Ulcerative colitis is a type of inflammatory bowel disease that can cause intense periods of abdominal discomfort, diarrhea, and a loss of appetite. A person can manage it by eating or avoiding certain foods that can help reduce the risk of flares and inflammation.
If you have ulcerative colitis, you may already know which foods worsen your flares. But figuring out what to include in your colitis diet is equally important, because the right foods will provide you with key nutrients without aggravating your symptoms.
If you have been diagnosed with ulcerative colitis, your doctor may have told you that making changes to your colitis diet can help you manage symptoms. As with any health condition, one way of eating won’t necessarily work for everyone who has ulcerative colitis. However, if you can identify foods and beverages that are more likely to give you a flare-up of ulcerative colitis symptoms, it may be easier for you to manage your symptoms. Some people change their colitis diet to avoid trigger foods when having a flare-up while others make long-term changes. It is important to ensure good nutrition no matter which eating pattern you choose.
Most experts recommend that you limit your fiber intake when you’re having an ulcerative colitis flare. A general rule is to replace high-fiber foods, such as nuts, seeds, and raw fruits and vegetables, with more easily digestible fare. Here are eight foods to eat during an ulcerative colitis flare and the reasons they can help.
What Is Ulcerative Colitis?
Ulcerative colitis (UC) is a chronic, inflammatory disease of the colon and rectum. It’s one of two main inflammatory bowel diseases, the other being Crohn’s disease.
When a person has UC, sores called ulcers develop inside the colon.
Symptoms of the disease include:
- abdominal pain
- blood or pus in the stool
- diarrhea
- nausea
- rectal bleeding
- fatigue
- weight loss
What Causes Ulcerative Colitis?
The cause of ulcerative colitis is unknown but it is believed to be caused by a combination of several factors including an overactive immune system, genetics, and the environment.
Overactive immune system: It is believed that in ulcerative colitis, the immune system is triggered to mistakenly attack the inner lining of the large intestine, causing inflammation and symptoms of ulcerative colitis.
Genetics: Ulcerative colitis can run in families. The genetic link is not entirely clear but studies show that up to 20% of people with ulcerative colitis have a close family member with the disease.
Environment: Certain environmental factors including taking certain medications (nonsteroidal anti-inflammatory drugs or NSAIDs, antibiotics, and oral contraceptives), and eating a high fat diet may slightly increase the risk of developing ulcerative colitis.
Physical or emotional stress, and certain foods do not cause ulcerative colitis, however, they may trigger symptoms in a person who has ulcerative colitis.
Ulcerative Colitis Diet
There’s no single colitis diet that will help everyone with UC. The condition can also change over time, so your plan will need to be flexible, too. The key is to find what works for you.
To stay organized, keep a food diary. Use your smartphone or a small notebook to record what you eat and drink and how they make you feel, both good and bad. It takes a bit of time and patience, but it will help you track your condition and fine-tune your colitis diet plan.
When you prepare your meals, don’t forget that a well-balanced colitis diet gives you enough protein, whole grains, and fresh fruits and vegetables.
You might not be able to eat everything in the grocery store or on the menus at the restaurants you like. But try to focus on the ones that you can enjoy without triggering your symptoms. Some simple tweaks in your meal prep can make it easier to eat some foods, like steaming veggies or switching to low-fat dairy.
Some people follow a low-residue diet or low-fiber diet every so often, getting about 10-15 grams of fiber a day. That can help you go to the bathroom less often.
What Is an Ulcerative Colitis Diet?
A person with ulcerative colitis may find they need to modify their colitis diet to help manage their symptoms. There is not a single diet or meal plan that fits everyone with ulcerative colitis, and diets are individualized for each patient. Depending on symptoms different types of diets may be recommended, such as:
- A high-calorie diet: Many people with ulcerative colitis lose weight and can develop signs of malnutrition. A high calorie diet may prevent these problems.
- A lactose-free diet: People with ulcerative colitis may also have lactose intolerance.
- A low-fat diet: Ulcerative colitis may interfere with fat absorption and eating fatty foods may trigger symptoms. This is often recommended during an ulcerative colitis flare.
- A low-fiber diet (low-residue diet): This can help reduce the frequency of bowel movements and abdominal cramps.
- A low-salt diet: This diet is used when patients are on corticosteroid therapy to help reduce water retention.
- A low FODMAP diet: FODMAP stands for Fermentable Oligo-Di-Monosaccha-rides and Polyols, which are types of sugars found in certain carbohydrates and sugar alcohols. This diet is used in people who have intolerance to FODMAPS.
- A gluten-free diet: People with ulcerative colitis may also be sensitive to gluten.
Attention to nutrition is important for patients with ulcerative colitis, as the symptoms of diarrhea and bleeding can lead to dehydration, electrolyte imbalance, and loss of nutrients. It may be necessary to take nutritional supplements if your symptoms do not allow you to eat a nutritionally balanced colitis diet . Talk to your health-care professional about what supplements to take. Many people with ulcerative colitis find it easiest to eat smaller, more frequent meals rather than a few large ones. This can also help increase the nutrition absorbed from the foods you eat.
Foods To Avoid with an Ulcerative Colitis Diet Plan
Dietary choices do not cause ulcerative colitis, but certain foods can trigger and worsen symptoms. Learning to identify trigger foods can help reduce the frequency and severity of ulcerative colitis symptoms. Not all people with ulcerative colitis have the same triggers, but a list of some of the most common include:
- Alcohol can stimulate the intestine, triggering diarrhea. Some people tolerate alcohol better than others.
- Caffeine, found in coffee, tea, chocolate, and energy drinks, is a stimulant and can speed up the transit time in the colon, leading to more frequent trips to the bathroom.
- Carbonated beverages including sodas and beer contain carbonation that can irritate the digestive tract, and cause gas. Many contain sugar, caffeine, or artificial sweeteners, which can also be ulcerative colitis triggers.
- Dairy products should be avoided if you are lactose intolerant, as they can cause symptoms similar to ulcerative colitis. Not everyone with ulcerative colitis is lactose intolerant.
- Dried beans, peas, and legumes are all high in fiber and can increase bowel movements, abdominal cramping, and gas. If you are a vegetarian or vegan, you can try these foods in small amounts, or pureed to see if they do not trigger symptoms.
- Dried fruits, berries, fruits with pulp or seeds are other foods high in fiber that can trigger ulcerative colitis symptoms.
- Foods containing sulfur or sulfate can cause excess gas production. Sulfate may be found in many foods, including beer, wine, some juices, dairy milk, eggs, cheese, dates, dried apples and apricots, almonds, wheat pasta, breads, peanuts, cruciferous vegetables, raisins, prunes, red meat, and some supplements.
- High fiber foods, including whole-grains, can increase bowel movements, abdominal cramping, and gas.
- Meats, especially fatty meats, can trigger ulcerative colitis symptoms. Excess fat may not be properly absorbed during a flare, and this can make symptoms worse. Red meat can be high in sulfate, which triggers gas.
- Nuts and crunchy nut butters, and seeds that are not ground up (such as in smooth peanut butter or tahini) can cause worsening abdominal cramping, bloating, and diarrhea. During a flare, even tiny fruit seeds (such as those in strawberries or in jams) may trigger symptoms.
- Popcorn is another high fiber, bulky food that is not completely digested by the small intestine and can trigger diarrhea and bowel movement urgency.
- Sugar alcohols (such as sorbitol and mannitol) are found in sugar-free gum and candies, some ice creams, and some fruits and fruit juices (apples, pears, peaches, and prunes) and can cause diarrhea, bloating, and gas in some people.
- Chocolate contains caffeine and sugar, both of which can irritate the digestive tract and cause cramping and more frequent bowel movements.
- Vegetables, especially raw vegetables, are high in fiber and can be difficult to digest, causing bloating, gas, and abdominal cramps. This is particularly true for stringy vegetables such as broccoli, celery, cabbage, onions, and Brussels sprouts. Many people with ulcerative colitis also find it hard to digest corn and mushrooms because they are hard to digest to begin with.
- Refined sugar can pull more water into the gut and cause diarrhea.
- Spicy foods, hot sauces, and pepper can cause diarrhea in many people, and in someone with ulcerative colitis experiencing a flare spicy hot foods may trigger or worsen symptoms.
- Gluten, found in wheat, rye, barley, and some oats, can trigger symptoms similar to ulcerative colitis in people who have gluten sensitivity.
What Foods Help Manage and Soothe Ulcerative Colitis Flares?
Avoiding foods that trigger ulcerative colitis symptoms is one way to help manage symptoms through colitis diet. Another is knowing what foods to eat that may help relieve flares. Following is a list of foods that may help soothe ulcerative colitis flares:
- Salmon and albacore tuna contain omega-3 fatty acids, which can help reduce inflammation during a flare and may help you to stay in remission. Other sources of omega-3s include mackerel, herring, sardines, flaxseed oil, ground flaxseed, and walnuts. Some people may be unable to eat whole nuts and flaxseeds during a flare, but they may be tolerated if ground up.
- Lean meats and poultry are recommended following flares of ulcerative because proteins are often lost. Increasing your protein intake can help replenish the nutrients lost during a flare.
- Eggs are another great source of protein, and are often well-tolerated even during flares. Some eggs are fortified with omega-3 fatty acids, which can help reduce inflammation.
- Soy-based protein can be substituted for animal protein in vegetarians and vegans. Other good sources of non-animal proteins include legumes and whole grains.
- Probiotics, usually found in yogurt, kefir, sauerkraut, and miso, are good bacteria that can aid in digestion. Choose yogurts that are low in added sugars, as sugar can aggravate ulcerative colitis symptoms.
- Avocados are an excellent source of protein and healthy fats. They are calorie dense, but because they are about 70% water, they are easily digested.
- Unsweetened applesauce is bland and may be tolerated after an ulcerative colitis flare, though some people may find it difficult to tolerate during a flare-up.
- Instant oatmeal contains refined grains and is often easier than steel cut or old-fashioned oatmeal because it has a little less fiber.
- Squash is a healthy choice that is usually well-tolerated during an ulcerative colitis flare. It’s full of fiber, vitamin C, and beta carotene. Any variety of squash (butternut, zucchini, spaghetti, acorn, winter, and summer) are best tolerated cooked. Raw squash may aggravate ulcerative colitis symptoms during a flare.
- Juice and smoothies can be tolerated by some during a flare, and can help you maintain good nutrition. Carrot juice is chock full of vitamin A and antioxidants and many people with ulcerative colitis find it easy to tolerate.
- Plantains, which are a variety of banana, can help aid digestion.
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