What to Drink and What Not to Drink With Crohn-s Disease (2024)

Herbal tea may help you stay hydrated, but make sure it contains little to no caffeine.

Proper hydration is important for everyone, and even more so when you have an inflammatory bowel disease (IBD) like Crohn's disease. “Hydration is especially important for people with Crohn’s disease who are having active bowel movements or diarrhea and are losing fluids more quickly than others,” says Randy Longman, MD, PhD, a gastroenterologist and an assistant professor of medicine in the Jill Roberts Center for Inflammatory Bowel Disease at Weill Cornell Medicine and NewYork-Presbyterian Hospital in New York City.

Most guidelines call for at least eight glasses of water or fluids a day for adults to stay adequately hydrated. But all fluids aren’t created equal: While some beverages are clearly good or bad for Crohn’s, how you react to other drinks may vary.

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Soda Just Isn’t Good

Even if you don’t mind the taste of diet soda, you might be better off choosing a different beverage to quench your thirst if you have Crohn’s. “Patients have complaints about bloating and abdominal discomfort,” says Keith Sultan, MD, the director of the inflammatory bowel disease program at Northwell Long Island Jewish Medical Center. “The carbonation and artificial sugars are notorious for causing cramps, bloating, and diarrhea.”

But Dr. Sultan notes this depends on the patient, as some may drink soda without any problem. If someone is looking for an alternative, drinks with electrolytes are good and will hydrate the body better. Just try to avoid those with artificial sweeteners.

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Water Is the Most Hydrating

It may not sound exciting, but the best hydration when you're managing Crohn’s disease is H₂O. There’s no other beverage that will work harder to help you overcome the negative effects of Crohn's symptoms, experts say. This is especially true when diarrhea strikes and you become dehydrated.

Sultan says people with Crohn’s should drink pretty much the same amount of water as any other person, which some experts claim is at least 2 liters, or 8 cups, a day.

The key is to pay attention to your body’s needs. Typically, if you go to the restroom and your urine is a dark yellow, you should drink more water.

“Don't feel like you need to force yourself,” explains Sultan. “There's no specific volume recommendation per patient. We may encourage a [certain] fluid intake depending on the patient's disease status, like flaring or diarrhea.”

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Coffee Has Its Pros and Cons

Coffee has both a good and bad rep across health conditions, but for people with Crohn’s, research remains unclear. So much so, that a study in the February 2021 Inflammatory Bowel Diseases found that coffee had little to no association with Crohn’s disease, though even those results were inconsistent.

In either case, the high amount of caffeine in coffee can aggravate certain unpleasant Crohn's symptoms.

But some people with Crohn’s tolerate coffee in small doses, such as a morning cup. “I think it’s fine for people to have their morning coffee,” Dr. Longman says. “I usually recommend hydration of 'one to one.' So if you’re going to have one cup of coffee, have at least 8 to 12 ounces [oz] of water to rehydrate from that coffee, since it’s clearly a diuretic.”

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Meal-Replacement Drinks May Help if You Need Nutrients

If you’re having difficulty maintaining weight, a characteristic trait of Crohn’s disease, a good meal-replacement shake will have the concentrated nutrition you need. "Make sure the product is free of lactose, fructose, inulin (a type of carbohydrate fiber), and sugar alcohols [sorbitol, maltitol, xylitol],” advises Patsy Catsos, RDN, a nutritionist and author in Portland, Maine. "Commercially prepared shakes can be very helpful, either as meal replacements or between meals to increase calorie and protein intake.”

One of the challenges during a flare-up is keeping any food, and its nutrients, in your body long enough to derive any benefit. Meal-replacement drinks may help with this.

“If somebody can't eat real food, we want to get them nutrition,” says Danielle Gaffen, RDN, an IBD dietitian. “[We do] whatever we can do to prevent malnutrition through a flare-up, because if someone stops eating, their body doesn't have the nutrients to fight off what's going on.”

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Fruit Juices Can Worsen Symptoms

Though seemingly healthy, juices are often loaded with sugar — natural and added — which can be a real problem.

“Drinking beverages high in concentrated sugar, like sports drinks, can absolutely make flare-ups worse,” says Gaffen. “Even sugar-free drinks can have additives like aspartame that I would watch out for.”

Gaffen does suggest looking into oral rehydration solutions instead, which has the correct mixture of water, sugar, and salt to keep a person hydrated. There are recipes online for how to make these drinks at home, and you can flavor them with diluted fruit juice if you still need a little juice your life.

And that's okay, according to Sultan. As with most liquids, each person will have a different response to juice. The best hydration solution will be low in sugar and contain some electrolytes.

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Coconut Water Can Help With Hydration

After a bout of severe diarrhea, a common Crohn’s symptom, you may need a little more than just plain old water. Coconut water contains electrolytes such as potassium, sodium, and manganese, but has the consistency of water, is low in calories, and has just a hint of coconut flavor.

If you’re looking for other electrolyte beverages, avoid those sweetened with high fructose corn syrup or crystalline fructose, or those with artificial coloring. Talk to your doctor if you’re concerned about dehydration.

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Milk and Milk Alternatives Have Benefits

While milk provides protein and essential vitamins and minerals, it may aggravate Crohn’s symptoms if you have small-bowel Crohn’s disease. Sultan says to be careful, because what seems like a Crohn’s flare-up may actually be something else.

“The most common recommendation, particularly for those who are admitted to the hospital, is that we'll put them on a lactose-free diet,” says Sultan. “But there is no proof that lactose worsens inflammation. In patients who are sick, we find out they either have or are developing lactose intolerance.”

The answer seems obvious: Remove dairy and replace it with dairy-free alternatives. But removing dairy removes calcium, which is vital for good nutrition.

“When we make plant-based swaps for dairy products, we make sure they are fortified with calcium,” says Gaffen. “My oat milk even says that it has 50 percent more calcium in a serving than normal milk — plant-based stuff can be helpful.”

If a person with Crohn’s needs more protein in their diet and is looking for a cow's milk substitute, Gaffen recommends soy milk. Just keep track of what you are drinking and what makes you feel best.

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Herbal Teas May Soothe the Digestive System

As with coffee, decaffeinated teas and other beverages in general are the way to go, says Gaffen.

That’s because even low-caffeine tea like white tea may cause symptoms. Green tea has anti-inflammatory properties, but can still stimulate the gut because of its caffeine content, she says.

“I typically recommend herbal teas to Crohn’s patients,” she says. “Chamomile tea can be calming. If someone is experiencing nausea as a symptom, an herbal ginger tea might be soothing. Peppermint tea gets two thumbs up.”

As with everything else, it really depends on the person.

“If someone's feeling fine, it’s okay to have the white tea or even green tea,” she says. “But for some, why risk it?”

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Alcohol May Be Okay — in Moderation

Alcohol isn’t completely off the table if you have Crohn's disease, but you need to practice moderation to ensure that you don’t exacerbate your symptoms, as alcohol can have a significant impact on the disease, according to a study in the May 2021 Gastroenterology & Hepatology. This is due to sugar and sulfates contained in alcohol that can inflame the microbiome and disrupt the intestinal barrier.

Experts ultimately want people to listen to their bodies and drink accordingly.

"Limit to one drink per day or less," says Catsos. "Some individuals find that any amount of alcohol irritates their GI tract."

Longman recommends drinking one glass of water for every alcoholic beverage consumed. He also warns that alcohol may interact with certain medications that treat Crohn’s disease, particularly some antibiotics. “It’s important to check your medication list and review with your doctor to make sure that it’s safe to use alcohol,” he says.