Tips for Managing Ulcerative Colitis

While eating a healthy diet might not prevent inflammatory bowel disease, it can certainly help manage symptoms. Get expert tips on what to eat and drink and what to avoid to help manage ulcerative colitis.   While no evidence exists that eating a healthy diet can prevent or cure an inflammatory bowel disease like ulcerative colitis, what you consume does matter. Nutritionists know that certain foods can aggravate ulcerative colitis symptoms, and frequent diarrhea, which is common in colitis, can leave your body feeling depleted and dehydrated.

“People experiencing symptoms of inflammatory bowel disease can lose a lot of fluids and nutrients. Foods and beverages that aggravate symptoms will need to be restricted during these times,” says Maxine Smith, RD, a clinical dietitian at the Cleveland Clinic in Ohio.

Colitis Diet: Healthy Foods for Ulcerative Colitis

Although you need to maintain a well-balanced diet for optimum health, you also need to avoid or limit certain types of foods when ulcerative colitis symptoms act up. Here are food pointers to keep in mind:

Fiber

Fiber, the undigested part of food, is found in whole grains, fruits, and vegetables. While fiber is good for most people’s digestion, it can be hard for someone with ulcerative colitis to digest. “You should limit fiber to less than 2 grams per serving when your symptoms are active,” Smith says. Fibrous foods, which may also produce excess gas, include beans, legumes, bran, nuts, seeds, and popcorn.

Fruits and vegetables

Don’t eat raw fruits, except for ripe bananas and melons. With vegetables, remove the seeds, and then cook well. “You should be able to cut vegetables with the edge of your fork,” Smith says. Potatoes are fine to eat as long as you remove the skin.

Spices, fats, and sweets

Certain food can make colitis symptoms worse. Avoid spicy, fried, and fatty foods. Fats can be difficult to digest and can cause diarrhea and gas. Chocolate and artificial sweeteners can also aggravate symptoms.

Proteins

Protein is an essential part of a healthy diet. Good sources of protein can include smooth peanut butter, fish, eggs, soy, and poultry.

Colitis Diet: Healthy Fluids for Ulcerative Colitis

Ulcerative colitis can leave you dehydrated, so drinking fluids are important: Consume at least 8 cups of fluid a day, says Smith.  But that doesn’t mean just any kind of fluid is good for you. Consider the following guidelines:

Caffeine

Avoid caffeine in all forms. Caffeine stimulates digestion, which is not good for a person living with ulcerative colitis.

Juice

Juice is fine if it’s unsweetened; it’s a good way to get nutrition from fruits and vegetables. But stay away from juices with added sugar. “Sugar is not well tolerated in inflammatory bowel disease,” says Smith.

Soft drinks

Avoid soft drinks that have sugar or caffeine.

Milk

If you are lactose intolerant, limit dairy products to help reduce diarrhea.

Alcohol

Many nutritionists and doctors agree that alcohol should be avoided in a colitis-friendly diet.

Nutritional Supplements for Ulcerative Colitis

Because of symptoms like diarrhea and poor appetite, people with ulcerative colitis may have vitamin and mineral deficiencies. Some medications used to treat ulcerative colitis can add to this deficiency. Your doctor and nutritionist may recommend certain nutritional supplements, including:

Folic acid

Many people with ulcerative colitis have low levels of folic acid. Ulcerative colitis raises your risk of developing colon cancer, and some studies show that folic acid supplements can reduce this risk.

Probiotics

Probiotics are “good bacteria” that may improve colon health. Some studies show probiotics can reduce ulcerative colitis symptoms. “You can get good bacteria from eating active yogurt cultures. Ask your doctor if you should take probiotic nutritional supplements,” advises Smith.

Vitamin D and calcium

People with ulcerative colitis frequently need to take steroids, which can lead to low levels of vitamin D and calcium. Many nutritionists recommend vitamin D and calcium supplements as part of a colitis diet.

Omega-3 fatty acids

These fatty acids are found in cold-water fish and some studies show they may reduce symptoms of inflammatory bowel disease. Studies also show omega-3 fatty acids may be valuable when combined with certain medications used to treat ulcerative colitis.

Final Thoughts on a Healthy Diet

“Everyone with inflammatory bowel disease is a little different,” says Smith. “Some people may be more sensitive to certain foods than others. Keeping a food diary that tracks foods and symptoms is a good idea.” When you are struggling with colitis symptoms, you can help your digestion by chewing completely and eating slowly.    “It’s also a good idea to eat several smaller meals a day instead of three big meals,” says Smith. Try six to eight small servings every three to four hours.  Finally, even when your ulcerative colitis symptoms are in remission, you still need to maintain a healthy diet. Experts recommend eating a variety of foods from all the major food groups. If you are struggling with what to eat, talk to your doctor or nutritionist for additional suggestions.

By Chris Iliades, MD Medically reviewed by Pat F. Bass III, MD, MPH