this study started it with dairy based nutrition supplements or dairy based enteral feed. Therefore, we do not yet know if the plant based equivalent would be effective.

5. Anti-Inflammatory Diet

What is it?
A diet high in antioxidant-rich fruits and vegetables, omega-3 fatty acids (from fish, flaxseeds, walnuts), whole grains, and fermented foods, while limiting ultra-processed items and added sugars.

Does it help?
🟨 Maybe — early evidence suggests benefit.
One study supports its use to reduce inflammation and support symptom control, but its role in inducing remission remains under investigation.

Downsides to the study: Used in combination of IBD medications, small study size (24 people) and no comparison group.

Supporting Evidence:

• The only study (Olendzki. B., et al. 2014) shows improvements in symptom burden,  quality of life and potential reduction of IBD medications, but not yet definitive for remission induction.

Conclusion: What’s the Takeaway?

 Diet plays a crucial role in managing Crohn’s Disease and IBD, but its impact depends on the goal — whether it’s remission induction or symptom control. EEN remains the most evidence-based approach for active disease, while CDED shows promise, and other diets may support long-term health and symptom relief.

🌱 A Note for Plant-Based Eaters

Most studies on EEN, CDED, and semi-vegetarian diets use dairy-based nutrition drinks or supplements, so it’s unclear if plant-based versions would give the same results.

That said, plant-based diets are showing early promise for helping maintain remission — though the evidence is still growing. In many cases, diet is used alongside medication, and what works can vary from person to person.

If you’re plant-based and managing Crohn’s or IBD, you’re not alone — and with the right support, you can still make nutrition work with your values and your health.

Need help figuring out what’s right for your gut?

I offer 1:1 support for people with IBD who want evidence-based advice, not guesswork. If you’d like a personalised plan that fits your life (and your symptoms), book a free discovery call here

References:

1. Narula, N., Dhillon, A., Zhang, D., Sherlock, M. E., Tondeur, M., & Zachos, M. (2018). Enteral nutritional therapy for induction of remission in Crohn’s disease. The Cochrane database of systematic reviews, 4(4), CD000542. https://doi.org/10.1002/14651858.CD000542.pub3
2. Lomer, M. C. E., Wilson, B., & Wall, C. L. (2023). British Dietetic Association consensus guidelines on the nutritional assessment and dietary management of patients with inflammatory bowel disease. Journal of human nutrition and dietetics : the official journal of the British Dietetic Association, 36(1), 336–377. https://doi.org/10.1111/jhn.13054
3. Levine, A., Wine, E., Assa, A., Sigall Boneh, R., Shaoul, R., Kori, M., Cohen, S., Peleg, S., Shamaly, H., On, A., Millman, P., Abramas, L., Ziv-Baran, T., Grant, S., Abitbol, G., Dunn, K. A., Bielawski, J. P., & Van Limbergen, J. (2019). Crohn’s Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial. Gastroenterology, 157(2), 440–450.e8. https://doi.org/10.1053/j.gastro.2019.04.021
4. Yanai, H., Levine, A., Hirsch, A., Boneh, R. S., Kopylov, U., Eran, H. B., Cohen, N. A., Ron, Y., Goren, I., Leibovitzh, H., Wardi, J., Zittan, E., Ziv-Baran, T., Abramas, L., Fliss-Isakov, N., Raykhel, B., Gik, T. P., Dotan, I., & Maharshak, N. (2022). The Crohn’s disease exclusion diet for induction and maintenance of remission in adults with mild-to-moderate Crohn’s disease (CDED-AD): an open-label, pilot, randomised trial. The lancet. Gastroenterology & hepatology, 7(1), 49–59. https://doi.org/10.1016/S2468-1253(21)00299-5
5. Pedersen, N., Ankersen, D. V., Felding, M., Wachmann, H., Végh, Z., Molzen, L., Burisch, J., Andersen, J. R., & Munkholm, P. (2017). Low-FODMAP diet reduces irritable bowel symptoms in patients with inflammatory bowel disease. World journal of gastroenterology, 23(18), 3356–3366. https://doi.org/10.3748/wjg.v23.i18.3356
6. Chiba, M., Tsuji, T., Nakane, K., Tsuda, S., Ishii, H., Ohno, H., Watanabe, K., Ito, M., Komatsu, M., & Sugawara, T. (2017). Induction with Infliximab and a Plant-Based Diet as First-Line (IPF) Therapy for Crohn Disease: A Single-Group Trial. The Permanente journal, 21, 17–19. https://doi.org/10.7812/TPP/17-009
7. Olendzki, B. C., Silverstein, T. D., Persuitte, G. M., Ma, Y., Baldwin, K. R., & Cave, D. (2014). An anti-inflammatory diet as treatment for inflammatory bowel disease: a case series report. Nutrition journal, 13, 5. https://doi.org/10.1186/1475-2891-13-5