A Guide to Eating at Restaurants for Anyone with Chron's Disease

I have Chrohn's, an Inflammatory Bowel Disease (IBD) that causes inflammation of the intestinal tract and can cause intestinal ulcers, diarrhea, cramping, pain, and many other symptoms. For more information on Chrohn's, you can read my AC article How I've Learned to Live a Normal Life with Crohn's Disease. This article discusses one aspect of ordinary living: eating in restaurants.

Before my IBD became serious, but after I was diagnosed, I started keeping a food diary. This diary wasn't about counting calories or fat grams, though; it was about what foods in what amounts triggered a reaction from my digestive system, and what foods I could eat comfortably. Whether you have IBD or the less serious Irritable Bowel Syndrome, making such a diary is an excellent idea. For me, it saves having to rely solely on my memory, which is impaired both by the IBD and the medications I take for it, and also gives me clues about what foods that I haven't yet tried may cause problems.

One of the things I learned very early is that eating a full or heavy meal is almost certain to cause problems for me. I had my gall bladder removed a few years ago, and that contributes to this difficulty, as it means I have to avoid fatty foods as well as high-roughage foods. I try to eat five small meals, or three small meals and two snacks, through the day, and not the two to three full meals that most people have. If I know I'm going to be eating at a restaurant, I make certain that I eat something my intestines can handle by mid-afternoon. That makes me less likely to overeat, and more likely to order something that is both healthy and the right amount of something I can handle.

When I get to a restaurant, I usually ask for a table near the restroom. If I can't get one, I make sure I know where the restroom is (it's the first thing I look for), and I scope out the quickest route to get to it. If I'm in a booth, I make sure I have the outside edge, so no one has to move to let me get up. I bring Immodium ^TM , or any prescription medicine for my IBD, just in case something starts up. That stomach gurgle that most people call a "hunger growl?" For me it's a signal from my intestines that I'd better get into the bathroom, immediately. Another thing I do for my own comfort is to either take my own car, or bring enough money for a taxi, so that if I need to go home in a hurry, I can do it without causing inconvenience for the people I'll be eating with.

Once I'm in and seated, I look at the menu. I don't order an alcoholic drink, because I know it will cause me problems; I generally stick to water, since carbonated soft drinks produce more stomach acid than water, and possibly more than alcohol, and once there's acid in my stomach, it generally heads south. If apple juice is on the menu, I may order it; it's easier to tolerate than most of the other beverage choices. Herbal teas, in general, work for me too.

Then I use my food journal to compare against items on the menu so I can best avoid things I know will cause problems. This doesn't always work; in most Italian or Mexican restaurants, as well as ethnic restaurants not found in my town, the spice in almost everything can cause irritation to my bowels, although most of them in my home town offer an "American" item or two as well. This is really difficult for me, because I've always liked spicy and highly-seasoned foods. If you have an IBD and are wondering about any ethnic cuisine, my advice would be to try it at home first, and see how your body reacts. When I'm doing well, and far from a flare, something like a cheese enchilada, without onions, can work for me. A simple cheese quesadilla is also a good choice for me, as long as I haven't been eating too much dairy.

I know immediately some of the things that won't work for me. A salad bar equals many trips to the bathroom. Most salads with meat are the same. Fast food is something I try to avoid on general principle, but the one thing I can eat at some of them are french fries, which I find surprising considering my problems with fat. Anything that is deep-fried is usually something to avoid; so is anything with nuts, unless I can pick them out (which I only do with my very best friends or my family, as it is considered rude by many people). "Health" foods with lentils, black beans, or pinto beans are also off-limits for me.

So what does that leave? The first thing I look for are soups, especially broth-based soups rather than cream-based soups. Even a vegetable soup has cooked the vegetables enough so that they don't trouble me. White bread toast, plain English muffins, or plain bagels are also safe items. One restaurant chain best known for its breakfasts (yes, Perkins) serves an open-faced turkey sandwich with stuffing, gravy, and mashed potatoes. Unless I'm having symptoms before I go out to eat, I can safely order this, as long as I get a "to-go" box with it and put half the food in there before I start eating. I can have desserts that don't have too much fat in them; most fruit pies work well for me, but again, this will vary for everyone, and if you're not sure, you're better off not trying it. If I'm out for breakfast, toast and scrambled eggs make a good choice, as long as I can be sure that they don't use a lot of fat when they cooking the eggs.

Something that most people without an IBD suggest is milk, or other dairy products. Believe it or not, dairy products, with the possible exception of yogurt with live cultures, are very hard for most people to digest, especially people with stomach and intestinal disorders. Milk may seem like it coats the stomach, but what it does is to stimulate the stomach lining to produce more acid; so does cheese. If I know I'll be wanting to eat cheese or ice cream, I use Lactaid ^TM or a similar product before I leave home, to make it less likely that something I want to eat will cause my intestines to become more inflamed.

There are times when going to a restaurant is simply not possible; if I can't leave my bathroom for ten minutes at a time, I stay home. If you have an IBD, you'll know those times, and you should also learn to recognize the signs that indicate a 'flare" is coming. For me, and probably most people, these signs can be the things I mentioned above: intestinal pain or cramping, gas, diarrhea, and stomach rumbles. My doctor tells me they can vary from person to person, though.

There are other times when I can go to a restaurant and eat almost anything on the menu (except for raw or nearly raw vegetables). This can fool me, though. I recently ate at a Ruby Tuesday's restaurant. Both my sisters ordered the "Mini cheeseburgers" with french fries. Although I felt well, I thought that might be too much fat for me. I opted for the chicken pot pie, thinking that anything in it would be well-cooked. But the chicken pot pie there contains a lot of broccoli -- really a whole big lot of broccoli -- and it's only lightly steamed. The taste, the sauce, the chicken, the puff-pastry it came in were all excellent. But I made the mistake of trying to eat some of the still-crunchy broccoli, and I suffered for it for the rest of that day and much of the night as well.

For me, eating in a restaurant means four things. First, I can't be having a flare of the symptoms of the on-set of one; second, I must know in general what things I can eat without causing more intestinal problems than I already have at that time. Third, I must make sure that I am near the bathroom and have easy access to it. Finally, I have to make a conscious choice to eat food that will provide some nutrition without causing an intestinal flare. Sometimes that means giving up foods that I ate in the past, foods that I love, but the consequences just aren't worth the brief enjoyment of the food. I'm just glad that most of the time, I can eat out, and I can do it in a way that doesn't draw the attention of the entire restaurant and wait-staff to me. With planning, other IBD sufferers can do the same.