A low FODMAP diet won’t address the inflammation of ulcerative colitis (UC) but may help to improve gastrointestinal (GI) symptoms.
Ulcerative colitis (UC) causes many gastrointestinal (GI) symptoms, including bowel urgency, diarrhea, blood in the stool, pain, and frequency. Inflammation is the underlying cause of symptoms. Medication to lower inflammation is the core of UC treatment.
A low FODMAP diet may help with the GI symptoms of UC. FODMAPs are types of carbohydrates that can be harder to digest. In some people, high FODMAP foods may increase symptoms such as diarrhea, urgency, bloating, and abdominal pain.
A low FODMAP diet won’t lower inflammation in the body but may help to lessen gut symptoms.
A low FODMAP diet is often helpful for people with irritable bowel syndrome (IBS). There is an overlap in the symptoms of IBS and UC, including diarrhea, urgency, abdominal pain, and bloating. Even when in remission, many people with UC continue to experience IBS-like symptoms.
Here’s more about a low FODMAP diet and whether it might be worth a try.
FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. These are all types of sugars, or short-chain carbohydrates, that are found in many different foods.
FODMAPs digest and absorb differently in the small intestine than other types of carbohydrates. Many carbohydrates are broken down in the small intestine before they get to the large intestine.
FODMAPs resist digestion in the small intestine. They arrive in the large intestine, or the colon, as bigger molecules, which can be a problem for anyone with UC or IBS.
The bacteria in your large intestine try to break them down. This process is known as fermentation. This creates a lot of gas, which increases bloating and abdominal pain. These larger molecules also cause fluid shifts in your large intestine. This can change your bowel movements and lead to constipation or diarrhea.
It’s important to note that FODMAPs are found in nutritious foods and should only be avoided if they trigger GI symptoms. People with IBS or IBS-like symptoms may be more sensitive to FODMAPs, but many people tolerate FODMAPs just fine.
That’s why a low FODMAP diet might be a helpful strategy to lessen those GI effects.
A low FODMAP diet won’t reduce the inflammation of UC or repair damage from inflammation. It may still be helpful to manage digestive symptoms. Foods high in FODMAPs can cause GI symptoms in some people. When you’re already experiencing these symptoms due to inflammation, high FODMAP foods may make them worse.
More than
Several studies have also shown that a low FODMAP diet can improve IBS-type symptoms in people with UC. A 4-week trial published in 2020 explored whether a low FODMAP diet would improve digestive symptoms in people with Crohn’s disease and UC in remission. The study found that a low FODMAP diet significantly improved bloating and overall IBS symptom scores.
A low FODMAP diet includes a variety of foods that are low in FODMAPs. Reducing your overall intake of foods high in FODMAPs might reduce GI symptoms.
It might seem overwhelming, especially if you have other dietary needs. It’s smart to work with a registered dietitian who specializes in low FODMAP eating. It’s a lot to navigate on your own, especially if you’re experiencing the GI symptoms, pain, and fatigue of a flare.
These are not complete lists, but some examples of what to eat and avoid on a low FODMAP diet.
Foods to eat
These foods are lower in FODMAPs:
- Fruits: grapes, oranges, kiwis, pineapple, and papaya
- Vegetables: carrots, eggplant, bok choy, kale, lettuce, cucumber, tomato, and spinach
- Grains: products made without wheat, barley, and rye, such as those labeled gluten-free, oats, corn tortillas, sourdough bread, spelt bread, rice cakes, rice, quinoa, and amaranth
- Dairy: lactose-free dairy products, milk alternatives such as almond or soy beverage, and cottage cheese
- Meat and meat alternatives: plain beef, pork, chicken, fish and seafood, eggs, tofu, and some nuts/seeds such as macadamias, peanuts, and pine nuts
- Sweeteners: Honey, high-fructose corn syrup, and sugar-free products that include sugar alcohols such as sorbitol, xylitol, and erythritol
Foods to avoid
These foods are higher in FODMAPs:
- Fruits: apples, mangos, cherries, watermelon, blackberries, pears, apricots
- Vegetables: onions, garlic, mushrooms, cauliflower, artichoke, asparagus
- Grains: most wheat-, barley- or rye-based grain products
- Dairy: milk products that contain lactose, such as milk, ice cream, or yogurt
- Meat and meat alternatives: meat seasoned with onion or garlic, some processed meats, beans, legumes, dried peas and lentils, cashews, and pistachios
- Sweeteners: table sugar, maple syrup, rice malt syrup, and dark chocolate
It’s important to note that the quantity of FODMAP foods also matters. For example, eating higher FODMAP foods in smaller amounts or less often may be fine, whereas eating higher FODMAP foods in larger amounts or more often might cause symptoms.
A low FODMAP diet is not intended to replace any medications or treatments for UC. During a flare of UC, you will need to continue to take any medications as directed.
If a low FODMAP diet improves your GI symptoms, you might be able to cut down on medications you use for specific symptoms such as diarrhea.
Some people start to see results within a few days to weeks of being on a low FODMAP diet. It’s recommended that you don’t stay in the elimination phase of the low FODMAP diet for more than 6 weeks.
The elimination phase can last up to 4 to 6 weeks. If you’re not feeling any better after 6 weeks, there’s no benefit to continuing a low FODMAP diet.
The elimination phase of a low FODMAP diet is short-term because it’s hard to get all the nutrients you need with a restricted diet. The next phase of a FODMAP diet is to reintroduce foods into your diet. This process can help narrow down what foods might have been making your symptoms worse and what foods you tolerate.
If you plan to try a low FODMAP diet, it’s a good idea to mention it to your doctor.
Ask for a referral to a dietitian who has experience working with people on a low FODMAP diet. They can also ensure you’re eating a nutritionally balanced diet and that you don’t develop any nutritional deficiencies during the process. This way, you won’t be trying to figure it all out alone.
The goal is to be as least restrictive as possible. You want to keep any foods that don’t trigger symptoms and only exclude those that do.
If you’ve already started a low FODMAP diet and you’re starting to feel better, that’s great news. If you’re anxious about reintroducing foods after the elimination phase of a low FODMAP diet, you’re not alone. It’s normal to worry that your symptoms will get worse again.
The reintroduction phase is a slow, gradual way to explore your tolerance of FODMAP foods. Work with a healthcare professional who has experience with a low FODMAP diet so you have the support you need.
A low FODMAP diet may be helpful to reduce GI symptoms in people with UC.
A low FODMAP diet won’t lower inflammation, but it may help lessen overall symptoms. Consider working with a registered dietitian who has experience with a low FODMAP diet. It can be tricky to figure it out alone.