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In Episode 16 of Wrestling the Octopus: The IBD Patient Podcast, we're talking a perennial favourite with Crohn's and UC patients: diet and nutrition in inflammatory bowel disease. Our expert guest is Dearbhaile O'Hanlon, principal gastroenterology dietitian at Guy's & St Thomas' Hospital in London, UK.

We discuss everything from emulsifiers and ultra-processed foods to prebiotics, probiotics and the Mediterranean diet, Nigel shares his journey through a food additive trial (and his now-famous homemade bread), while Rachel reflects on the challenge of distinguishing flares from functional symptoms. Whether you’re newly diagnosed or you've had inflammatory bowel disease for years, this episode will give you a great overview of diet in IBD.

Key Topics Covered:

🍽️ Can diet cause IBD? What the evidence says
🥣 Exclusive enteral nutrition vs Crohn’s Disease Exclusion Diet
🥗 Mediterranean diet: a safe bet for remission?
🧪 Emulsifiers, ultra-processed foods & emerging research
🧬 Prebiotics vs probiotics: what’s the difference, and do they help?
🚽 “Evacuate!” moments: food triggers vs flares vs functional symptoms
🧠 Gut-brain signaling and why some foods are louder than others
🩺 Low FODMAP diet: when and how to trial it safely
🧻 Diet tips for stoma management, bloating, and gas
🌾 Soluble vs insoluble fibre: what they are and where to find them
🧬 Strictures and modified fibre diets: what’s safe, what’s risky
📱 Food diaries and apps: helpful tools or homework overload?
🌳 Bark, miracle cures & internet myths: how to spot misinformation

What You Will Learn

There’s no one-size-fits-all IBD diet, but there are patterns worth exploring
Ultra-processed foods and certain emulsifiers may play a role in inflammation
Prebiotics (like onions, garlic, pulses) can be beneficia but also bloating triggers
Probiotics may help some people with UC, but evidence is mixed and costs can be high
If you’re in remission but still sensitive, it might be functional symptoms but not active inflammation
For stoma care: chew well, watch fizzy drinks and caffeine and consider a gentle food challenge process
With strictures, insoluble fibre may need to be reduced or blended though soluble fibre can still help
If it sounds too good to be true, it probably is - so always check with your clinical team
The benefits of using food diaries

Follow Rachel at @bottomlineibd

Follow Nigel at @crohnoid

#16 Learning the basics of diet in IBD - with dietitian Dearbhaile O'Hanlon

Wrestling the Octopus (IBD)