Foods to eat and avoid with ulcerative colitis

Dietary measures such as eating or avoiding certain foods may help manage symptoms of ulcerative colitis (UC).
Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that causes inflammation and ulcers in the colon.
inflammatory bowel disease (IBD)
Currently, there is no exact cause for this disease. However, doctors believe it has links to:
links
environmental factors
Westernized dietary patterns and lifestyles
genetics
There is no single dietary plan for people with ulcerative colitis, identifying and eliminating foods that trigger symptoms can help reduce discomfort.
ulcerative colitis
This article looks at which foods to avoid or consume to help people with ulcerative colitis manage their symptoms.
To discover more evidence-based information and resources for Crohn’s disease and ulcerative colitis, visit our dedicated hub.
our dedicated hub
Foods to eat
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A person’s diet may contain various potential triggers, so it can be difficult for someone with ulcerative colitis to know what is safe to eat.
Someone may find it difficult to digest certain nutrients, such as fiber, during a flare-up. They may be able to eat these foods outside of a flare-up but find they cause discomfort when symptoms occur.
fiber
Because they may not be able to consume various foods, people with ulcerative colitis are at a higher risk of nutrient deficiencies. Other factors, such as problems with nutrient absorption, may also contribute to this.
higher risk
It’s important that someone with ulcerative colitis eats foods high in vitamins and minerals, including iron, calcium, and vitamin A, to help ensure they get enough nutrients.
vitamins
iron
calcium
vitamin A
Some of the more suitable food choices for a person with ulcerative colitis may include:
include
The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) recommends a higher intake of omega-3 fatty acids for those with the condition.
International Organization for the Study of Inflammatory Bowel Diseases (IOIBD)
omega-3 fatty acids
Some of these foods may include:
salmon
salmon
mackerel
walnuts
walnuts
flaxseed
flaxseed
hemp
hemp
chia seeds
chia seeds
These foods include yogurt, which contains active probiotics. The “good” bacteria in probiotics can aid digestion. Some research suggests that using probiotics regularly may help reduce ulcerative colitis flare-ups and symptoms.
yogurt
probiotics
Some research
Fruits such as bananas and cantaloupes and cooked fruits may be suitable for people with ulcerative colitis.
Fruits
bananas
cantaloupes
These may be easier to digest than whole grains, and may include:
potatoes
potatoes
white pasta
pasta
gluten-free bread
gluten-free
white rice
rice
oatmeal
oatmeal
Manufacturers enrich many white bread and grain products with extra minerals and vitamins.
vitamins
Sources of protein that exclude red meat may be suitable for someone with ulcerative colitis. These include:
red meat
fish
fish
chicken
eggs
eggs
firm tofu
tofu
People with ulcerative colitis may tolerate noncruciferous cooked vegetables without the skin. These include cucumbers, squash, and asparagus tips.
cucumbers
squash
asparagus
People with conditions like ulcerative colitis may need to drink extra fluids, as diarrhea can lead to dehydration.
diarrhea
dehydration
Oral vitamin supplements and protein shakes may help people with ulcerative colitis get enough nutrients. However, it is recommended that a person consult a doctor before they start taking supplements.
Foods to avoid
Dietary patterns can affect ulcerative colitis flare-ups. However, this will vary from person to person, as not all people respond the same way to a particular food.
Some foods may act as potential triggers for ulcerative colitis. These include:
include
Lactose is a sugar in dairy products like milk, cheese, and yogurt. Lactose is not problematic for all people with ulcerative colitis, but lactose-containing products can trigger symptoms in some individuals.
milk
cheese
The IOIBD recommends people with ulcerative colitis limit their intake of these foods to help avoid worsening symptoms.
IOIBD
Alcoholic drinks, such as wine, beer, and liquor, may trigger ulcerative colitis symptoms in some people.
wine
beer
Some sodas and beers contain carbonation that can irritate the digestive tract and cause gas. A 2022 study involving people living in Saudi Arabia suggested a link between drinking carbonated soft drinks and a higher risk of developing ulcerative colitis.
sodas
2022 study
Consumed sugar alcohols, such as sorbitol and xylitol, are not absorbed in the digestive tract and may trigger symptoms. These are found mainly in sugar-free products like chewing gum, mints, and candies. However, sugar alcohols also occur naturally in lower amounts in certain fruits.
These include raw green vegetables like broccoli, whole nuts, whole grains, and fruits with skin on. They may increase abdominal cramping, the number of bowel movements, and the amount of gas experienced.
broccoli
nuts
abdominal cramping
Some sugary foods can trigger an ulcerative colitis flare-up, including:
cakes
pastries
candy
juices
The IOIBD recommends that people with UC limit consuming foods high in saturated fat, such as:
IOIBD
full fat dairy
coconut
processed foods containing palm oil
These include hot sauces, chilies, and hot peppers. Spicy foods may trigger or worsen a flare-up.
This is a protein present in wheat, rye, and barley. It can sometimes trigger symptoms in those with ulcerative colitis. In a 2014 study, almost 66% of participants who tried a gluten-free diet reported an improvement in IBD symptoms, and 38% reported fewer or less severe IBD flares.
barley
2014 study
According to the IOIBD, it may be helpful for people with ulcerative colitis to limit their intake of emulsifiers such as carboxymethylcellulose and polysorbate-80. Manufacturers add these to many processed foods. However, to be transparent, the IOIBD notes that this recommendation is based on limited evidence.
IOIBD
For more science-backed resources on nutrition, visit our dedicated hub.
dedicated hub
Identifying inflammatory foods
Keeping a daily food journal may help someone with ulcerative colitis identify potential dietary triggers and make informed decisions about their diet.
Some useful information to include are:
the date
which foods a person ate, including a list of extras like sauces
the time of day at which a person ate the food
any immediate reactions
any flare-ups or worsening symptoms
Food journals are particularly helpful when people are looking to add additional types of food to their diets.
By adding one food at a time and recording it, a person can determine whether the food is a safe choice by assessing their symptoms.
A person can also share their food journal with a doctor for further insight.
Ulcerative colitis diet plans
Dietary plans for people with ulcerative colitis will vary. The best tend to start with a food journal, which outlines the food choices and ideas in the plan.
Dietary plans should include the following:
Foods to eat: This will consist of foods a person knows will typically not aggravate their symptoms.
Foods to avoid: A dietary plan should also list the specific foods that are known triggers.
Balanced nutrition: One of the most significant complications for people with ulcerative colitis is inadequate nutrition due to certain food tolerances. A person with UC might consider looking for ways to modify foods rather than avoiding them as one way to help increase access to nutritional benefits. For example, peeling or cooking a fruit or vegetable might make it more tolerable.
nutrition
Supplements: An individual can take supplements to replace nutrients they cannot get in their food. They can speak with a registered dietitian or doctor about which supplements may be best, as people’s needs will vary.
Meal plans: These should consider a person’s schedule and include snacks. Someone is more likely to stick to eating better foods if their meals are well planned in advance.
Medical approval: It is a suitable idea to seek approval from a doctor or registered dietitian. These professionals can offer advice and suggest alternative food choices that an individual might not have considered.
It is important that people continue logging their foods and symptoms, even after establishing a dietary plan. Ulcerative colitis symptoms can change over time, so it is essential to track and record any dietary-related changes.
Occasionally reviewing the dietary plan will help account for any changes. It is also vital to inform a doctor if flare-ups worsen or occur more often with the dietary plan and any changes made.
Some premade dietary plans, such as the low FODMAP diet, are available. However, these dietary programs may not be suitable for everyone with ulcerative colitis. If someone is looking to switch eating patterns or follow a premade plan, it is recommended that they talk with a doctor or dietitian first.
low FODMAP diet
Having a support network of experienced doctors and other health professionals is vital when living with ulcerative colitis. Bezzy IBD is a free app for people living with ulcerative colitis. The app is part of the Medical News Today brand and is available via AppStore and Google Play. Download it here.
here
What are the best diets for ulcerative colitis?
Some recent research has investigated new developments in how certain dietary plans affect IBD and ulcerative colitis.
A 2021 review of studies suggests that the Mediterranean diet may benefit people with IBD. However, the authors stated that more research is necessary to investigate this link.
2021 review of studies
Mediterranean diet
Researchers also noted that plant-based and reduced-calorie diets might benefit those with IBD. However, they pointed out that reduced-calorie eating patterns are not appropriate options for those at risk of nutritional deficiency.
plant-based
The review also suggests that the low FODMAP diet did not appear to reduce IBD but may reduce certain gastrointestinal symptoms.
Additionally, a gluten-free diet did not seem to have a notable effect on IBD symptoms.
However, one 2014 study in the literature review found that about 66% of people reported an improvement in at least one IBD symptom following a gluten-free diet. Additionally, 38% of participants also reported having fewer or less severe flare-ups while on the diet.
2014 study
It is important to note that the research into ulcerative colitis and diet is limited. Scientists need to do more research to provide well-informed dietary guidelines for those living with the condition.
Considerations and things to keep in mind
It may be difficult for people with ulcerative colitis to find the dietary plan that works for them.
This may be frustrating and can negatively affect the way a person interacts with food, people, and themselves.
In a 2021 review of 29 studies, participants living with IBD reported patterns of disordered eating, such as restrictive dietary behavior and avoiding food altogether, after receiving a diagnosis.
2021 review
Disordered eating refers to a wide range of eating patterns that may affect a person’s physical and mental well-being. Examples may include:
include
skipping meals or fasting
restricting certain foods even if it has not been recommended to do so by a doctor
constantly thinking about food, diet, and their effects on the body
binge eating
feeling guilty for eating certain foods
Disordered eating may actually worsen symptoms of IBD and have negative outcomes.
Eating disorders can severely affect the quality of life of people living with these conditions and those close to them. Early intervention and treatment greatly improve the likelihood of recovery.
Anyone who suspects they or a loved one may have an eating disorder can contact the National Alliance for Eating Disorders, which offers a daytime helpline staffed by licensed therapists and an online search tool for treatment options.
National Alliance for Eating Disorders
For general mental health support at any time, people can call the Substance Abuse and Mental Health Services Administration 24 hours a day at 1-800-662-4357 (or 1-800-487-4889 for TTY).
1-800-662-4357
1-800-487-4889
Many other resources are also available, including:
The National Association of Anorexia Nervosa and Associated Disorders
The National Association of Anorexia Nervosa and Associated Disorders
F.E.A.S.T., which provides support and educational resources to friends and family who want to help someone living with an eating disorder
F.E.A.S.T.
Some people with ulcerative colitis may find that certain traditional foods from their culture may cause symptoms of IBD, which may be frustrating.
However, a person may not have to completely remove all cultural foods from their dietary plan. They can try keeping as many traditional foods as possible and only replacing those that trigger their UC symptoms.
For example, if a dish contains common trigger foods like red meat, cheese, or gluten, a person can try swapping these for another protein source like chicken, a lactose-free cheese, or a gluten-free alternative.
If spicy foods are the trigger, a person may consider retaining the mild spices in the dish or cutting back on the amount of hot spices used.
People with ulcerative colitis may experience weight gain due to increased hunger resulting from taking certain medications or arising when their symptoms settle down.
due to
This may cause some people to think more negatively about their physical appearance, which may lead to disordered eating or negative feelings about themselves.
It is important to remember that the body is always changing for a variety of reasons. Societal expectations of how to “look” or what to eat are not always scientifically supported and do not always support positive health outcomes.
To discover more evidence-based information and resources for weight management, visit our dedicated hub.
our dedicated hub
Can ulcerative colitis progress to a worse health condition if I eat the wrong thing?
Research suggests that consuming a diet high in meat and low in fruits and vegetables can increase the risk of ulcerative colitis flare-ups.
Research
In some cases, these flare-ups do not respond to medical treatment and may require surgery to remove part of the colon. Additionally, the risk for colon cancer is higher in people with ulcerative colitis, especially when the disease is more severe and a person has issues managing it.
surgery
risk for colon cancer
While there is no cure for ulcerative colitis, following a nutritious diet and avoiding trigger foods may help people manage symptoms and maintain good overall health.
Frequently asked questions
Some types of foods that are recommended for people with ulcerative colitis include:
omega-3-rich foods like salmon and walnuts
probiotic foods like yogurt
low fiber foods like cantaloupes and bananas
refined grains like potato and white pasta
lean protein like fish and chicken
noncruciferous vegetables like cucumbers and squash
It is important to note that fiber, whole grains, and cruciferous vegetables should only be avoided during flares. Over the long term, high fiber diets may help improve UC symptoms.
help improve UC symptoms
Trigger foods vary for everyone who has ulcerative colitis. However, some common trigger foods to avoid may include:
lactose products, such as milk and cheese
red meat and processed meat
alcohol
carbonated drinks
sugar alcohols, such as those found in sugar-free products like chewing gum, mints, and candies
insoluble fibers, such as in broccoli and whole nuts
high fat foods
sugary foods
gluten
spicy foods
There are many types of pizza that people can and cannot eat. It depends on the types of food that trigger a person’s ulcerative colitis symptoms. If gluten and dairy both trigger symptoms, a person may consider eating a pizza made using a gluten-free dough and either having no cheese or lactose-free cheese.
Summary
There is no single dietary plan that will work for all people with ulcerative colitis. However, identifying and eliminating any foods that may worsen an individual’s symptoms can help reduce discomfort.
Foods that a person with UC may want to avoid include lactose products, alcohol, gluten, spicy foods, and foods high in sugar and fats.
Some foods that may benefit individuals with ulcerative colitis include salmon, mackerel, chia seeds, walnuts, and other foods high in omega-3 oils.
Creating a food journal may help a person identify and limit trigger foods. A doctor or dietitian can also assist a person in finding a dietary plan that works best.