What’s a Good Diet for Someone With Ulcerative Colitis?

Staff WriterLast Updated Sep 15, 2020 1:18:04 PM ET
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Ulcerative colitis is a health condition that affects your digestive tract, and that’s one of the main reasons why it’s important to watch your diet. The foods you eat can play a big role in whether or not you have an uncomfortable flare-up, and because there’s currently no known cure for ulcerative colitis, doing what you can to avoid aggravating your symptoms — which eating certain foods may be more likely to do — can be one effective way to manage this condition. Learn more about the ways diet and menu planning can help you lead a lifestyle that may limit colitis discomfort, including what to eat — and what to avoid.

Foods to Avoid When You Have Ulcerative Colitis

There’s no definitive evidence that specific foods are universal triggers for ulcerative colitis, but people who have this condition do often find that certain foods can make their symptoms feel worse, especially when they’re experiencing a flare-up. If you’re in the middle of an active symptomatic period, a low-fat, low-fiber diet may help you feel better.

Limiting dairy could help improve your symptoms, particularly because people with ulcerative colitis tend to be sensitive to lactose, a type of sugar in milk products that can lead to diarrhea, gas and abdominal pain. High-lactose dairy products to avoid during a flare include milk, cream and soft cheeses like cream cheese. High-fat dairy products like butter may also worsen your symptoms.

In addition to high-fat dairy products, you might also avoid high-fat foods in general. Ulcerative colitis can make it difficult for your body to process and absorb fat, and fat molecules can encourage inflammation in your gut, which you want to avoid when you have ulcerative colitis. Eating high-fat foods can also interfere with digestion. Try to stay away from items like red meat, coconut, oils and anything fried or greasy, such as fast food.

Foods with insoluble fiber — the type that your body can’t completely break down and digest — are also known triggers that can cause diarrhea, bloating and pain. Fruits and vegetables with skin on are typically higher in fiber and may trigger symptoms. In particular, raw vegetables with skin; cruciferous veggies like cabbage and broccoli; and fruits like prunes, apples, pears, citrus and berries may have more fiber than your body can handle. Nuts and whole grains like those in some breads may also be more difficult to digest.

A few other ingredients may exacerbate flare-ups, too. Alcohol, caffeine, sugar and “hot” spices like cayenne pepper are common trigger foods. If you drink them, consider reducing or stopping your consumption of sodas; they’re sugary, packed with caffeine and carbonated, which can cause bloating and gas. Baked goods, candies and juices are other foods in this group to avoid. 

Foods to Enjoy on an Ulcerative Colitis Diet

It can be easier to become malnourished and not get all the nutrients your body needs when you have ulcerative colitis, but there are foods you can eat to give yourself necessary nutritional support without aggravating your symptoms. Many people with ulcerative colitis are generally able to tolerate lean proteins, easily digestible fruits and veggies, and refined grains.

Just as high-fiber and high-fat foods may worsen a flare-up, low-fiber and low-fat foods may ease symptoms while your ulcerative colitis is active. Low-fiber fruits to enjoy include bananas, melons, and fruits that have been cooked, peeled or stewed. Smoothies and juices are also usually easier to tolerate, particularly during a flare. It’s typically best to eat cooked vegetables as well; squash and avocado tend to be easy to digest, but cucumbers, asparagus tips, and potatoes are also ideal. Whenever possible, remove the seeds and skins from your vegetables before eating them.

Protein is an essential nutrient, even when you have ulcerative colitis, but the source matters. Stick with lower-fat options like tofu, chicken, turkey, lean cuts of pork and white fish. Many people also tolerate eggs well, even during flares, and you may be able to eat some hard cheeses without experiencing any issues. If you need to supplement protein, homemade shakes may help you get more into your diet. Your doctor and dietician will be able to discuss this with you in depth, and it’s important to speak to them first before adding protein shakes to your menu.

Refined carbohydrates are generally easy for people with ulcerative colitis to tolerate. This group of foods includes pastas, breads like French and sourdough, white rice and oatmeal. The fiber in oatmeal may pose some issues for your digestion if you’re very sensitive, but most people handle it well while in remission from a flare. Remember to check ingredient lists and avoid products — often breads — that have added sugar.

Finally, it may also help to try foods with probiotics, which support digestive health. Yogurt and miso may be easiest for your system to process and draw nutrients from. However, sauerkraut is another prime source of probiotics. If you’re sensitive to cabbage, you may want to forego this option or try it while you don’t have an active flare-up to see how your body responds.

Identifying Your “Trigger Foods"

If you want to work to determine which foods you should avoid, a few steps can be helpful in this journey. One way to do this is to maintain a food journal. Each day, write down what you eat and when, and make note of how you felt after eating it. You may notice a pattern pop up that reveals certain foods cause more discomfort that others. Once you’re aware of these trigger foods, you can eliminate these individual ingredients or items from your diet to see if your symptoms improve. A dietician who specializes in helping people with ulcerative colitis or inflammatory bowel disease can assist you with this.

Another way to approach this is to try an elimination diet. During an elimination diet, you begin by avoiding certain categories of food that you suspect may aggravate your colitis, such as dairy or spicy foods. You’ll start out by not eating anything at all from these groups of foods for a month or so and see how your symptoms may change. Then, every few days, you can reintroduce an individual item from the category to determine how your body responds — for example, if you eliminate dairy entirely, you might reintroduce yogurt one day and, a few days later, try milk. This “clears” your system and helps you pinpoint foods that may be changing your symptoms. If you’re considering an elimination diet, it’s essential to talk to your doctor about the best ways to approach it first, keeping in mind that it can take a few months to complete the process.

Lifestyle Habits for Healthy Eating With Colitis

When you have ulcerative colitis, how you eat can be just as important as what you eat. Changing or adopting a few key habits may play a role in managing your symptoms and preventing a flare-up. If you’re experiencing a flare, your dietary habits may also help alleviate some of the discomfort you’re experiencing.

Try to eat smaller meals every three to four hours instead of two or three large meals a day. It’s easier for your body to process smaller quantities of food and won’t stress your digestive system as much. Many people with ulcerative colitis eat four to six small meals or larger snacks per day.

It’s also essential to get enough fluids throughout the day, which promotes healthy digestion and prevents or alleviates dehydration if you’re experiencing a flare-up with diarrhea. Aim for at least 8 cups of water, which you can also supplement with broth, tomato juice and rehydration solutions like Pedialyte with your doctor’s approval. Another helpful tip? Avoid using straws whenever possible. They may cause you to suck air into your stomach, which can give you painful gas.

Rethinking your cooking techniques is another surprisingly effective lifestyle change that can help you manage flare-ups. Try to keep things simple by boiling, poaching or steaming your foods instead of grilling or frying in oil or butter — the added fat can be difficult to digest. If you find that most raw vegetables are too hard on your system, stick with cooked veggies by adding them to soups or stews to soften up.

Resource Links:

https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/diagnosis-treatment/drc-20353331

https://www.hopkinsmedicine.org/IBDsymposium/Presentations_2011/What%20is%20the%20Right%20Diet%20for%20IBD_Mullin.pdf

https://www.uwhealth.org/healthfacts/nutrition/375.pdf

https://www.crohnscolitisfoundation.org/diet-and-nutrition/what-should-i-eat

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607699/

https://badgut.org/information-centre/health-nutrition/the-role-of-fats-in-ulcerative-colitis/