Smart Swaps: A Guide to Crohn’s-Friendly Food Textures

With Crohn’s disease, you’re likely aware that it’s crucial to get adequate nutrients from whole foods to support your health. But sometimes during a flare or when you have strictures (narrowing) of the digestive tract, it may seem impossible to eat certain foods or textures without making symptoms worse.

“When foods are well-cooked, blended, ground, pureed or finely milled, they no longer have the same mechanical effect in the gut,” says Kristen Nicolai, RD, a registered dietitian at Mount Sinai in New York City. “This allows patients to incorporate a wider variety of foods in their diet, in a way that is safe and comfortable for them.”

Find out which food swaps you can try when your inflammatory bowel disease (IBD) symptoms are exacerbated and how to include modifications in your diet.

Common Triggers and Smart Swaps

When your Crohn’s symptoms are worse than usual and certain foods or textures are making things harder, try the following expert-recommended swaps.

1. Swap Raw Pear Slices for Skinless Baked Pears

But sometimes, the insoluble fiber content of pears can be too much for your digestive system. “Skins of fruits and vegetables can irritate the walls of the colon, which can worsen symptoms by increasing urgency or frequency of bowel movements,” Nicolai says.

If you want the benefits of pectin, but even peeled pears aren’t well tolerated, apples contain pectin as well. “Consider swapping [pears] for [baked] apples [or] applesauce,” says Courtney Schuchmann, RD, a registered dietitian in the department of gastroenterology, hepatology, and nutrition at University of Chicago Medicine. “Some patients with Crohn’s who have strictures or are at risk of obstructions have to be extra cautious.”

2. Swap Roasted Cashews for Cashew Nut Butter

But even softer nuts like cashews can be tough to digest when you have active inflammation or strictures. “Nuts in their whole form can have large hard pieces, which can be physically abrasive on the GI tract and brush up against the lining of the gut, causing more irritation,” Nicolai says.

But swapping a snack of roasted cashews for something like cashew butter on sourdough toast can make digestion easier. “These have the exact same amount of fiber, but the texture is smooth, which helps improve tolerance,” says Schuchmann. “Try other nut [or] seed butters [like] peanut butter, almond butter, [or] tahini if you find one version easier to tolerate than another. Each nut and seed provides slightly different micronutrients, which is why it is helpful to aim for a variety.”

3. Swap a Salad With Raw Leafy Greens for Pureed Soups

“Finely chopped leafy greens like spinach and kale are great to add to soups to increase fiber, vitamin K and iron intake,” says Schuchmann. “If needed, you can blend these vegetable soups to create a smooth texture, which is sometimes easier to tolerate. Green leafy vegetables also are a great addition to smoothies or blended into vegetable sauces for pasta.”

Whether you use an immersion blender, a regular blender or a food processor, the benefit is the same. “The smaller particle size of fiber found in pureed or blended foods requires less work for our digestive system to break down,” Nicolai says.

4. Swap Roasted Chickpeas for Hummus

Breaking down the chickpeas’ fiber mechanically to make hummus can make them even easier to digest. “Blend[ing] them into dips like hummus are a great way to incorporate these if you have difficulty tolerating whole beans [or] lentils,” Schuchmann says. “Try serving them with roasted carrots or peeled cucumbers for an additional fiber boost.”

5. Swap Raw Carrots for Roasted Peeled Carrots

Before you put the carrots in a roasting dish, make sure to peel them. “Skins can contain rough insoluble fiber, which is harder to break down,” Nicolai says. “Removing the skins of vegetables removes the larger particle size.”

The nutrients in roasted, peeled carrots make them more than just a side dish. “Carrots are a great source of fiber and vitamin A,” says Schuchmann. “Roasting them softens the texture of the fiber, which makes them easier to tolerate. Serve roasted carrots cold alongside dips, or serve warm with a drizzle of tahini for an addition[al] fiber and nutrient boost.”

Smart Swaps in Action: Practical Tips

Now that you know how to make potentially bothersome food textures more digestible, how can you integrate them into your diet when necessary?

Start Simple

Go slowly when you begin incorporating modified textures. “Not everyone with Crohn’s needs to avoid rough textures, but those with active symptoms, inflammation or risk of obstruction should start with limiting or avoiding high roughage [fiber] foods and swapping for more gentler, softer textures,” Nicolai says. “Giving your GI tract a rest is an important step in the healing process so it may be important to temporarily eliminate these coarse textures, so your gut doesn’t have to work harder.”

You might also remind yourself that things won’t always be this way. “Once you no longer have active symptoms or inflammation, you can cautiously reintroduce these textures if you don’t have any strictures or risk of obstruction,” Nicolai says.

Dining Out Strategies

Eating out may be an unlikely prospect when your digestion is compromised. Even so, there may be times when you decide to join friends or family at a restaurant, especially if it’s a special occasion.

When you’re symptomatic, it can help to find restaurants that serve Crohn’s-friendly textures. “Mediterranean restaurants may be more likely to have Crohn’s-friendly textures on the menu,” says Nicolai. “[L]ook for restaurants that offer lean sources of protein such as chicken, fish, or eggs, simple starches, or cooked vegetables. Look for menu items with simple ingredients that you already know are well tolerated, and take into account how the food is prepared.”

That means also avoiding fried or fatty foods, if they make your symptoms worse. “During a flare, be cautious of menu options that list words such as ‘crispy,’ ‘fried’ or ‘crunchy,’” Nicolai says. “Instead, look for items that are baked, broiled, steamed, grilled, poached, or sautéed.”

A little planning can go a long way. “Many restaurants now list their menus on their websites, so it’s always a good idea to look at the menu online when researching options,” Nicolai says. “You can also call the restaurant ahead of time to ask questions about menu items and see if they can make any substitutions for you. While dining out, you may also speak with the staff and inquire about modifications.”

Most restaurants should understand that certain medical needs require accommodations. “Letting the waiter know you have a medical condition and can't have certain foods is perfectly acceptable, and most restaurants should be willing to accommodate,” she says. “Don't be afraid to advocate for yourself and ask for what you need.”

A Day of Smart Swaps: Your Blueprint

Understanding how to modify individual dishes is great, but what about creating whole meals? Here’s what experts recommend.

Breakfast: Swap Steel-Cut Oats With Berries and Almond Slivers for Quick Oats With Berry Jam and Almond Butter

Fiber-rich berries with potentially abrasive seeds can be hard to handle at breakfast when digestion is limited. The rest of this meal can be tough, too. “Quick oats are more processed than steel-cut oats and therefore will be much more easily digested due to their smaller particle size,” Nicolai says. “Almond slivers are harder to digest and will require more effort, including more chewing and gut motility to break them down, when compared to a smooth, creamy almond butter.”

Lunch: Swap Roasted Shrimp Atop Lentil Salad for Baked Tuna Cakes and a Bowl of Pureed Lentil Soup

Both the protein and the fiber in this meal are less than ideal for someone facing digestive difficulty. “Chewy shellfish such as shrimp can be difficult to break down, and may worsen symptoms or increase [the] risk of obstruction in someone with a stricture or narrowing, and should be swapped for a softer protein,” says Nicolai.

“Whole beans are high in insoluble fiber,” she says. “During a flare, it may be harder to break down these components and may worsen symptoms. Therefore, whole beans may be swapped for bean purees to provide a softer, gentler texture for easier digestion.”

Dinner: Swap Whole-Wheat Pasta With Blistered Whole Cherry Tomatoes for Refined-Grain Pasta With Tomato Sauce

In this scenario, exchangin whole-wheat pasta for regular pasta made with refined grains will improve tolerability, Nicolai says. And using tomato sauce made with peeled tomatoes and no seeds instead of blistered cherry tomatoes with skin reduces the insoluble fiber content, making it less likely to exacerbate symptoms.

Snack: Swap Whole-Grain Crackers and Whole-Milk Cheese for Refined-Grain Crackers and Low-Fat Cottage Cheese and Spices

When it comes to grains, it’s hard to digest them whole when Crohn’s symptoms are triggered. “Ritz or rice crackers or rice cakes provide lower roughage and a gentler swap,” says Nicolai. “A whole-grain cracker may include coarse whole grains that may have intact or large particles that may irritate the gut.”

The kind of spices you top your snack with matter, too. “If a [spice] blend includes seeds, I would also avoid [it] when a patient is following a texture-modified diet,” Nicolai says.