Ulcerative colitis can cause intense periods of abdominal discomfort, diarrhea, and loss of appetite. While there is no one diet for people with ulcerative colitis, certain dietary modifications may help manage the condition and avoid flares.
This article explores which foods may trigger ulcerative colitis. It also looks at which foods might be beneficial for people with this form inflammatory bowel disease.
Foods to eat
Avocados are high in nutrients and do not aggravate symptoms of ulcerative colitis.
With so many potential dietary triggers, it can be difficult for a person with ulcerative colitis to know what is safe to eat.
As with trigger foods, those that do not aggravate symptoms will vary from person to person. Some of the better choices for someone with ulcerative colitis include:
- Applesauce: This is a good source of nutrients. But similarly to other foods on this list, the high fiber content and fructose may make it less helpful during a flare.
- Salmon: This is rich in omega-3 fatty acids, which may have health benefits beyond the digestive tract.
- Squash: Many varieties are high in fiber, which may make them a bad choice for some people. However, a lot of people find that squash is well tolerated.
- Avocados: These are rich in nutrients and considered a good food choice for people with ulcerative colitis.
- Some fermented foods: These include yogurts, containing active probiotics. The good bacteria in these can aid digestion. Some studies have shown routine use of probiotics can help reduce flares and symptoms.
- Instant oatmeal: If eaten with no flavors added, this is slightly easier to digest than other forms of grains and oats.
- Eggs: These offer a number of nutrients, including omega-3 supplementation. They are typically easy to digest, which makes them good for a diet plan.
- Plenty of fluid: People with conditions like ulcerative colitis may need to drink extra fluid, as diarrhea can lead to dehydration.
Foods to avoid
Though the cause of ulcerative colitis is not understood completely, doctors are sure food is not a cause of the disease. However, the foods people choose to eat seem to have an impact on the episodes of ulcerative colitis flares.
Some foods are generally good to eat, while others may need to be avoided. Not all people will respond the same way to a food, so diets will vary.
Foods to avoid
There are some foods commonly recognized as trigger foods. These include:
Dairy products may trigger symptoms of ulcerative colitis.
- Caffeine: Although there is not a lot of data on the affect of caffeine on ulcerative colitis symptoms, a 2013 survey of 442 people found that 20 percent of individuals with the condition reported caffeine made symptoms worse. Caffeine is found in coffee, tea, soda, and chocolate.
- Dairy products: While not bad for all people with ulcerative colitis, dairy products can trigger symptoms in some. People who are also lactose intolerant should avoid dairy, as the symptoms are similar.
- Alcohol: This may trigger diarrhea in some people.
- Carbonated drinks: Some sodas and beers contain carbonation that can irritate the digestive track and cause gas. Many carbonated beverages also contain sugar, caffeine, or artificial sweeteners, which can be ulcerative colitis triggers.
- High fiber foods: These include dried beans, fruits, whole grains, berries, peas, and legumes. They may increase the number of bowel movements, amount of gas, and abdominal cramping.
- Popcorn: Similarly to other seeds and nuts, this can be difficult to digest.
- Foods that contain sulfur or sulfites: This mineral can cause excess gas production. Some of these foods include beer, wine, almonds, cider, soy, wheat pasta, breads, peanuts, raisins, and cured meats.
- Fatty meat: Fat from meat may not be properly absorbed during a flare, which may make symptoms worse.
- Nuts and seeds: Included are those in nut butters. They may cause abdominal cramping, bloating, and diarrhea. When a person experiences a flare, even small seeds may trigger symptoms.
- Sugar alcohols: These can cause bloating, diarrhea, and gas. Sugar alcohol is in many sugar free gums and candies, some fruit juices, and various ice cream.
- Fructose sugar: This can be poorly absorbed causing increased gas, cramping, and diarrhea. Check the label for things like high-fructose corn syrup, fruit juice, honey, and molasses, as these all contain fructose.
- Many vegetables: These are often high in fiber, which can be hard to digest, causing bloating, gas, and abdominal cramps. Stringy vegetables like celery are similar. Other gas-producing vegetables include cabbage, Brussels sprouts, and broccoli. Cooked vegetables are better tolerated than raw.
- Spicy foods: These include buffalo wings, hot sauces, and hot peppers. They may cause diarrhea in many people. For people with ulcerative colitis, hot and spicy foods may trigger or worsen a flare.
- Gluten: This is found in wheat, rye and barley and can sometimes trigger symptoms in ulcerative colitis, Although oats do not contain gluten, they have a similar protein that can cross-react in individuals sensitive to gluten. Oats are also often processed in the same factory space as wheat.
Identifying inflammatory foods
A diet plan or food journal should concentrate on nutrition and which foods to add or subtract based on symptoms.
The best approach to determine what foods to eat or avoid is through a food journal.
A daily food journal allows a person with ulcerative colitis to make informed decisions about potentially bad foods. It should be organized so it is easy to read and share with a doctor. Some good things to include are:
- food eaten, including a list of extras added, such as sauces
- time of day food was eaten
- any immediate reactions
- any flares or worsening symptoms
Food journals are particularly helpful when people are looking to add additional food to their diets.
By adding one food at a time and recording it, a person can determine if the food is a good choice or not, by assessing whether symptoms are worsening or staying the same.
Ulcerative colitis diet plans
Diet plans for people with ulcerative colitis will vary. The best tend to start with a food journal, which shapes the food choices and ideas in the plan.
Diet plans should include the following information:
- Good foods to eat: This will include a list of foods a person knows do not aggravate their symptoms.
- Bad foods to eat: Similarly, a list of foods they know are triggers.
- Properly balanced nutrition: One of the biggest complications for people with ulcerative colitis is inadequate nutrition, due to limited food tolerances or poor choices. People should look for ways to modify foods rather than avoiding them, so the nutritional benefits are not lost. For example, peeling or cooking a fruit or vegetable might make it more tolerable.
- Supplements: Some foods high in nutrients may not be digestible for people. Or a person may lack nutrients. In these cases, they can add supplements to replace nutrients not obtained in their food.
- Meal plans: These should take into account a person's schedule and have built-in snacks. The better planned out a meal is, the more likely someone is to stick to eating foods that do not aggravate their symptoms.
- Review and approval of a doctor or nutritionist: Either professional can give advice on balancing the diet or alternative food choices an individual might not have considered.
- Continue the food journal: Ulcerative colitis can change over time, so it is important to track and record food intake, as part of the diet plan's maintenance.
Good diet plans should be reviewed occasionally to account for any changes in the body's reaction to food. It is important, too, to keep a doctor in the loop about any changes.
There are some pre-made diets and plans available to help people. Some examples include diets that avoid certain fermentable sugars, such as the low FODMAP diet, which are low in residue or low in fiber.
However, diets that are "one size fits all" may not work for all people. It is important for anyone looking to switch diets or follow a pre-made plan, to talk with their doctors or dietitians before starting.