The Ultimate Guide to Managing Inflammatory Bowel Disease (Crohn’s and Ulcerative Colitis) with AIP

An overwhelming percentage of our audience is currently managing one of the long list of symptoms that fall under the Inflammatory Bowel Disease (IBD) umbrella. For some, this is their only autoimmune condition, and for others, it accompanies other diseases affecting different areas of the body. Either way, it’s prolific in the autoimmune world.

Luckily, the AIP has been shown (now in a medical study!) to have a remarkable impact on the symptoms of IBD. Today, we’re giving the floor to Alexa Federico of the blog Girl in Healing to share with you a detailed overview of exactly what constitutes IBD, it’s common treatments, how the AIP can help, and a long list of resources and community groups for you to find solidarity as you manage your symptoms. There is some fantastic information in this blog post and we’re so grateful to Alexa for putting it together for you!

For folks who want to learn more, Alexa recently published a wonderful book, The Complete Guide to Crohn’s Disease & Ulcerative Colitis: A Road Map to Long-Term Healing which is now available on Amazon! Check it out here.

The Inflammatory Bowel Diseases (IBD)

Inflammatory bowel disease or IBD, is a complex autoimmune condition and is the overarching name for Crohn’s disease and ulcerative colitis. Sometimes Crohn’s and colitis are viewed as just having a “bad stomach” or general IBS. However, like all autoimmune diseases, there is a lot going on in the body with mixed signals between cells and chronic inflammation. Caring for a body with IBD takes an individualistic approach. Every case of IBD will have different signs, symptoms, reactions to treatments, and therefore, a tailored healing regimen.

The Differences Between Crohn’s Disease and Ulcerative colitis

Crohn’s disease can occur at any point in the gastrointestinal (GI) tract and it may skip some parts of the bowel lining, leaving some parts of the intestine healthy and disease-free. Ulcerative colitis occurs only in the large intestine (aka the colon) and doesn’t skip parts of the colon, so there are no disease-free parts amidst the inflammation.

Common Treatments for IBD

To date, there are different types of medications used to treat IBD. Depending on the severity and where the disease is will be taken into account for anyone who may need a pharmaceutical support.

The main types of treatment for IBD are:

Biologic drugs (aka anti-TNF agents, which block a protein called TNF-alpha, that creates inflammation in the bowels) – These include adalimumab, certolizumab pego, golimumab, infliximab, infliximab-dyyb, natalizumab and vedolizumab.

Immunomodulators (weaken the immune system to down regulate the inflammatory response) – These include azathioprine, 6-mercaptopurine, cyclosporine A, tacrolimus, and methotrexate.

Corticosteroids (powerful, fast-acting, usually short-term drugs) – These include prednisone, methylprednisone, hydrocortisone, and budesonide.

Antibiotics (used in acute situations of infection) – These may include Metronidazole (Flagyl), Ciprofloxacin (Cipro), and Amoxicillin.

Aminosalicylates (help with maintaining remission and preventing relapses) – These include sulfasalazine, mesalamine, olsalazine, and balsalazide.

IBD and the Efficacy of AIP

Many of us with IBD have faced backlash from our doctors who are not particularly supportive of diet changes to manage our conditions. We can now present them with the first ever study on AIP and IBD patients, involving our very own Angie Alt!

I feel incredibly grateful that there was (a) a study done on AIP for autoimmune disease and (b) that it was for IBD! In this study, a group of adults with active Crohn’s disease or ulcerative colitis were guided through the AIP elimination phase over six weeks and were followed for five weeks as a maintenance phase. Not surprisingly, the results supported the use of the AIP diet for IBD! Out of the 15 participants, 11 achieved clinical remission (73%) by week six and they maintained remission throughout the maintenance phase of the study as well.

I have personally used food as medicine as a long-term strategy for managing my Crohn’s disease. While I wasn’t aware of AIP when I was diagnosed in 2007, I found a practitioner to work with who uses nutrition to improve all kinds of illnesses, and that is when I finally started to see improvement in my condition.

There are more people like me with stories of using a nutrient dense template to heal from IBD. There is Stella, who suffered for 10 years with Crohn’s misdiagnosed as IBS. Stella and I had similar circumstances; we both suffered from diarrhea, weight loss, arthritic pain, and were very close to having surgery. Stella utilized the best of modern medicine (a temporary steroid) and a real food diet on AIP to put her IBD symptoms into remission, avoiding the need to continue a long-term drug.

And Brandi, who suffered from digestive dysfunction for years and was later diagnosed with Crohn’s disease. Brandi turned to holistic ways of healing early on, but faced bumps in the road dealing with H. pylori, Epstein Barr virus, and Salmonella. She went through different diet modifications to heal her gut and as well as supplements and drug therapies like antibiotics when SIBO had to be addressed. Brandi is able to fulfill her love of traveling and teach other people how to cook!

Special Considerations

It’s wonderful that a nutrient-dense protocol like AIP can have such beneficial impacts on those of us with IBD. Just keep these circumstances in mind as you are going through the protocol that might need extra attention.

  • Too much fiber can be irritating to an inflamed gut. When it comes to fruits and veggies, start slow and small. Gauge how your body deals with a little bit of raw produce. Increase it a little bit if you feel fine. Decrease it for now if it causes digestive distress. Fibrous foods are more easily digested when they are cooked, so cooked and/or pureed vegetables are a safe way to go. Additionally, make sure you are eating a high-quality fat to increase nutrient absorption from those veggies!
  • Inflammation impairs digestion and absorption, so even though you may feel like you’re eating loads of nutrient dense foods, it’s likely that you aren’t absorbing all that they have to offer. This is when supplementation may be necessary. It’s important to always work with a practitioner to determine what supplements your body needs and to use high-quality supplements in their most easily absorbed forms.
  • Weight loss and maintaining weight can be very difficult for those struggling with impaired absorption and diarrhea. This may be a circumstance when an early reintroduction may be necessary, such as introducing white rice sooner than suggested, for example.

Where to Connect

We know the power of connection with other people is so important, especially when dealing with autoimmune conditions. The IBD community is growing every day, in person and online!

Facebook Groups to Join

IBD Bloggers

These folks are putting their own spin on nutrient dense foods and living well with autoimmune disease. (Note: Not all recipes are AIP elimination phase compliant, so always double check and modify to your needs.)

Support Groups

Camp Oasis

  • Camp Oasis is a co-ed summer camp for children with IBD to hang out together and just be kids!

Additional Resources

Make an Impact

Cure for IBD

Looking to make a monetary contribution to support IBD research? Cure for IBD is a remarkable foundation you may want to consider supporting. The founder, Chris Pedicone has an inspirational story for starting Cure for IBD.

Chris’ son was diagnosed with Crohn’s in 2011 when he was just 11 years old. Chris was determined to get closer to a cure and dove right into all the fundraising efforts he could get his hands on including runs, cycling, and even triathlons. It became a family affair.

However, they wanted every penny of their efforts to go to researching for a cure. They were unable to find a foundation that was doing that, so they started their own and Cure for IBD was born! It is 100% run by volunteers and is Chris’ full time job. They encourage people to raise money and never place minimum requirements. They also provide the option for fundraisers to choose the IBD research center or hospital to fundraise for as a way to give back to a place that has helped them.

As of January 2016 over $600,000 was raised by Cure for IBD that went directly to research for a cure!

The Crohn’s & Colitis Foundation

The Crohn’s & Colitis Foundation hosts several ways to fundraise for IBD.

There is no single path to healing. But together, with the foundation of a nourishing diet, appropriate lifestyle changes, and medications when necessary, a healthy, fulfilling life with IBD can be achieved!

Let me know, have you implemented AIP for your Crohn’s or ulcerative colitis? What other healing strategies have you found helpful? Reply in the comments!

Want to learn more about IBD and how to manage it successfully with diet and lifestyle? Check out Alexa’s wonderful book, The Complete Guide to Crohn’s Disease & Ulcerative Colitis: A Road Map to Long-Term Healing which is now available on Amazon! Check it out here.

About Alexa Federico

Alexa Federico is the blogger behind Girl in Healing, a website committed to providing real food based recipes and resources for the IBD community. She is the author of “The Complete Guide to Crohn’s Disease & Ulcerative Colitis: A Road Map to Long-Term Healing,” available on Amazon. She is a Nutritional Therapy Practitioner and Certified AIP Coach working with clients online who have Crohn’s, ulcerative colitis, and other digestive and autoimmune conditions.


  • Kathleen Kennedy says

    Thanks for this great post. I have Crohn’s Disease and, after a severe flare in March compounded by acquiring a C.Diff. infection in the hospital, I have embarked on the AIP diet as I continue my recovery. I am also figuring out medication changes with my doctor – I’m not ready to go off medication entirely but do feel like this diet is really helping with my recovery and I feel SO MUCH BETTER than I did, even before my flare.

    I appreciate that Alexa brings up that those of us with IBD may need to modify the AIP diet even further. I am definitely finding this to be the case. I am still eating very few raw veggies and have also reacted negatively to both cassava flour and tigernut flour. I tried making recipes with them both which left me almost immediately bloated and uncomfortable. Last weekend, I made an asparagus salad where the asparagus was only blanched, not fully cooked, and it gave me a stomachache pretty quickly (I tried it again last night with the same reaction). I remember Danielle Walker at Against All Grain posting recently on Instagram that she gets bloated from cassava flour and that tipped me off to be on the lookout when I tried it. It’s a bummer because so many AIP baked good recipes use these flours but so it goes. I’m thankful I seem to tolerate coconut flour, and all coconut products, pretty well. Another set of foods I don’t tolerate very well is cruciferous veggies, especially cauliflower, so no cauliflower rice for me! I did see a recipe for sweet potato rice recently that I’m excited to try.

    Thanks for all the other great resources listed too. I look forward to checking them out.

    • Mickey Trescott says

      Hey Kathleen! Thanks for sharing some of your story here – and I agree, Alexa’s modifications are spot-on. When we have AI disorders affecting the digestive tract sometimes further tweaking is necessary to dial in which fruits, veggies, fibers or starches do or don’t work for our systems. Wishing you the best!

    • Jackie says

      Hi, I am wondering where I can find alexas modifications for AIP with chrons.. I have been aip for 4 years, adding things back in but am suffering greatly and need to go back strict AIP and figure out what on aip isn’t good for me for chrons. I react to all aip flours/starches, coconut, and pork 😕

      • Mickey Trescott says

        Hi Jackie, your best bet would be to check out her book or blog!

  • Eliz says

    Trying to eat right. What supplements are good for calming inflammation, please. Recent physical showed cholesterol 247; LDL..148 ; HDL: 83. C-Reactive Protein 1.6 and Triglyceride..76.0. Vit. D 52.

    • Angie Alt says

      We are medical professionals & can’t give specific recommendations, but in general the AIP diet is typically helpful for reducing inflammation.

    • Mickey Trescott says

      Hi Eliz,
      Unfortunately we aren’t medical practitioners and can’t advise on lab work. We recommend reaching out to an AIP Certified Coach for personalized help –!

  • […] The Ultimate Guide to Managing Inflammatory Bowel Disease (Crohn’s and Ulcerative Colitis) wit… (Written by me for Autoimmune Wellness) […]

  • Howard Fishbein, MD says

    Thanks for sharing your health hacks for Crohn’s disease. Your ideas are practical and helpful. Thanks for sharing!

  • Howard Fishbein, MD says

    Crohn’s disease also known as inflammatory bowel disease (IBD) is an inflammation in the digestive tract. It is therefore important that we take care of it through timely treatment and medications. Thanks for talking about it through your blog. Keep writing on such topics more often.

  • c farrelly says

    Hello, I know it is a little trial and error, but what flours have been safest and shown to be least reactive in IBD sufferers that are sensitive and following an AIP diet? I have had negative reactions or aggravations to coconut recently. Interested in cassava, but a little apprehensive. Any others? Or, safe ways to try them (other than starting low and going slow)?

    • Mickey Trescott says

      Hi Chris! Unfortunately we don’t have good data on that, besides anecdotal – hopefully something for future AIP/IBD studies! For now, I recommend eliminating any flours that give you a reaction, even if they are AIP. And you are right, if you are trying something new, definitely try low and slow. I would say coconut and cassava are the most common offenders, but it should also be noted, that not tolerating them can also indicate a gut infection (like SIBO) so best to look into that as well with your healthcare provider if you continue to have issues. Good luck!

  • Dr. David Greene R3 Stem Cell says

    Thank you Alexa for sharing this post, individuals suffering from IBD will get lots of helpful from this post.

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