For many people with ulcerative colitis, finding the right diet plan is a process of elimination. You cut out certain foods that seem to aggravate your symptoms and then see how you feel.
No one diet is proven to help with ulcerative colitis, but a few eating plans might help some people with the condition keep their symptoms at bay.
Your dietary needs may change when you’re in a flare. In general, the best foods for people with this condition include:
- low fiber fruits like bananas and cooked fruits
- non-cruciferous vegetables like asparagus, potatoes, and cucumbers
- refined grains like white pasta, white rice, oatmeal, and certain breads
- lean protein sources like fish, chicken, lean pork, eggs, and tofu
Certain foods may aggravate your symptoms, including these:
- fruits with seeds and skins
- dairy products
- spicy foods
- fried or greasy food
The low-residue diet
The “residue” in this diet’s name refers to foods your body can’t digest well that end up in your stool. It’s sometimes used interchangeably with the term “low fiber diet.”
The low-residue diet is low in fiber and allows the digestive tract to rest.
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 normally eat, while keeping your fiber consumption down to around 10 to 15 grams per day.
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-residue 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, 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, and dressings (not tomato), whipped cream, and smooth condiments
- plain cakes, cookies, pies, and Jell-O
What not to eat:
- 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
This diet should only be used temporarily while experiencing a flare-up. Talk with your doctor or nutritionist for further guidance on how and when to follow a low-residue diet.
The Paleolithic diet, or paleo diet as it’s commonly known, takes 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 caveman 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 not to eat:
- 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 can lead to vitamin D deficiency and other nutrient shortages.
If you’d like to try it, ask your doctor whether you’ll need to take a supplement.
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 allow 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 ulcerative colitis 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 not to eat:
- processed meats
- table sugar
- corn syrup
You may need to modify it based on your symptoms.
For example, fruits, raw vegetables, and eggs could make diarrhea worse when you’re in a flare.
This diet can also leave you low in certain nutrients, including B vitamins, calcium, vitamin D, and vitamin E. Ask your doctor if you’ll need to take supplements if you go on the Specific Carbohydrate Diet.
The low-FODMAP diet is similar to the Specific Carbohydrate Diet. Both diets follow the premise that poorly absorbed carbs and sugar in the gut lead to the excess growth of bacteria and ulcerative colitis symptoms.
Yet the components of this diet are slightly different.
What you can eat on the low-FODMAP diet:
- bananas, blueberries, grapefruit, honeydew
- carrots, celery, corn, eggplant, lettuce
- all meats and other protein sources
- rice, oats
- hard cheese
- maple syrup
What not to eat:
- apples, apricots, cherries, pears, watermelon
- Brussels sprouts, cabbage, legumes, onions, artichokes, garlic, leeks
- wheat, rye
- milk, yogurt, soft cheese, ice cream
- high-fructose corn syrup
While the low-FODMAP diet may improve symptoms like gas and bloating, it won’t bring down inflammation and prevent damage to your GI tract.
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 not to eat:
- wheat, barley, rye, and oats
- processed products like beer, cake, bread, pastas, and gravies made with these grains
The Mediterranean diet includes fruits and vegetables, poultry, fish, dairy, whole grains, nuts, seeds, olive oil, and red wine. Red meat is included only in small amounts.
Although the Mediterranean diet hasn’t been well studied in people with ulcerative colitis, it has been shown to bring down inflammation in general.
Researchers are currently investigating how well it stacks up against the Specific Carbohydrate Diet for treating IBD.
What you can eat on the Mediterranean diet:
- vegetables and legumes
- nuts and seeds
- whole grains
- dairy products
- olive oil and other healthy fats
This diet doesn’t really restrict any foods, although it includes red meat only in limited amounts.
All of the diets above are intended to be temporary and followed during a flare-up. Working with a dietitian can help prevent deficiencies in certain micronutrients, which is common with IBD.
During a flare it’s helpful to eat four to six small meals per day rather than fewer larger meals. It’s also very important to drink fluids because diarrhea can occur with a flare and cause dehydration.
Everyone’s body is different, so it’s possible for two people who have ulcerative colitis to have different trigger foods.
Logging what you eat throughout the day and when digestive systems occur can help you and your doctor narrow down your personal food triggers. This can be especially helpful if you’re trying a new diet.
Creating an ulcerative colitis diet is not a one-size-fits-all process. Your dietary needs and restrictions will change as your symptoms come and go.
To ensure that you eat the right balance of nutrients and don’t aggravate your condition, work with a dietitian. You may need to keep a food diary to see which foods you can’t tolerate.