When you’re diagnosed with ulcerative colitis (UC), you may wonder what it means for your diet. After all, food is a central part of living. Eating not only provides our bodies with nutrition—it brings people together.
For people with UC, a healthy diet is a balanced diet. Adequate intake of foods from all the food groups is important. These groups include red meat, fish, and poultry; grains, starches, and breads; fruits and vegetables; and healthy fats, including olive oil. Click through this slideshow to learn more about building a healthy diet plan.
Knowing what to eat when you’re feeling well can make it easier to maintain a healthy weight, prevent fatigue, and get the vitamins and minerals your body requires to stay healthy.
Likewise, knowing what your body does and doesn’t need during a painful bout of ulcerative colitis can reduce symptoms like gas and diarrhea and help you feel better.
The Link Between Diet and Ulcerative Colitis
People with ulcerative colitis may feel fine for extended periods of time between bouts of painful symptoms. Medications and other treatments are designed to lengthen the time between ulcerative colitis flares, and diet can play a role as well.
Flares of ulcerative colitis may arise for no apparent reason, but several possible triggers have been identified: stress, not taking prescribed medications as directed, taking antibiotics or certain nonsteroidal anti-inflammatory drugs (NSAIDs), and eating certain foods.
Although diet has not been proven to cause or contribute to ulcerative colitis, many people with the condition associate flares with the foods they eat. However, there’s no one type of food that causes symptoms in everyone — colitis triggers vary dramatically from person to person.
“Ulcerative colitis is not a condition that has a lot of common factors between people,” says Sonya Angelone, MS, RDN, CLT, a spokeswoman for the Academy of Nutrition and Dietetics and a nutritionist in private practice in San Francisco. “There are really individual food tolerances, so the diet needs to be tailored to each specific person.”
According to experts, some key steps can help you identify your personal dietary triggers:
Work with a dietitian who specializes in treating inflammatory bowel diseases
- Keep a food diary
- Get tested for food sensitivities
“Ulcerative colitis has a strong inflammatory component,” Angelone adds. “A person with colitis can try to identify those foods that cause their inflammation and then omit them.” But always talk to a dietitian or another health care professional before eliminating healthy foods from your diet.
Foods for Ulcerative Colitis
When you’re symptom-free, it may not seem important to eat certain foods or omit others. However, weight loss, fatigue, and nutrient deficiencies are all common problems with ulcerative colitis, which makes following a healthy diet between flares critical.
Since some people with ulcerative colitis have a tough time eating fiber, fear of flares may keep them from eating nutritious fruits and vegetables, explains Tracie Dalessandro, MS, RD, CDN, a clinical dietitian in private practice in New York City and author of What to Eat With IBD: A Comprehensive Nutrition and Recipe Guide for Crohn’s Disease and Ulcerative Colitis.
However, thoroughly cooking and pureeing fruits and vegetables can make them easier to digest (while still rich with vital nutrients).
To combat fatigue and weight loss, Dalessandro recommends eating foods with the highest quality nutrients, such as high-quality proteins, fruits, and vegetables, and staying away from fried and highly processed foods that are low in nutrient quality and density.
People with ulcerative colitis may also benefit from taking supplements. Dalessandro gives the following advice:
- Get screened by a dietitian and then take suggested nutritional supplements
- Take a well-rounded multivitamin
- Take a probiotic or eat foods with natural probiotics, like certain types of yogurt, which can also help maintain a healthy balance of intestinal flora and improve digestion
- Following an overall healthy lifestyle — such as getting regular exercise — is also important to maintain when you’re feeling well with colitis.
What to Eat (and What to Avoid) During Flares
During flares, it’s crucial to put as little stress on the intestine as possible, while still getting enough calories to help you feel better. Here are some ways to ease the toll:
Steer clear of high-fiber foods. During flares of ulcerative colitis, it’s important to reduce irritation in the colon. That means staying away from foods that are very high in fiber like nuts, seeds, and popcorn, which can scratch the lining of the colon.
Eat smaller meals. If you have smaller, more frequent meals, you’re putting less of a toll on the intestines at one time, says Abalone. Instead of large meals just a few times a day, try eating five or six smaller meals spaced evenly throughout the day.
This gives your bowels time to more freely digest the food you eat, and may reduce symptoms as well.
Stay hydrated. If you’re experiencing a lot of diarrhea, make sure to get plenty of fluid to guard against dehydration.
Try a little juice. Although she doesn’t generally recommend juicing for people with colitis, during flares, Abalone does acknowledge that getting rid of the fiber through juicing fruits and vegetables can be an easy way to get good nutrition into the body. “Have just a little juice at a time, since too much can fuel diarrhea.” she advises. “And get green juices like kale or smoothies that have fiber already broken down.”
Eat nutrient-dense foods. If they are well tolerated, try to eat nutrient-dense foods that are high in protein and lower in fiber during flares, she suggests. For example, avoid foods like steel-cut oats and try instant oatmeal instead.
Count your calories. Over time, UC makes calorie absorption difficult. This can lead to malnutrition and weight loss during a flare. If your UC flares typically cause you to experience weight loss, you may need to increase your calorie intake during a flare.
This measure can help ensure you receive adequate nutrition.
The same is true for vitamins and minerals. UC makes nutrient absorption difficult, so you may need to take multivitamins or carefully monitor the nutrient level of the foods you eat to ensure you’re ingesting enough vitamins and minerals to meet your body’s daily needs.
Cut back on dairy. Lactose intolerance can cause diarrhea, gas, and abdominal pain. People who are lactose sensitive or lactose intolerant should avoid milk, milk products, and dairy foods.
If you have to eat foods containing dairy proteins or prefer not to avoid them, taking a lactose enzyme product can help your body break down the milk sugar without causing unwanted side effects. Talk with your doctor to see if these products are right for you.
Finally, avoid fatty foods that can be harder to digest and any other known individual triggers you’ve been able to identify. Some medications used for treatment of UC can cause side effects, such as swelling and bloating, if you eat too much sodium.
If you’re using corticosteroid therapy to treat UC, your dietitian may recommend you eat a low-salt diet while using the steroids to prevent or reduce water retention.
Your dietitian may also recommend a low-fat diet, especially during a flare. During this more active phase, greasy, fattening foods can cause gas, bloating, and diarrhea. Avoiding heavy doses of fat may reduce the risk for these complications.
For people with UC, informed dietary choices can make a big difference. Nutrition takes on special importance because the disease makes calorie and nutrient absorption more difficult. You need the most nutrition out of what you eat, when you eat.
Additionally, avoiding trigger foods can potentially make the condition less severe on your body. Your trigger foods can make symptoms worse during flares, and can even keep your body from properly absorbing nutrients from the foods you eat.
For those reasons and more, a well-balanced diet is very important. It can help you prevent triggers and potentially avoid symptoms and complications related to UC.