Can you eat sushi if you have IBD? What to know and how to navigate

November 8, 2025 •

4 min read

Individuals with inflammatory bowel disease (IBD) often have to navigate a complex diet to manage symptoms and prevent flares. For many, the question of whether you can eat sushi if you have IBD depends heavily on the ingredients, preparation, and your current disease state.

Quick Summary

It is possible for many with IBD to enjoy sushi by selecting simpler options with cooked fish or low-fiber vegetables. Managing risk involves avoiding triggers like fried items, high-fiber additions, and certain sauces.

Key Points

Start Simple: Begin with simple options like sashimi or nigiri with white rice, as these have fewer ingredients to cause irritation.
Choose Cooked over Raw: If you're sensitive to raw foods or have histamine issues, opt for cooked fish rolls or cooked seafood to reduce risks.
Avoid Common Triggers: Stay away from fried (tempura) sushi, spicy sauces with garlic and onion, and high-fiber vegetables during a flare-up.
Opt for Gluten-Free Soy Sauce: Standard soy sauce contains wheat, a potential trigger. Always request or bring your own tamari instead.
Understand Your Body's Response: Keep a food diary to track how different ingredients and preparations affect your IBD, helping you identify personal triggers.
Prepare it Yourself: For the greatest control over ingredients and preparation, consider making sushi at home.

Understanding the Individualized Nature of IBD

Dietary management of Inflammatory Bowel Disease, which includes Crohn's disease and ulcerative colitis, is highly personal. What one person tolerates perfectly fine, another may find causes significant distress. Many factors influence whether sushi is a good choice, including whether your IBD is in remission or an active flare-up. In general, when in remission, your gut is less inflamed and can handle a wider variety of foods. During a flare-up, a very low-fiber, bland diet is often recommended to reduce irritation.

Safer Sushi Options During Remission

For many with IBD in remission, simple and fresh sushi can be a good option. Oily fish like salmon and tuna contain omega-3 fatty acids, which have anti-inflammatory properties that can be beneficial for the digestive tract.

Best Choices to Consider

Sashimi: This is simply thinly sliced raw fish without rice or other components, making it a pure protein source. As long as the fish is extremely fresh, it's a very simple and low-fiber choice.
Nigiri: A small slice of fish over a compact mound of white sushi rice. This is generally well-tolerated, as the white rice is low-fiber and the fish is minimally prepared.
Simple Maki Rolls: Stick to rolls with basic, well-tolerated ingredients. Examples include a simple tuna roll (tekka maki) or a cucumber roll (kappa maki). Nori, the seaweed wrapper, is usually thin and not high in fiber.
Cooked Rolls: Opting for rolls with cooked fish, such as cooked salmon or shrimp, can reduce any risk associated with raw fish and make digestion easier.

Practical Tips for Dining Out

Ask for Specifics: Don't hesitate to ask your server or sushi chef about ingredients. Inquire about sauces and preparations, and request modifications if needed.
Choose Freshness: Go to a reputable sushi restaurant known for its high-quality, fresh fish to minimize risks associated with older seafood.
Portion Control: Even with safe ingredients, large meals can overwhelm the digestive system. Eating smaller portions can help prevent discomfort.

Ingredients and Preparation to Approach with Caution

Many of the risks associated with sushi for IBD patients come from the added ingredients rather than the basic fish and rice.

High-Risk Sushi Components

Tempura and Fried Items: Fried food is high in fat, a known trigger for IBD symptoms. Tempura batter also contains wheat, which can be problematic for those with gluten sensitivity.
Spicy Sauces and Mayo: These often contain irritating ingredients like garlic and onion powders, which are high-FODMAP and can trigger symptoms.
Cream Cheese: Found in rolls like the Philadelphia roll, dairy can be a major trigger, especially for those with lactose intolerance.
High-Fiber Vegetables: Vegetables like edamame or uncooked bell peppers can be difficult to digest during a flare. Limit or avoid these if you know fiber is a trigger.
Standard Soy Sauce: Most soy sauce contains wheat. Request tamari (gluten-free soy sauce) or bring your own to be safe.
Sesame Seeds: Some individuals find that seeds can be irritating during a flare.

Raw Fish Considerations for IBD

While the omega-3s in fatty fish are beneficial, raw fish presents two primary concerns:

Histamine Sensitivity: Certain fish, particularly tuna and mackerel, can develop higher histamine levels the longer they sit. For those with histamine sensitivity, this can cause digestive issues.
Parasites: Although rare in countries with strict food safety standards, there is a small risk of ingesting parasites from raw or undercooked fish. Cooking fish eliminates this risk. Freezing fresh fish appropriately can also kill parasites, a common practice for sushi-grade fish.

Sushi with IBD: Remission vs. Flare-up Comparison

This table outlines general guidelines for choosing sushi options based on your disease state. Always remember to prioritize your personal triggers and consult a healthcare professional.


Feature	During Remission	During Flare-up
Raw Fish	Generally safe if high-quality and very fresh. Simple sashimi and nigiri are best.	Avoid raw fish due to potential histamine and parasite concerns during a compromised digestive state.
Cooked Fish	Good choice, provides protein and healthy fats. Broiled or steamed is best.	Excellent choice. Tender, cooked fish is often well-tolerated and high in protein.
White Rice	Well-tolerated and low in fiber.	Staple, low-fiber base. Stick to white rice over brown.
Brown Rice	May be tolerated by some; start with small amounts to test.	Avoid due to high fiber content, which can exacerbate symptoms.
Vegetables	Cucumber, avocado (in small amounts) may be fine.	Limit or avoid raw vegetables; cooked carrots or mushrooms may be better.
Sauces	Tamari (GF soy sauce) and wasabi (in moderation) are usually fine.	Avoid spicy, creamy, or high-fat sauces entirely.
Fried Foods	Avoid or limit heavily, even during remission.	Avoid completely, as high fat content is a major trigger.

Homemade Sushi: The Ultimate Control

The safest way to enjoy sushi when you have IBD is to make it at home. This gives you complete control over ingredients, ensuring everything is fresh and prepared in a way that is safe for you. You can use your preferred type of rice, include well-tolerated cooked fish or veggies, and use gluten-free tamari. This eliminates risks from hidden ingredients, cross-contamination, and food that might not be perfectly fresh.

Conclusion: Making an Informed Choice

While having IBD requires a thoughtful approach to diet, it doesn't necessarily mean giving up all the foods you love. For sushi, the key is personalization and caution. Start with simple, well-prepared ingredients, especially during remission, and monitor your body's response carefully. By understanding your specific triggers and making smart choices, you can often find a way to enjoy sushi safely. For comprehensive guidance on diet and IBD, it's always recommended to consult with a registered dietitian or gastroenterologist. The American Gastroenterological Association offers excellent resources on nutritional therapies for IBD.

Frequently Asked Questions

Raw fish carries a small risk of parasites and can contain high levels of histamine if not perfectly fresh. During an IBD flare-up, your digestive system is already compromised, so it's generally best to avoid raw fish. In remission, very fresh, high-quality sashimi is often tolerated well, but listen to your body.

Tempura rolls should be avoided by individuals with IBD. The frying process adds high amounts of fat, and the batter contains wheat (gluten), both of which are common triggers for digestive upset and inflammation.

Individuals with IBD should use tamari, which is gluten-free. Standard soy sauce contains wheat, which is a potential trigger for many people. It's wise to request tamari or bring your own when dining out.

Yes, for some individuals, especially during a flare-up, high-fiber additions like sesame seeds can be irritating to the digestive tract. It is safer to request rolls without seeds.

No, it is best to avoid sushi during an IBD flare-up. During this time, you should stick to a low-fiber, bland diet to give your digestive system a rest. Many common sushi ingredients, including raw fish and high-fiber vegetables, are not recommended during a flare.

While both conditions can be sensitive to some sushi ingredients, IBD is characterized by chronic inflammation of the digestive tract, making food choices even more critical, especially during a flare. IBS symptoms are related to gut function, but not inflammation. Both require personalization and trigger identification.

For many with IBD, brown rice is too high in fiber and can be difficult to digest, particularly during a flare. White sushi rice is a lower-fiber, safer alternative that is generally well-tolerated.