What to Know About Diet and Nutrition When You Have Ulcerative Colitis
Ulcerative colitis, a chronic inflammatory disease of the large intestine (colon), isn’t known to be caused by any particular food or diet.
Studies suggest that people who eat more saturated fat and sugar and fewer fruits and vegetables are at a greater risk for the disease.
Changing your diet won’t cure ulcerative colitis. But during a disease flare, some foods may aggravate your symptoms more than others.
If you have a flare-up and experience frequent loose stools, have a fecal infection, or have constipation or incomplete evacuation, you will need to stay hydrated and replace lost fluids.
When the disease is in remission (not causing symptoms), experts suggest simply following a balanced diet that provides the basic nutrients needed for good health. The fewer foods you restrict, the easier this is to accomplish.
What Foods Can You Eat When You Have Ulcerative Colitis?
There is no one-size-fits-all diet for people living with ulcerative colitis. Your diet will likely vary when you are in remission versus when you have disease flares.
During remission, it’s important to maintain a nutrient-rich diet to stay healthy by eating foods like these:
Fiber-Rich Food Beans, barley, nuts, oat bran, and whole grains are part of this category. But if you have an ostomy or intestinal narrowing, or have had a recent surgery, a low-fiber diet is advised.
Foods High in Protein This includes lean meats, eggs, fish, and tofu.
Fruits and Vegetables Include as many different colors of fruits and vegetables in your diet as you can.
Calcium-Rich Foods Yogurt, collard greens, and milk (if you are not lactose intolerant) are among the offerings as well as calcium-fortified foods and drinks.
Foods to Eat When You Are Having a Flare
During a disease flare, it’s often helpful to stick to bland foods that are easy to digest.
You may want to try the following foods:
Bananas
White or sourdough bread
Crackers made with white flour (not whole-grain flour)
White rice (not brown rice)
Cheese (if you’re not lactose intolerant)
Diluted fruit juices and sports drinks
Applesauce
Canned fruit
Smooth peanut butter
Plain cereal
Refined pasta (not whole grain)
Broth
Cooked vegetables
Potatoes without skin
Broiled or steamed fish
Plain turkey, chicken, or eggs
Keeping a food journal can help you figure out which foods bother you and which ones don’t.
Consuming more omega-3 fatty acids may help reduce inflammation in ulcerative colitis.
Foods high in omega-3 fatty acids include these items:
What Foods Should You Avoid When You Have Ulcerative Colitis?
While no foods have been clearly found to worsen inflammation or ulceration in ulcerative colitis, some foods may make symptoms such as cramping and diarrhea worse.
During a flare, it’s often best to avoid high-fiber foods, which are harder to digest than low-fiber foods.
High-fiber foods include these items:
Fresh fruits
Prunes
Legumes like beans and lentils
Nuts
Seeds
Uncooked vegetables or vegetables with skin
Cruciferous vegetables like broccoli and cabbage
Whole grains
Greasy, fried, or high-fat foods such as butter, margarine, and cream may also cause diarrhea.
Approach some other foods and beverages cautiously:
Alcoholic Beverages Drinking alcohol can make diarrhea worse.
Caffeine This substance found in coffee, tea, chocolate, and many soft drinks can trigger diarrhea.
Carbonated Beverages Fizzy drinks can cause bloating and gas in some people.
Grains Some grains may cause abdominal discomfort and diarrhea, especially if you’re sensitive to gluten.
Dairy Products These foods may cause bloating and diarrhea, especially if you’re lactose intolerant. But they can be a good source of protein and other nutrients.
Spicy Foods These foods may trigger diarrhea.
Sweets High-sugar foods and beverages like candy and juices can contribute to water loss and dehydration.
Ultra-Processed Foods Soft drinks, refined sweetened foods, salty snacks, and processed meat are part of this category.
Some people will have more trouble with certain foods and beverages than others. It’s important to find out which foods cause you digestive discomfort and then avoid them.
Getting Enough Fluids When You Have Ulcerative Colitis
The colon absorbs water from digested food and moves solid waste out of the body. When your colon is inflamed during an active bout of ulcerative colitis, it doesn’t absorb water properly, which can lead to diarrhea and dehydration.
That’s why it is so important to drink enough fluids when your ulcerative colitis is active.
A good rule of thumb is to consume half an ounce (oz) of fluid per pound (lb) of body weight per day.
If you weigh 150 lbs, for example, you need at least 75 oz of fluid a day, or more than 9 cups. Most beverages, and even some high-water foods like watermelon and cucumbers, count toward this total.
Since drinking ice-cold liquids or consuming too much fluid at once can worsen diarrhea, it’s best to take sips of warm or cool beverages throughout the day.
Avoid gulping fluids, since this can aggravate diarrhea and cause you to swallow air along with the fluid, resulting in burping.
A good way to gauge your fluid intake is to monitor the color of your urine. If it’s pale or clear, you’re probably getting enough fluids.
Getting Enough Nutrients When You Have Ulcerative Colitis
Ulcerative colitis can make it difficult to get the nutrition you need — in terms of both major components of your diet, like protein, and specific vitamins and minerals.
You may need to take vitamin or mineral supplements to make up for nutrient deficiencies caused by ulcerative colitis, your diet, or the medication you take to treat the disease.
Talk to your doctor or registered dietitian nutritionist about what supplements, if any, you may need.
Focus on two major nutrition categories:
Total Calories Since ulcerative colitis can reduce your appetite while increasing your calorie needs, you may need to consume more calories than you’re used to.
Protein When you’re in remission, an adequate intake of protein is usually considered 1 gram (g) each day for each kilogram (kg) — about 2.2 lbs — of body weight.
This means that if you weigh 150 lbs (68 kg), you should consume 68 g of protein daily.
But your protein needs may increase by as much as 50 percent right after a flare.
Folate, especially if you take sulfasalazine (Azulfidine)
Magnesium, especially if you have chronic diarrhea
Calcium, especially if you take prednisone (Deltasone)
Iron, especially with greater blood loss from severe disease
Potassium, a higher risk with chronic vomiting or diarrhea, or if you take prednisone
Eating during a disease flare may cause abdominal cramping. One way to minimize this discomfort is by eating frequent, small meals of bland foods.
If you’re having trouble finding foods that don’t worsen your symptoms, or if you’re losing weight because of that difficulty, consult a registered dietitian who is knowledgeable about inflammatory bowel disease.
Your dietitian may recommend liquid supplements if you can’t tolerate solid foods.
Additional reporting by Ali McPherson and Quinn Phillips.
