If you have ulcerative colitis, avoiding triggers such as alcohol and spicy food may help reduce flare-ups. During a flare-up, certain foods, such as low fiber fruits and vegetables, may help prevent symptoms from worsening.
For many people with ulcerative colitis (UC), which is a chronic inflammatory bowel disease (IBD), finding the right diet plan is usually a process of elimination. You cut out or limit certain foods that seem to aggravate your symptoms, and then see how you feel.
No specific diet is proven or “best” to help with UC. But having a plan in place can help some people with the condition manage their symptoms.
Planning meals, snacks, and even your hydration efforts in advance gives you control over everything you’ll be consuming.
With preparation, you can avoid making quick (and sometimes inadvisable) decisions when you’re hungry or thirsty that could result in a flare-up.
Taking the time to plan out your meals and read nutrition labels may take a couple of hours initially, but it can save tons of time throughout the week overall. Helpful steps include:
- buying ingredients in bulk
- cooking in batches
- preportioning your meals before storing them in the fridge or freezer, making them easier to reheat and eat
Not only will you have your meals prepared ahead of time, but you’ll also help limit food triggers, allowing you to feel better and be more productive overall. Buying and planning your snacks ahead of time is a good way to avoid reaching for trigger foods, too.
Additionally, because frequent diarrhea from UC can cause you to lose more fluid than you put into your body, planning water intake can help you avoid dehydration.
Constipation can be a symptom for some individuals, and their dietary needs may differ.
Keeping a food journal
Everyone’s body is different, so it’s possible for two people who have UC to have different trigger foods.
Logging what you eat throughout the day and when digestive issues occur can help you and your doctor narrow down your personal food triggers.
A food journal can be especially helpful if you’re trying a new diet.
Even when you do everything right, it’s still possible to experience a flare-up of your
- frequent diarrhea
- urgent bowel movements
- rectal bleeding
That’s why it’s important to understand which foods you may want to limit when experiencing a flare-up, and which foods may help you get the nutrients you need without making your symptoms worse.
Easier foods to digest vs. foods that may trigger your symptoms
|Foods to eat||Foods that may trigger symptoms|
|low fiber fruits like bananas, honeydew melon, and cooked fruits||fruits with seeds and skins|
|cooked, non-cruciferous vegetables like asparagus, potatoes, and cucumbers||dairy products|
|refined grains like white pasta, white rice, oatmeal, and certain breads||spicy foods|
|lean protein sources like chicken, lean pork, eggs, and tofu||caffeine|
|omega-3 fatty acids, including fish||nuts|
|homemade protein shakes||alcohol|
|sugar-free or unsweetened applesauce||carbonated beverages like soda and seltzer water|
|nut butters||raw vegetables|
|fatty, fried, or greasy food|
|excess sugar or nonabsorbable sugar|
While there’s no cure for UC, you may experience periods of remission. During this time, you’ll be symptom-free and your UC won’t interfere with your daily life.
There’s no definitive way to avoid flare-ups forever, but you can prolong your remission periods by maintaining a diverse and nutrient-rich diet that does not include trigger foods.
To stay symptom-free, it may be helpful to follow one of the diets that other individuals with UC find successful, as well as introduce new foods slowly and stay hydrated.
However, it’s important to consult with your doctor or dietician before making any changes to your diet.
Some foods that may help keep you feeling good and hydrated during remission
- fiber-rich foods like oats, beans, and nuts
- healthy fats, including olive oil and nut and seed butter
- protein, including lean meats, fish, and eggs
- whole fruits and vegetables
- whole wheat bread, pastas, and brown rice
- vitamin D supplements
Some individuals with UC have found that consistently sticking to a certain diet can help prolong remission and limit flare-ups.
Here are some of the most common diets for UC that may decrease inflammation and keep you symptom-free longer.
Low fiber diet
It was once referred to as a “low residue diet.” The “residue” refers to foods your body can’t digest well that end up in your stool. Recently, this diet was removed from the American Academy of Nutrition and Dietetics Nutrition Care Manual.
Low fiber foods are easy for your body to digest. They can help slow your bowel movements and limit diarrhea. You can still eat a lot of the foods that you’d typically eat while keeping your fiber consumption down to around
Your body will still get enough protein, minerals, fluids, and salt. But since chronic diarrhea and rectal bleeding can lead to nutrient and mineral deficiencies, your doctor may want you to add a multivitamin or other supplement to your diet.
What you can eat on a low fiber diet:
- milk, cottage cheese, pudding, or yogurt
- refined white breads, pasta, crackers, and dry cereals that have less than a 1/2 gram of fiber per serving
- soft and tender cooked meats, such as poultry, eggs, pork, and fish
- smooth peanut and nut butter
- fruit juices with no pulp
- canned fruits and applesauce, not including pineapple
- raw and ripe bananas, melon, cantaloupe, watermelon, plums, peaches, and apricots
- raw lettuce, cucumbers, zucchini, and onion
- cooked spinach, pumpkin, seedless yellow squash, carrots, eggplant, potatoes, and green and wax beans
- butter, margarine, mayonnaise, oils, smooth sauces, dressings (not tomato), whipped cream, and smooth condiments
- plain cakes, cookies, pies, and Jell-O
What to limit or avoid:
- deli meats
- dried fruits
- berries, figs, prunes, and prune juice
- raw vegetables not mentioned in the list above
- spicy sauces, dressings, pickles, and relishes with chunks
- nuts, seeds, and popcorn
- foods and beverages that contain caffeine, cocoa, and alcohol
Talk with your doctor or nutritionist for further guidance on how and when to follow a low fiber diet.
The paleolithic diet, or paleo diet as it’s commonly known, claims to take the human diet back a few thousand years.
Its premise is that our bodies weren’t designed to eat a modern grain-based diet and that we’d be healthier if we ate more like our hunter-gatherer ancestors.
This diet is high in lean meat, which accounts for at least 30 percent of its daily calorie total. Fiber in the diet comes from fruits, roots, legumes, and nuts, rather than from grains.
What you can eat on a paleo diet:
- most vegetables
- lean grass-fed beef
- chicken and turkey
- game meats
What to limit or avoid:
- cereal grains
- refined sugar
Although some people claim they feel better on a paleo diet, there’s no evidence from clinical trials that it helps with IBD. Plus, this diet may lead to vitamin D deficiency and other nutrient shortages.
But due to the limited number of study participants and the fact that most people were also on medication to manage their symptoms, it’s clear that much more research is needed.
If you’d like to try the paleo diet, talk with your doctor about the pros and cons for you.
Specific carbohydrate diet
This diet was originally developed to treat celiac disease, but it has since been promoted for other gastrointestinal (GI) issues. The idea behind it is that the intestines don’t digest or use certain grains and sugars very well.
Eating foods that contain these ingredients allows bacteria in the gut to multiply too quickly, which leads to the excess production of mucus. This contributes to the cycle of intestinal damage that produces UC symptoms.
What you can eat on the specific carbohydrate diet:
- most fruits and vegetables
- nuts and nut flours
- milk and other dairy products that are low in the sugar lactose
What to limit or avoid:
- processed meats
- table sugar
- corn syrup
You may need to modify this diet based on your symptoms.
For example, fruits, raw vegetables, and eggs could make diarrhea worse when you’re in a flare-up.
This diet can also leave you low in certain nutrients, including:
- B vitamins
- vitamin D
- vitamin E
While the specific carbohydrate diet has been popular with individuals with inflammatory diseases, public health experts often recommend diet alternatives due to the lack of health benefits.
Low FODMAP diet
FODMAP is an acronym for fermentable, oligo-, di-, monosaccharides, and polyols. While this may sound complicated, it’s simply a diet that cuts back on sugars that may not be absorbed well by your GI tract.
The low FODMAP diet is similar to the specific carbohydrate diet.
Both diets follow the premise that improperly absorbed carbs and sugar in the gut lead to the excess growth of bacteria and UC symptoms, yet the details are slightly different.
What you can eat on the low FODMAP diet:
- bananas, blueberries, grapefruit, and honeydew
- carrots, celery, corn, eggplant, and lettuce
- all meats and other protein sources
- rice and oats
- hard cheese
- maple syrup
What to limit or avoid:
- apples, apricots, cherries, pears, and watermelon
- Brussels sprouts, cabbage, legumes, onions, artichokes, garlic, and leeks
- wheat and rye
- milk, yogurt, soft cheese, and ice cream
- high fructose corn syrup
Research shows that a low FODMAP diet can decrease the severity of symptoms and provide gut relief, as well as improve the quality of life for people with IBD.
While the low FODMAP diet may improve symptoms like gas and bloating, it may not bring down inflammation or prevent damage to your GI tract. This is why it’s only intended for short-term use to reduce symptoms.
If you want to try this diet, ask a dietitian to help you figure out which sugars make your symptoms worse and which ones you can still eat.
Gluten is a protein found in grains like wheat, rye, and barley. Some people with IBD find that cutting out gluten improves their symptoms, although there’s no evidence this diet slows GI damage.
What you can eat on the gluten-free diet:
- fruits and vegetables
- beans, seeds, and legumes
- eggs, fish, poultry, and meat
- most low fat dairy products
- grains like quinoa, corn, buckwheat, flax, and amaranth
What to limit or avoid:
- wheat, barley, rye, and oats
- processed products like beer, cake, bread, pastas, and gravies made with these grains
While a gluten-free diet may help manage your symptoms, many gluten-free products lack necessary nutrients and can be higher in fat or sugar.
Talk with your doctor before starting a gluten-free diet to ensure you’re receiving the nutrients you need.
The Mediterranean diet includes a lot of nutritious foods like fish, fruits and vegetables, and olive oil. Red meat is included only in small amounts. Red wine is also allowed — but in moderate amounts.
Although the Mediterranean diet hasn’t been well studied in people with UC, it has been shown to bring down inflammation in general.
When compared to the specific carbohydrate diet, both diets can help achieve remission. However, due to the health benefits associated with the Mediterranean diet, it is often recommended by health officials over the specific carbohydrate diet.
What you can eat on the Mediterranean diet:
- vegetables and legumes
- nuts and seeds
- whole grains
- dairy products
- olive oil and other healthy fats
- red wine
This diet doesn’t really restrict any foods, although it includes red meat only in limited amounts.
If the Mediterranean diet sounds like something you would enjoy, talk with your doctor to see if it could be the right option for you.
UC is a long-term, chronic disease that can cause inflammation in your bowel as well as digestion issues. Many individuals with UC find that modified diets help ease their symptoms and can sometimes bring on periods of remission.
However, creating a UC diet is not a one-size-fits-all process. Your dietary needs and restrictions will change as your symptoms come and go, and trigger foods — or foods that set off symptoms — can be different for everyone.
Keeping a food diary to track what foods you can and can’t tolerate, and working with your doctor or dietician consistently to ensure you’re eating the right balance of nutrients, is the best way to ease your personal symptoms.
While some UC diets are meant only for the short term to lessen symptoms, others may provide longer periods of relief. Work with your doctor and dietician to find the right diet for your personal health needs.