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IBD

Expert Inflammatory Bowel Disease Dietitian

Manage flare-ups, rebuild your gut health, and optimise your digestion with proactive, evidence-based medical nutrition therapy.

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What is Inflammatory Bowel Disease (IBD)?

Your gut is the control centre of your immune system and nutrient absorption.

Inflammatory Bowel Disease (IBD) is a broad term used to describe conditions characterised by chronic, destructive inflammation of the gastrointestinal (GI) tract.

Infographic on inflammatory bowel disease and differences between chrons and ulcerative colitis. Image by brgfx on Freepik

It primarily includes two distinct conditions:

1. Crohn’s Disease: Can affect any part of the GI tract from the mouth to the anus, but most commonly affects the end of the small intestine (the ileum) and the beginning of the colon. The inflammation can extend through the entire thickness of the bowel wall, leading to strictures and fistulas.

2. Ulcerative Colitis: Affects only the colon (large intestine) and the rectum. The inflammation is typically confined to the innermost lining (mucosa) of the bowel, creating continuous ulcers.

Irritable Bowel Syndrome (IBS) VS Inflammatory Bowel Disease (IBD)

There is a big difference!

IBS is a sensitive gut, while IBD is a damaged gut

1. The Treatments are Completely Different

  • For IBS: You treat the symptoms. You might change your diet, try to lower your stress, or take certain medications to stop cramping or diarrhea and improve real symptoms (but not real damage)

  • For IBD: You aim to stop the body from attacking itself and causing real damage. This requires strong prescription medicines to calm down the immune system. A diet change alone won’t fix the root problem but can often be incredibly supportive in reducing damange and pain presentation.

2. The Long-Term Dangers (why it matters)

  • IBS: Normal cancer risk, looks healthy internally, no permanent damage.
  • IBD: Higher cancer (colon) risk, permanent damage or scarring can occur, surgery may be required.

3. Red flags- Signs it might be IBD, not just IBS:

  • Seeing blood, dark stools or mucus in the toilet.

  • Losing weight without trying.

  • Having a mild fever that won’t go away.

  • Changes in bowel movements from your normal

  • Waking up in the middle of the night urgently needing the bathroom.

Irritable Bowel Syndrome (IBS), stomach pain, IBS, bloating, distension, gas, diarrhoea, constipation

What causes IBD?

Historically, people blamed stress or specific foods for causing IBD. Today, we know that while these factors can trigger a severe flare-up, they are not the root cause.

The “perfect storm” that causes IBD involves a complex interaction between:

  • Immune System Malfunction: In IBD, the immune system mistakenly identifies food, healthy bacteria, and other materials in the intestine as foreign invaders, launching a relentless attack that leads to chronic inflammation.

  • Genetics: You are significantly more likely to develop IBD if you have a family history of the disease. Specific genetic markers have been linked to both Crohn’s and Colitis.

  • Environmental Triggers: Factors such as living in an urban or industrialised area, smoking (a major risk factor and accelerant for Crohn’s disease), and a history of severe GI infections or heavy antibiotic use can trigger the onset.

  • The Gut Microbiome: A profound imbalance in the trillions of bacteria living in your digestive tract (dysbiosis) plays a significant role in driving gut inflammation and permeability.

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Inflammatory bowel disease (IBD) affects your GI tract. Crohn’s disease and ulcerative colitis are the main types of IBD. -Image from Cleveland Clinic

-Image from Cleveland Clinic

What we can do

How is IBD diagnosed?

IBD is typically diagnosed through a combination of blood tests (checking for anaemia and inflammation markers like CRP), stool tests (measuring faecal calprotectin), and endoscopic procedures (such as a colonoscopy or endoscopy with tissue biopsies).

Common Diagnostic Mistakes:

  • Confusing IBD with IBS: This is the most frustrating and dangerous misconception. Irritable Bowel Syndrome (IBS) is a functional disorder, whereas IBD causes physical, visible damage and ulceration in the gut. Many patients are initially dismissed as having “just IBS,” delaying crucial medical treatment.

  • Relying solely on “normal” blood tests: Just because your inflammatory markers (CRP) in the blood are normal does not mean your gut isn’t actively inflamed. A faecal calprotectin stool test is far more accurate for detecting gut-specific inflammation.

  • Skipping the biopsy: An endoscopist might see a bowel that looks visually “normal” during a colonoscopy, but microscopic inflammation can still be present. Failing to take tissue samples (biopsies) is a massive missed opportunity for an accurate early diagnosis.

How common is IBD

It is a growing, silent epidemic. It is estimated that 1 in 250 Australians currently live with Inflammatory Bowel Disease, and Australia has one of the highest prevalence rates of IBD in the world.

Because it is an “invisible illness,” you cannot always see the physical toll it takes on a person. It can cause debilitating symptoms, including severe abdominal pain, persistent diarrhoea, chronic fatigue, and rapid unintended weight loss.

If your GI tract is compromised, your energy levels, nutrient absorption, and immune function will inevitably crash unless you take steps to manage the disease.

How is IBD (Chrons and Ulcerative Colitis) treated? (The REAL Nutrition Approach)

The GI tract is incredibly resilient but highly complex. While medical management (steroids, immunosuppressants, or biologics) is often necessary to switch off severe inflammation, your diet plays a critical role in managing symptoms, inducing remission, and correcting profound nutritional deficiencies.

There is no one-size-fits-all “IBD Diet”; your nutrition must be tailored to your specific disease location, severity, and personal triggers.

Here is how an Accredited Practising Dietitian targets IBD:

1. Reversing Malnutrition and Deficiencies

Nutrient dense protein foods to optimise protein intake, bone density, muscle mass and falls risk

If your bowel is inflamed, it struggles to absorb nutrients. We focus on correcting common deficiencies in Iron, Vitamin B12, Vitamin D, and Calcium, Omega 3’s, Vitamin E, Vitamin A, Vitamin K and more.

We build high-protein, energy-dense nutrition strategies to prevent muscle wasting (sarcopenia) and restore your vitality, especially after a severe hospitalisation or flare-up.

2. Crushing Insulin Resistance & Refined Sugars

High soluble fibre, high polyphenol berries (raspberries, blueberries, strawberries)

During an active flare, the goal is bowel rest and symptom reduction. We implement a personalised low-inflammatory, low-residue, easily digestible diet.

We strategically reduce insoluble fibre, spicy foods, and specific fats to minimise bowel output and give your gut lining a chance to heal, without relying on dangerously restrictive crash diets.

3. Sustaining Remission & Microbiome Support

Nutrient dense variety of foods including wholegrain carbs, nutrient dense vegetables, legumes and plant based protein sources

Once the inflammation is under control, the strategy shifts entirely. We aggressively target the health of your gut microbiome by slowly and systematically reintroducing highly fermentable fibres, prebiotics, and anti-inflammatory fats (like Extra Virgin Olive Oil and Omega-3s, specific fruits and veg).

4. Navigating Concurrent IBS (FODMAPs)

High fructan pasta (FODMAP) which may influence people with IBS and IBD

Up to 30% of people with IBD also suffer from concurrent IBS symptoms.

We use targeted, short-term protocols like the Low FODMAP diet to identify the exact fermentable carbohydrates that trigger bloating, gas, and pain, allowing for the broadest, least restrictive diet possible in the long term.

When should you see a Doctor?

You should see your GP or a Gastroenterologist immediately if you experience persistent changes in your bowel habits. Red flags include chronic diarrhoea, waking up at night to empty your bowels, severe abdominal pain and cramping, visible blood or mucus in your stool, unexplained fever, or rapid, unintended weight loss.

These symptoms require urgent medical investigation and likely a colonoscopy.

When should you see a Dietitian for IBD?

The exact moment you are diagnosed with Crohn’s disease or Ulcerative Colitis, you should book an appointment with an Accredited Practising Dietitian.

Do not wait until you are severely malnourished, dropping weight, or terrified to eat.

We cut through the nonsense of “gut healing bone broths” and highly restrictive “autoimmune protocols” (which frequently cause malnutrition) and provide a realistic, science-backed dietary roadmap to manage your symptoms, restore your nutritional status, and protect your long-term health.

Why Choose REAL for Supporting Your Gut Health?

At REAL Health & Nutrition, we believe living with IBD shouldn’t mean a lifetime of highly restrictive diets.

Our Accredited Practising Dietitians use evidence-based Medical Nutrition Therapy to help you navigate Crohn’s and Colitis, giving you the tools to manage flare-ups while safely enjoying a broad, nourishing diet.

Realistic nutrition solutions

REAL Health & Nutrition was founded in Melbourne by Matthew Rigoni alongside a passionate team that provides evidence-based nutrition strategies that fit into your life.

Our diverse clientele includes individuals seeking to manage chronic disease, enhance their energy, and those aiming to improve their healthspan and longevity through sustainable health and nutrition strategies.

Matthew Rigoni, expert Dietitian and sports dietitian- REAL Health & Nutrition

Practitioners

Meet the team

Highly skilled and qualified Dietitians and Sport Nutritionists

  • Matthew Rigoni Accredited Practising Dietitian (APD), sport Nutritionist, Accredited Sport Dietitian (ASD)

    Matthew Rigoni

    Head Dietitian (APD) & Sports Nutritionist

    Matthew Rigoni is an Accredited Practising Dietitian and Sports Nutritionist supporting clients across Eltham, Diamond Creek and Melbourne’s North-East. He specialises in weight management, chronic disease care, IBS/low-FODMAP nutrition, and sports-performance nutrition. His approach focuses on evidence-based, realistic strategies tailored to each client’s health goals. Matthew also brings experience in strength training and rehabilitation, helping clients build long-term, sustainable habits.

  • Max Dennehy Dietitian, body building coach

    Max Dennehy

    Dietitian and Bodybuilding Coach

    Max Dennehy is a qualified Dietitian with strong expertise in sports nutrition, weight loss, muscle gain and body recomposition. He has more than seven years of hands-on experience in bodybuilding and strength training, blending clinical nutrition with practical performance coaching. Max supports clients managing chronic conditions, improving metabolic health, and achieving body-composition goals. His coaching style is structured and supportive, helping clients stay consistent and confident.

  • Emma Westlake Accredited Sports Nutritionist

    Emma Westlake

    Accredited Sports Nutritionist

    Emma Westlake is a Nutritionist and Accredited Sports Nutritionist with experience in athletic performance, endurance nutrition, injury recovery and rehabilitation. She brings a strong background in Biomedical Science and works with clients to improve energy, health and long-term wellbeing. Emma has supported athletes across AFL/AFLW, triathlon and running communities, offering clear and practical guidance. Her passion lies in helping active individuals optimise performance through personalised, evidence-based nutrition.

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Qualifcations, profesional interests and why they're unique!

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Maintaining Excellence in Nutrition Care

This commitment ensures you always receive the most current, evidence-based nutrition guidance available.

Frequently Asked IBD Questions

Common questions for gut health.

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    No. IBD is a chronic autoimmune condition, and currently, there is currently no medical or dietary cure.

    However, targeted medical nutrition therapy is highly effective at managing your symptoms, correcting nutritional deficiencies, and keeping you in remission for much longer periods.

    It can be, but only for managing functional symptoms.

    The Low FODMAP diet reduces gas, bloating, and urgency (concurrent IBS symptoms), but it does not reduce the actual immune-driven inflammation in the bowel caused by IBD.

    It should only be used short-term under the strict guidance of a Dietitian.

    Not necessarily. Unless you have been diagnosed with Coeliac disease or a specific lactose intolerance, unnecessarily eliminating gluten or dairy removes valuable, easily accessible sources of energy, calcium, fibre, specific B-vitamins and more.

    A Dietitian can help you accurately determine if these are actual inflammatory triggers for your body and nutrition personally tailored to you

    During an active flare, your gut requires easily digestible, low-residue foods.

    The safest options are well-cooked foods like white rice, lean proteins (chicken, white fish), smooth nut butters (as long as you can tolerate these), cooked and peeled root vegetables, and plain yoghurts.

    The clinical evidence is highly mixed. While some specific, high-dose strains have shown targeted benefits in maintaining remission for Ulcerative Colitis, probiotics are generally not recommended for Crohn’s disease and can sometimes worsen symptoms or cause bacterial overgrowth.

    Always consult your medical team first.

    Chronic gut inflammation rapidly increases your body’s basal metabolic rate while simultaneously blocking your ability to absorb calories, protein and many different micronutrients

    This combination forces the body to cannibalise its own fat and muscle tissue for fuel, leading to severe, unintended weight loss and malnutrition.

    It depends entirely on the individual and the stage of the disease.

    Coffee actively stimulates bowel motility, which can significantly worsen diarrhoea and urgency during an active flare-up.

    However, during clinical remission, many people with IBD can tolerate coffee perfectly well without it triggering inflammation.

Extra reading

Bischoff, S. C., Bager, P., Escher, J., Forbes, A., Hébuterne, X., Hvas, C. L., Joly, F., Klek, S., Krznaric, Z., Ockenga, J., Schneider, S. M., Shamir, R., Stardelova, K., Wierdsma, N., Wiskin, A. E., & Zmora, N. (2020). ESPEN guideline on clinical nutrition in inflammatory bowel disease. Clinical Nutrition, 39(3), 732–760. https://doi.org/10.1016/j.clnu.2019.11.002

Crohn’s & Colitis Australia. (2023). Understanding IBD. https://crohnsandcolitis.com.au/understanding-ibd/

Gastroenterological Society of Australia. (2022). Inflammatory Bowel Disease (IBD) Clinical Guidelines. https://www.gesa.org.au/education/clinical-information/ibd/

Lamb, C. A., Kennedy, N. A., Raine, T., Hendy, P. A., Smith, P. J., Limdi, J. K., Hayee, B., Lomer, M. C. E., Parkes, G. C., Selinger, C., Barrett, K. J., Davies, R. J., Bennett, C., Gittens, S., Dunlop, M. G., Faiz, O., Fraser, A., Garrick, V., Johnston, P. D., … Hawthorne, A. B. (2019). British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut, 68(Suppl 3), s1–s106. https://doi.org/10.1136/gutjnl-2019-318484