Ulcerative colitis is a type of inflammatory bowel disease (IBD) in which the immune system is thought to attack the lining of the gut and not recognize it as part of the body. A targeted ulcerative colitis diet can therefore help manage symptoms. Under the guidance of an IBD team or a dietitian, people with ulcerative colitis may be placed on an elimination diet to identify potential trigger foods, or encouraged to keep a food journal to identify associations between specific foods and symptoms to track .
However, ulcerative colitis diet is often individual, so some experimentation under medical supervision may be required to find the right eating pattern for you. An ulcerative colitis diet may also not work at all, so it’s important to work with your medical team to properly manage your condition.
Ulcerative colitis diet: what to eat when you have a flare-up
A low-residue diet is often recommended to manage the symptoms of ulcerative colitis. The Canadian Society for Gut Research (opens in new tab) describes “residue” as the solid contents that remain in the gut after digestion with the goal of reducing the number of bowel movements in a day. “Residue” includes fiber, which is limited to 10-15g per day, but the low-residue diet differs from the low-fiber diet in that it includes foods that may encourage frequent bowel movements, such as dairy, caffeine, alcohol, and grist or fatty meat.
dr Deborah Lee, from dr Fox online pharmacyrecommends the following foods for a low-residue diet:
- Low-fiber fruits and vegetables such as melon and bananas as well as compotes
- Lean protein like white meat, eggs, and tofu
- Refined grains like white bread, white pasta, and oatmeal
- Cooked seedless and skinless vegetables such as cucumber, potato and squash.
While a low-residue diet can help with a flare-up, a spokesman for a UK-based charity said Crohn’s & Colitis UK (opens in new tab) recommends speaking to a nutritionist before attempting to reduce your fiber intake. “Fiber is important to your health, so it’s important to talk to a dietitian before cutting back,” they say. “You might suggest cutting back for a short time during a flare-up and then slowly bringing it back into your diet. It’s important to stay hydrated, especially if you have a lot of diarrhea. Drink plenty of fluids, but avoid caffeine and alcohol. You can take oral rehydration salts if you’re losing a lot of fluids. You can buy these in pharmacies or supermarkets.”
Cooking your food can also break down some of the fiber to make it more digestible, according to a study in the Journal of Vegetable foods for human consumption (opens in new tab)indicating that the cooking process reduces the amount of insoluble fiber in some vegetables.
Ulcerative colitis diet: what to avoid when you have an attack
A study in the Journal of advances in nutrition (opens in new tab) found that a high-fat diet can increase intestinal permeability, which is already a problem for people with ulcerative colitis. A review in mediators of inflammation (opens in new tab) Journal points out that the disruption in the gut wall caused by ulcerative colitis can also increase gut permeability, and so it’s wise to reduce foods that also affect gut permeability, especially during an flare-up.
A spokesman for Crohn’s & Colitis UK (opens in new tab) explains that there is no one-size-fits-all approach to eating during a flare-up.
“There is no evidence that any particular diet helps people with ulcerative colitis,” they say. “Some people find that certain foods trigger symptoms or flare-ups, but others don’t. Everyone is different and what works for one person may not work for another. There is no single diet that works for everyone. Although changing your diet can help you manage your symptoms, it is not a substitute for medical treatment. It’s important not to make any changes to your diet without talking to your doctor IBD Team or nutritionist first.”
They also warn that dietary changes may not be helpful for some people with ulcerative colitis. “Avoiding certain foods helps some people manage some common symptoms,” they say. “But for some people, a change in diet has no effect. Foods that sometimes make symptoms worse include spicy or fatty foods, foods high in fiber, foods that contain fiber gluten and dairy products. Drinks with caffeine, artificial sweeteners, or alcohol can also make diarrhea worse.”
Ulcerative Colitis Diet: Identifying Trigger Foods
There are a few ways you can identify your top trigger foods:
according to dr Lee can make an elimination diet easier for you to identify your trigger foods. “You can only do that under medical supervision,” she says. “The goal is to identify trigger foods that could be making your symptoms worse. Trigger foods can include foods high in fiber, foods high in lactose, certain types of sugar such as sorbitol or mannitol, foods high in sugar such as cakes and pastries, foods high in fat, alcohol, and spicy foods.”
Keep a food diary
Another method you could use is to keep a food journal and note any correlations between your diet and your symptoms. A Crohn’s & Colitis UK spokesperson told Live Science: “It can be helpful to talk to your IBD team or dietitian about your diet. It can help show if you’re getting enough nutrients or if any foods might be contributing to your symptoms.”
They also advise:
- Write down everything you eat and drink and at what time. You can use a printed food diary, a notebook, your phone, or an app. Provide as many details as possible.
- Write down any symptoms you had and when.
- Try keeping the journal for a few weeks and see if you notice any patterns.
Ulcerative Colitis Diet: Meal Prep and Meal Planning
While the idea of an elimination diet or restricting your intake of fiber, fat, or other trigger foods may seem daunting, planning meals and preparing your food ahead of time can take some of the stress out of eating in a flare-up. If your appetite is also affected, instead of making a whole new meal from scratch, you can cook a larger, prepackaged meal at your whim and eat whatever you want.
That Crohn’s and Colitis Foundation (opens in new tab) points out that rates of depression and anxiety are higher in patients with IBD, so anything that can reduce stress for patients with ulcerative colitis may be helpful in managing mental health. Therefore, pre-planned meals based on specific dietary needs can make the daily experience of ulcerative colitis a little less stressful and make the experience of a flare-up more bearable.
This article is for informational purposes only and is not intended to provide medical advice.
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