Ulcerative colitis and diet

Ulcerative colitis (UC) is an inflammatory bowel disease that causes cramping and chronic diarrhea. It can often be managed with medication, but paying attention to your diet is also important. Triggers like certain foods and beverages and stress can worsen symptoms. Triggers vary from person to person, and there’s no evidence that specific foods cause ulcerative colitis. However, diets that limit certain foods may alleviate symptoms. One such diet is the popular paleo diet.

The paleo diet follows the premise that our bodies are genetically programmed to eat in the same way as our preagricultural, hunter-gatherer ancestors. This means eating foods like meat, eggs, fruits, vegetables, and nuts. The paleo diet limits the amount of whole grains, dairy, refined sugar, and starchy vegetables you eat. It encourages increasing the amount of “healthy fats” in your diet, including omega-3 fatty acids.

Following the paleo diet means avoiding the following foods:

  • cereals and whole grains
  • dairy products
  • legumes
  • processed foods
  • refined sugar
  • potatoes
  • refined vegetable oils
  • salt

These restricted foods may include known common triggers of UC flare-ups.

Here are some reasons why following the paleo diet may help you manage UC:

Whole grains

Whole grains are common triggers of UC flare-ups. They cause gas and increase the amount of stool you produce. Whole grains can also worsen symptoms of proctitis, which is a common condition for those with UC. Eliminating these foods could relieve your symptoms.


Avoiding dairy products can help you manage symptoms. These symptoms include diarrhea, abdominal cramping, and gas. Dairy intolerance is common among those with UC.


You may get higher amounts of antioxidants in your diet from eating more fish and healthy fats. Omega-3 and other antioxidants encourage healing. They may have a protective effect on tissues, reducing inflammation and symptoms. Antioxidants may also help you achieve longer periods of remission.


The paleo diet allows you to get more B vitamins and other nutrients that you miss out on by keeping whole grains in your diet. People with UC often suffer from nutrient deficiencies because of rectal bleeding, chronic diarrhea, and poor appetite. Many of the B vitamins and other nutrients in whole grains aren’t well absorbed by the body.


The paleo diet doesn’t include beans and other legumes. These foods may aggravate your bowels and increase stool output and gas.


Meat, fish, and poultry contain heme iron, which is more easily absorbed by the body than non-heme iron found in plants. People with UC have a high risk of iron deficiency anemia from chronic diarrhea and bloody stools.

The paleo diet may offer several benefits for those looking to manage their symptoms, but there are some potential drawbacks. This includes the increased risk of nutrient and mineral deficiencies. Anytime you remove whole food groups from your diet, you run the risk of not getting enough of some essential nutrients.

Many people with UC have low levels of folic acid, a nutrient found in whole grains and legumes. Some medications can also decrease folic acid levels. Folic acid has been found to reduce the risk of colon cancer. The risk of colon cancer is higher in those with UC. The paleo diet may also be higher in fiber, which is not recommended for those experiencing symptoms during a flare-up. The moderate to high amounts of fats present in the paleo diet may also aggravate symptoms in some people.

There’s always some risk involved when drastically changing your diet. Speak to your doctor and dietitian before you embark on any new diet plan.