Ulcerative colitis (UC) is a type of inflammatory bowel disease that can cause abdominal pain and cramping, diarrhea, and a reduced appetite. A person can manage it by eating or avoiding certain foods that can help reduce the risk of flare-ups and inflammation.

There is no single diet for people with ulcerative colitis, but identifying and eliminating the foods that trigger symptoms can help reduce discomfort.

Doctors do not know the exact cause of this disease, but they believe it has links to environmental factors, Westernized diets and lifestyles, and genetics. Managing the diet may help a person manage ulcerative colitis.

This article explores which foods may trigger ulcerative colitis. It also looks at which foods might benefit people with this form of inflammatory bowel disease (IBD).

To discover more evidence-based information and resources for Crohn’s disease and ulcerative colitis, visit our dedicated hub.

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A person’s diet may contain various potential triggers, so it can be difficult for someone with ulcerative colitis to know what is safe to eat.

Some nutrients, such as fiber, may be hard for someone to digest during a flare-up. They may be able to eat these foods outside of a flare-up but find they cause discomfort when symptoms occur.

Because they may not be able to consume various foods, people with ulcerative colitis are at a higher risk of nutrient deficiencies. Other factors, such as problems with nutrient absorption, may also contribute to this.

To ensure they get enough nutrients, someone with ulcerative colitis must eat foods high in vitamins and minerals, including iron, calcium, and vitamin A.

Some of the more suitable food choices for someone with ulcerative colitis may include:

  • Omega-3-rich foods: Foods, such as salmon, mackerel, walnuts, flaxseed, hemp, and chia seeds, provide plenty of omega-3 fatty acids, which may have health benefits for people with ulcerative colitis. The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) recommends a higher intake of these foods for those with the condition.
  • Some probiotic foods: These include yogurts, which contain active probiotics. The “good” bacteria in these can aid digestion. Some studies have shown using probiotics regularly can help reduce ulcerative colitis flare-ups and symptoms.
  • Low fiber fruits: Fruits, such as bananas, cantaloupes, and cooked fruits, may be suitable for people with ulcerative colitis.
  • Refined grains: These may be easier to digest than whole grains. They include potato, white pasta, gluten-free bread, white rice, and oatmeal. Manufacturers enrich many white bread and grain products with extra minerals and vitamins.
  • Lean protein: Sources of protein that exclude red meat may be suitable for someone with ulcerative colitis. These include fish, chicken, eggs, and firm tofu.
  • Cooked vegetables: People with ulcerative colitis may tolerate noncruciferous cooked vegetables without the skin. These include cucumbers, squash, and asparagus tips.
  • Plenty of fluids: People with conditions, such as ulcerative colitis, may need to drink extra fluids, as diarrhea can lead to dehydration.
  • Dietary supplements: Oral vitamin supplements and protein shakes may help people with ulcerative colitis get enough nutrients. However, a person should consult a doctor before they start taking supplements.

Diet can affect ulcerative colitis flare-ups. However, this will vary from person to person, as not all people respond the same way to a particular food.

Some foods may act as potential triggers for ulcerative colitis. These include:

  • Lactose products: Lactose is a sugar within dairy products such as milk, cheese, and yogurt. While lactose is not problematic for all people with ulcerative colitis, these products can trigger symptoms in some individuals.
  • Red meat and processed meats: The IOIBD recommends people with ulcerative colitis limit their intake of these foods to avoid worsening symptoms.
  • Alcohol: Alcoholic drinks, such as wine, beer, and liquor, may trigger ulcerative colitis symptoms in some people.
  • Carbonated drinks: Some sodas and beers contain carbonation that can irritate the digestive tract and cause gas. A 2022 study also linked drinking carbonated soft drinks to a higher risk of developing ulcerative colitis in the Arabic population.
  • Nonabsorbable sugars: Consuming artificial sweeteners, such as sorbitol and mannitol, could trigger symptoms. The sugars in some fruits, such as prunes, pears, and peaches, may also be difficult for the body to absorb and could worsen symptoms.
  • Insoluble fiber foods: These include raw green vegetables such as broccoli, whole nuts, whole grains, and fruits with the skin. They may increase the number of bowel movements, the amount of gas, and abdominal cramping.
  • Sugary foods: Cakes, pastries, candy, and juices could trigger an ulcerative colitis flare-up.
  • High fat foods: A person with ulcerative colitis should avoid high fat foods, such as butter, fatty meats, and coconut, and fatty, fried, or greasy foods.
  • Spicy foods: These include hot sauces, chilies, and hot peppers. Spicy foods may trigger or worsen a flare-up.
  • Gluten: This is a protein present in wheat, rye, and barley. It can sometimes trigger symptoms in those with ulcerative colitis. A 2020 review article from New Zealand found that, in one 2014 study, a gluten-free diet significantly benefitted 66% of participants with IBD by reducing symptoms and flare-ups.
  • Dietary emulsifiers: According to the IOIBD, people with ulcerative colitis should limit their intake of emulsifiers such as carboxymethylcellulose and polysorbate-80. Manufacturers add these to many processed foods.

For more science-backed resources on nutrition, visit our dedicated hub.

Keeping a food journal is a suitable way for someone with ulcerative colitis to identify potential dietary triggers.

A daily food journal allows a person with the condition to make informed decisions about their diet. They should organize it so that it is easy to read and share with a doctor. Some useful information to include would be:

  • the date
  • which foods a person ate, including a list of extras, such as sauces
  • the time of day at which a person ate the food
  • any immediate reactions
  • any flare-ups or worsening symptoms

Food journals are particularly helpful when people are looking to add additional types of food to their diets.

By adding one food at a time and recording it, a person can determine whether the food is a safe choice by assessing their symptoms.

Diet plans for people with ulcerative colitis will vary. The best tend to start with a food journal, which shapes the food choices and ideas in the plan.

Diet plans should include the following:

  • Foods to eat: This will consist of foods a person knows will not aggravate their symptoms.
  • Foods to avoid: A diet plan should also list the specific foods that are known triggers.
  • Balanced nutrition: One of the most significant complications for people with ulcerative colitis is inadequate nutrition due to certain food tolerances. To avoid losing out on nutritional benefits, a person should look for ways to modify foods rather than avoid them. For example, peeling or cooking a fruit or vegetable might make it more tolerable.
  • Supplements: Some otherwise nutritious foods that are high in nutrients may not be digestible for some people. A person may need to compensate for this shortfall in nutrition. In these cases, an individual can take supplements to replace nutrients they cannot get in their food. They can speak with a registered dietitian or doctor about which supplements may be best, as people’s needs will vary.
  • Meal plans: These should consider a person’s schedule and include snacks. The better the planning of a meal, the more likely someone will stick to eating foods that do not aggravate their symptoms.
  • Medical approval: It is a suitable idea to seek approval from a doctor or registered dietitian. These professionals can offer advice and suggest alternative food choices that an individual might not have considered.

People should continue logging their foods and symptoms, even after establishing a diet plan. Ulcerative colitis symptoms can change over time, so it is essential to track and record any diet-related changes.

Occasionally reviewing the diet plan will help account for any changes. It is also vital to inform a doctor if flare-ups worsen or occur more often.

Some premade diets and plans are available, such as the low FODMAP diet. However, these dietary programs may not be suitable for everyone with ulcerative colitis. Anyone looking to switch diets or follow a premade plan should talk with a doctor or dietitian first.

Having a support network of experienced doctors and other health professionals is vital when living with ulcerative colitis. Bezzy IBD is a free app for people living with ulcerative colitis. The app is available via AppStore and Google Play. Download it here.

Some recent research has investigated new developments in how certain diets affect IBD and ulcerative colitis.

In a 2021 review of studies, researchers found that the Mediterranean diet may benefit people with IBD. However, the authors stated that more research is necessary to investigate this link.

Researchers also noted that plant-based and reduced-calorie diets might benefit those with IBD. However, they pointed out that reduced-calorie diets are not appropriate options for those at risk of nutritional deficiency.

The review also found that the low FODMAP diet did not appear to reduce IBD but may reduce certain gastrointestinal symptoms.

Additionally, a gluten-free diet did not seem to have a notable effect on IBD symptoms. However, one 2014 study in the review found that 66% of people reported an improvement in at least one IBD symptom following a gluten-free diet. Additionally, 38% of participants also reported having fewer or less severe flare-ups while on the diet.

However, the research into ulcerative colitis and diet is limited. Scientists need to do more research to provide well-informed dietary guidelines for those living with the condition.

Q:

Can ulcerative colitis progress to a worse health condition if I eat the wrong thing?

Anonymous

A:

Research suggests that consuming a diet high in meat and low in fruits and vegetables can increase the risk of ulcerative colitis flare-ups.

In some cases, these flare-ups do not respond to medical treatment and may require surgery to remove part of the colon. Additionally, the risk for colon cancer is higher in people with ulcerative colitis, especially when the disease is more severe and a person has issues managing it.

While there is no cure for ulcerative colitis, following a nutritious diet and avoiding trigger foods may help people manage symptoms and maintain good overall health.

Amy Richter, RD.
Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

There is no single diet plan that will work for all people with ulcerative colitis. However, identifying and eliminating any foods that may worsen an individual’s symptoms can help reduce discomfort.

Foods that a person with the condition may want to avoid may include lactose products, alcohol, gluten, spicy foods, and foods high in sugar and fats.

Some foods that may benefit individuals with ulcerative colitis include salmon, mackerel, chia seeds, walnuts, and other foods high in omega-3 oils.

Creating a food journal may help a person identify and limit problematic foods. A doctor or dietitian can also assist in finding a diet plan that works for someone.

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