Eating an Ulcerative Colitis Diet

Diet and the foods you eat are important components of managing ulcerative colitis (UC). On the one hand, certain foods can make UC symptoms worse, including sugary, fried, greasy, and high-fiber foods. On the other hand, a low-residue diet comprised of lean proteins, refined grains, and starchy vegetables may help ease or alleviate UC-related abdominal pain, cramping, and diarrhea.

This article provides you with a general framework for managing ulcerative colitis with diet, including the list of foods you can eat and those you should avoid.

Aims and Principles of a Colitis Diet

Ulcerative colitis is one form of inflammatory bowel disease (IBD) alongside Crohn's disease (CD). It is typically more severe than CD, causing inflammation and ulcers in the colon and rectum when the disease is active. Abdominal pain, cramping, and blood mixed with diarrhea (hematochezia) are hallmarks of the disease, along with fatigue and weight loss.

Diet can help manage UC by putting less stress on the colon. This typically involves a low-residue diet comprised of foods that don't leave undigested grit in stools. By eating low-residue foods, there is less chance that stools will scrape against open sores and cause pain and bleeding.

Another part of the dietary strategy is to eat foods that are binding. These are foods low in fiber that help ease diarrhea by making stools firmer. They include refined grains and soft fruits high in pectin (a natural gelatin-like substance). An example of this is the BRAT diet composed of bread, white rice, applesauce, and toast.

Among the foods to avoid are those that can irritate already-inflamed tissues and ulcers, such as spicy foods, alcohol, coffee, and foods high in saturated or trans fat (both of which trigger inflammation).

Sugary foods should be avoided as they can alter the balance of harmful/helpful bacteria in the gut and make UC symptoms worse.

While dairy doesn't usually make UC worse (and can often be helpful), many people with UC are lactose-intolerant and lack the enzymes needed to break down this form of sugar. In such cases, dairy may need to be replaced with non-dairy substitutes like almond milk or oatmeal yogurt.

By adhering to these general principles, you may be better able to manage UC flare-ups and possibly reduce the frequency of flare-ups when combined with the appropriate UC medications.

Ulcerative Colitis Doctor Discussion Guide

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Foods to Eat If You Have Ulcerative Colitis

When experiencing a UC flare-up, the best foods to eat are those that provide sufficient nutrients without worsening your symptoms. Speak with your healthcare provider or a nutritionist to help you find the foods that best meet these needs.

Low-fiber fruits are an ideal part of a UC diet and include:

• Applesauce
• Apricots (ideally skinned)
• Bananas
• Cantaloupes
• Cooked or canned fruit
• Fruit juices without pulp
  
• Honeydew melons
• Nectarines (ideally skinned)
• Papayas
• Peaches (ideally skinned)
• Plums (ideally skinned)
• Watermelon (seeded)

Vegetables that are low in fiber and residue include:

• Beets (cooked)
• Canned vegetables (without seeds or skins)
• Carrots (cooked)
• Cucumber (peeled and without seeds)
• Potatoes (without skins)
• Spinach (pureed)
• Squashes (like butternut and acorn squash)
• String beans (well-cooked)
• Tomato sauces
• Vegetable juice (strained)
  

Lean protein is also ideal whether you have active UC symptoms or not. These include plant- and meat-based proteins like:

• Canned tuna (packed in water)
• Cottage cheese (low-fat)
• Eggs (not fried)
• Fish (skinless)
• Hummus
• Peanut butter powder
• Pork (lean and trimmed)
• Poultry (without skin)
• Seitan
• Tofu
• Yogurt (plain)

Refined grains that are suitable for UC flare-ups include:

• Cornflakes
• Cream of wheat
• Farina
• Grits
• Melba toast
  
• Oatmeal
• Pasta and noodles
• Puffed rice cereal
• Saltines and other plain crackers
• White bread
• White rice
  

Foods to Avoid If You Have Ulcerative Colitis

During a flare-up, it's best to avoid foods that either create residue, are gassy, or can irritate the bowel. These include sugary, fatty, or processed foods, all of which are inflammatory and affect normal bowel function.

The list is extensive and includes:

• Alcohol
• Baked goods, like cakes, muffins, and brownies
• Candies and chocolate
• Coffee and other caffeinated beverages
  
• Dairy (if lactose intolerant)
• Dried beans and legumes
• Dried fruits
• Fast food
• Fried foods
• Fatty cuts of meat
• Gassy cruciferous vegetables, like cabbage, broccoli, and cauliflower
  
• Nuts and seeds
• Processed meats, like bacon and sausages
• Raw fruits with seeds or skins, like berries and unpeeled apples
• Raw vegetables
• Sodas and other carbonated beverages
  
• Sugary drinks, including high-sugar fruit juice
• Spicy foods, like curries and chili
• Whole grains, like brown rice, quinoa, and wild rice
• Whole-grain products, like whole-grain bread, pasta, and cereal

Other Tips

In addition to choosing the right foods, there are other simple tips that can help guide your eating habits if you have UC:

• Eat four to six smaller meals each day rather than two to three big meals.
• Chew your food until it is well-pulverized, and avoid gulping.
• Keep track of your daily food intake with a food journal. There are apps to help you calculate calories and nutrients so that you meet your daily nutritional needs.
• Rather than frying, used cooking techniques like broiling, steaming, and poaching.
• Keep well hydrated with plain water if you experience diarrhea.
• Avoid drinking through straws which can cause bloating and gas as you swallow air.