Nutrition
Gastrointestinal disorders
IBS, IBD, coeliac disease, reflux and post-surgical guts each need different advice — the one common rule is not to over-restrict without supervision.
What you are aiming for
- Control symptoms with the smallest necessary restriction
- Prevent nutrient deficiencies caused by malabsorption or elimination diets
- Maintain weight and muscle, especially in active inflammatory disease
- Re-expand the diet once symptoms settle
Build meals around
- Regular meals, eaten slowly and chewed thoroughly
- Soluble fibre — oats, bananas, peeled potatoes — which is usually better tolerated than insoluble
- Adequate fluid, especially with a stoma or with diarrhoea
- Strict gluten avoidance in coeliac disease, including cross-contamination
- Protein and energy-dense foods during flares of inflammatory bowel disease
Limit or avoid
- Trigger foods identified through a supervised trial — not by guesswork
- Very high-fat and fried meals in reflux and gallbladder disease
- Caffeine, alcohol and fizzy drinks in reflux
- Skins, pips, nuts and tough fibre during a stricture or acute flare
Meal timing
- Smaller, more frequent meals reduce symptoms in most gut conditions.
- In reflux, avoid eating within three hours of lying down and raise the head of the bed.
- With a stoma, eat a regular pattern; skipping meals worsens output problems.
Portions
- Moderate portions; large meals are a trigger in their own right.
- Increase fibre gradually — sudden increases cause pain and bloating.
A sample day
- BreakfastOat porridge with a ripe banana
- LunchChicken with white rice and well-cooked carrots
- SnackLactose-free yoghurt or a rice cake with smooth nut butter
- DinnerBaked fish with peeled potatoes and courgette
Common myths
“Cutting out whole food groups is the safest first step.”
Unsupervised elimination causes deficiency and eating anxiety. Low-FODMAP and similar diets are short-term, dietitian-led tools.
“Gluten-free is healthier for everyone.”
Only in coeliac disease and diagnosed sensitivity. Otherwise it removes fibre and fortified nutrients for no benefit.
Treatment-related challenges
- Iron, B12, folate, calcium and vitamin D deficiencies are common — ask for monitoring.
- Post-surgical malabsorption may require enzyme replacement or specific supplements.
- Fear of eating outside the home; work on gradual re-expansion with support.
See a registered dietitian if
- · Before starting any elimination or low-FODMAP diet
- · Coeliac disease at diagnosis and annually
- · Inflammatory bowel disease flares, strictures or surgery
- · A new stoma
Afya Companion offers education and self-help support. It does not diagnose, treat or replace care from your doctor, nurse, psychologist or dietitian. If something in your health changes, speak to your care team.