Ulcerative Colitis Diet

Build a tailored nutrition plan to treat your colitis

Alleviate your Ulcerative Colitis symptoms with a meal plan customized to your individual needs.

Although there is no "cure" for Ulcerative Colitis, combining traditional medicine with the recommendations from our Registered Dietitians can help you re-establish a normal routine and feel healthier.

Our Registered Dietitians help you determine:

• Which foods your digestive system handles well, across all food groups
• Tips on how to plan your snacks and meals throughout the day
• Foods to eat and foods to avoid
• How to treat an Ulcerative Colitis flare up
• If your stool indicates that you may have UC
• How to make these changes sustainable and set you up for long-term success.

What foods should you eat with Ulcerative Colitis?

If you have Ulcerative Colitis, very minor changes to what you eat can make a BIG difference in your symptoms. Consider keeping food logs or adjusting foods that trigger your symptoms. You may also want to work with your doctor or dietitian to work through an elimination diet. Generally, you should try to:

1. Take your time when you eat. The Crohn's and Colitis Foundation recommends eating 4-6 smaller meals per day. Eating a bit more slowly also prevents you from ingesting too much air and becoming gassy
2. Stay hydrated. Aim for 64 oz of water each today. Your urine should be a light yellow to clear color
3. Relax! Exercise and relaxation techniques alleviate your Ulcerative Colitis symptoms
4. Use simple cooking techniques. We recommend baking, grilling, or steaming to preserve most food's nutrient content

In terms of specific food recommendations, go with these:

During a flare up, you many find it more comfortable to eat bland, soft food, otherwise limiting spicy foods.  During periods of remission, you should eat all of your usual items with the omission of known offenders.

Probiotics for Ulcerative Colitis

The balance of "good” and “bad” bacteria within the gut likely plays a role in the development of Ulcerative Colitis. The beneficial bacteria within your gut help with digestion and maintaining colon health. The detrimental bacteria trigger the body’s immune system to send immune cells to the intestine. The constant presence of these immune cells in the intestine leads to chronic inflammation, which is associated with Ulcerative Colitis symptoms. This is where probiotics come in.

Probiotics may help relieve Ulcerative Colitis symptoms by restoring a healthy balance of bacteria within your intestine. When beneficial bacteria are added to the gut and balance is achieved, the immune system no longer needs to send cells to the area and the inflammation resolves along with your Ulcerative Colitis symptoms.

If you do begin taking a probiotic supplement, it may not have an immediate effect on your Ulcerative Colitis symptoms. You will need to take a probiotic supplement for at least seven to ten days to begin to build up the good bacteria in your gut. Additionally, to continue to see their benefits, you will need to continue to take the probiotics. Stopping the supplement may even shift the balance of bacteria in a negative way and trigger a flare.

Foods to avoid with Ulcerative Colitis

Although there are foods that are common triggers during both Ulcerative Colitis flares and remission, the list expands when you’re experiencing active Ulcerative Colitis symptoms. Keep in mind that Ulcerative Colitis triggers differ from person to person, so the real key to long-term Ulcerative Colitis management is identifying what works for you. Easier said than done, right?

If you’ve ever searched on your own to figure out how to manage your Ulcerative Colitis, you’ve probably found a ton of information. The challenge is that the information on the internet can be contradicting and confusing. If you’re struggling with Ulcerative Colitis, we recommend enlisting the help of a registered dietitian. They will be able to help you better understand your UC and determine what foods and behaviors most trigger your symptoms.

Remember to limit fiber when you are experiencing an Ulcerative Colitis flare.  High fiber foods are part of a healthy, well-rounded diet. However, when UC symptoms are active, you may need to temporarily limit fiber intake to reduce inflammation and allow your gut to heal. High fiber foods are harder to digest and can trigger UC symptoms. High fiber foods include whole grains, fruits with skin and seeds, vegetables with skin and seeds, raw vegetables, cruciferous vegetables, nuts, seeds, beans and legumes.

Below is a list of common trigger foods; keep in mind that they vary for each person:

• Alcohol
• Caffeine
• Carbonated beverages
• Dairy products (if lactose intolerant)
• Dried beans, peas, legumes, dried fruits or berries
• Fruits with pulp or seeds
• Foods containing sulfur or sulfate
• Foods high in fiber (including whole-grained products)
• Hot sauces and spicy foods
• High fat meats
• Nuts and crunchy nut butters
• Popcorn
• Products containing sorbitol (sugar-free gum and candies)
• Raw vegetables
• Refined sugar
• Seeds

Is Ulcerative Colitis a Genetic Condition?

One of the most significant risk factors for Ulcerative Colitis is family history. Scientists believe that individuals inherit genes that put them at risk for Ulcerative Colitis. At some point in life, environmental factors trigger the immune systems to attack the large intestine and the disease sets in.

Researchers estimate that between 10 and 25 percent of people with Ulcerative Colitis have an immediate family member with IDB. It is also believed that if one parent of a child has IBD, the child has a two percent risk of also developing IBD at some point in life. If both parents have IBD the risk for the child increases. Ulcerative Colitis is also more prominent in individuals who have more distant relatives that suffer from Ulcerative Colitis. Research also indicates that in individuals with a family history of Ulcerative Colitis, the age of disease onset tends to be earlier.

More specifically, studies have been conducted on both identical and fraternal twins who have Ulcerative Colitis. If one twin has Ulcerative Colitis, their identical twin will also have Ulcerative Colitis about sixteen percent of the time, while their fraternal twin will have Ulcerative Colitis about four percent of the time.

Despite all these statistics, it is important to note that most individuals with Ulcerative Colitis do not have a family history of IBD.

Researchers believe that certain genes may alter the body’s immune response, which would play a role in people who develop Ulcerative Colitis. Ulcerative Colitis is classified as an auto-immune condition. If you have an auto-immune disease, your body’s immune system mistakes its own healthy tissues as foreign and attacks them.

Read our full discussion of Ulcerative Colitis and Genetics here.

Ulcerative Colitis Plain

Pain is one of the key markers of Ulcerative Colitis. However, your pain location and severity often differ from person to person. Ulcerative Colitis pain originates from inflammation in the inner lining of the large intestine and can feel like stabbing pain or cramping in the abdominal area.

This inflammation can become so severe that it causes open sores (ulcers) to form in the innermost lining of the colon, large intestine or rectum. These sores can ooze mucus and pus, and cause pain in the area. Many people with UC also experience joint pain, a product of this inflammation spreading throughout the body.

Each person perceives pain differently and thus describes their pain in different ways. Many people experience Ulcerative Colitis pain in the following areas:

• Lower-abdominal pain
• Rectum
• Joints
• Back Pain
• Leg Pain
• Neck Pain

The link between Ulcerative Colitis and joint pain is not exactly clear, but researchers believe that the immune system overreacts in response to UC, the inflammation becomes systemic and can spread to your joints. Although not all people with Ulcerative Colitis have joint pain, many find that as their GI symptoms worsen, so does the pain throughout their body. In these situations, it’s important to work with your doctor and dietitian to ensure this is a product of your Ulcerative Colitis and not a convergent health condition such as Rheumatoid Arthritis.

Can Ulcerative Colitis Cause Me Constipation?

Some individuals with Ulcerative Colitis experience constipation. No matter which symptoms you experience, learn how to prevent and treat your Ulcerative Colitis constipation before it affects your quality of life.

In general, Ulcerative Colitis causes inflammation in the large intestine and the rectum. When the inflammation associated with UC is concentrated in the rectum, you are likely to feel constipated. This happens because the inflammation in the rectum (the body part that connects the large intestine to the anus) makes it difficult to pass stool out of your body. This form of Ulcerative Colitis is called proctitis. For individuals with proctitis, constipation may be accompanied by bleeding and a sense of urgency that are usually experienced with diarrhea. However, because the inflammation associated with proctitis is concentrated to the rectum (and not the entire large intestine) the large intestine can successfully absorb water, which prevents diarrhea.

• By Quantity: fewer than three bowel movements a week
• By Bowel Movement Characteristic: Having hard, dry stool that appears like pellets or nuts, and is painful to pass. Slightly less severe constipation can produce sausage-shaped stool that is hard and lumpy. Straining and pushing during a bowel movement is another sign of constipation.
• Association / Trigger with other Gastrointestinal Symptoms: including gas and stomach pain, which may further complicate Ulcerative Colitis.

Read our full discussion of Ulcerative Colitis and constipation here.

Can Ulcerative Colitis Cause Rash and Skin Irritation?

Swollen and painful areas of skin are common and affect up to 15 percent of individuals with UC. In general, skin irritation and rashes will get worse during a flare and resolve during periods of remission. These rashes oftentimes fluctuate in-line with the inflammation throughout your entire body. While most skin irritation and rashes are caused by Ulcerative Colitis inflammation, general UC symptoms do not always cause the irritation and rashes.

There are numerous skin conditions associated with Ulcerative Colitis, many of which are caused by auto-immune functions:

• Erythema nodosum
  
• Pyoderma gangrenosum
  
• Sweet's Syndrome
  
• Bowel-associated dermatosis-arthritis syndrome (BADAS)
  
• Psoriasis
  
• Vitiligo
  
• Mouth Sores
  
• Anal Fissures
  
• Acne
  
• Hives

Learn more about these conditions and how to treat them in our full discussion on Ulcerative Colitis and skin irritation / rash.

Will Ulcerative Colitis Affect my Stool?

Changes in bowel movements are one of the key markers of Ulcerative Colitis. UC stool shape, color, and smell can be quite different than your average bowel movement. If you have Ulcerative Colitis, your immune system essentially attacks healthy cells in your digestive tract, which causes inflammation in your colon and rectum. Below are some key indicators that you may have Ulcerative Colitis based on your stool.

• Color: You might notice bright red, maroon or black color indicating the presence of blood. You may also notice more mucus in the stool than normal.
• Odor: The odor of the stool may be increasingly foul compared to the typical smell.
• Texture: Presence of UC typically causes loose, watery stools. In reference to the Bristol stool chart, UC stool texture will most likely resemble types 5 through 7.
• Frequency: Inflammation can cause increased motility and frequency of bowel movements. Many people experience frequent urgency and diarrhea.
• Effort: People with UC may experience burning or painful stools.
• Shape: Stools may vary in shape due to changing bowel habits. Some stools may be watery, while others may have a more formed shape.

Do you have recipes that are GI friendly?

1. Yes! Anything from our member portal free of your trigger foods

2. Some bloggers specialize in GI issues such as Crohn's Disease

3. Anti inflammatory recipes cookbook

Who do I contact with my  Ulcerative Colitis questions?

1. A dietitian with an expertise in GI and digestive issues, such as OnPoint!

2. Always consult your primary care doctor. They can refer you to a local GI specialist if needed

3. If diagnosed, you may want to seek a specialist for your specific disease in your area

Is Ulcerative Colitis and Autoimmune Condition?

 We are frequently asked whether Ulcerative Colitis it is an autoimmune condition. The short answer is yes, but it’s most important to understand what that means for your treatment plan.

With Ulcerative Colitis, the body recognizes harmless gut bacteria as an enemy and attacks the tissues in the colon. In a typical immune response, the body will send white blood cells to the area of illness or infection to help protect the body. After the body has combated the illness or infection, the inflammation will resolve.

However, in a colon affected by UC, the body continues to send white blood cells (specifically called T cells) to the inner layer of the large intestine, which accumulate and continue to attack. This process causes a buildup of inflammation and can lead to sores, or ulcers, in the affected area. Because UC is recognized as an autoimmune condition, the treatment methods generally target the immune response within your body.

Medical Treatments for Ulcerative Colitis include:

• Biologics
• Immunomodulators
• Medical Nutrition Therapy

Read our full discussion of Ulcerative Colitis autoimmune treatment options here.

More information about Ulcerative Colitis

According to George Washington University, colitis is a chronic digestive disease characterized by inflammation of the inner lining of the colon. Infection, loss of blood supply in the colon, Inflammatory Bowel Disease (IBD) and invasion of the colon wall with collagen or lymphocytic white blood cells are all possible causes of an inflamed colon.

The following diseases fall into the colitis/IBD category; they all can be treated with a combination of medication and improvements to your eating habits:

Ulcerative colitis:

Ulcerative colitis is a chronic inflammatory bowel disease (IBD) in which abnormal reactions of the immune system cause inflammation and ulcers on the inner lining of your large intestine. Ulcerative colitis can develop at any age, but the disease is more likely to develop in people between the ages of 15 and 30. Read more below!

Crohn’s colitis:

Crohn’s disease is an inflammatory bowel disease that causes chronic inflammation of the gastrointestinal tract. Recent research suggests hereditary, genetic, and environmental factors contribute to Crohn’s disease development. In people with Crohn's, harmless bacteria are mistaken for foreign invaders and the immune system mounts a response. The inflammation caused by the immune response does not go away. This leads to chronic inflammation, ulceration, and thickening of the intestinal wall.

Diversion colitis:

Diversion colitis involves inflammation in the large intestine brought on after surgical treatment that diverts the fecal stream away from the large intestine, usually to a temporary ileostomy or colostomy. It should not be confused with being a type of inflammatory bowel disease (IBD), even though it often mimics the symptoms of IBD. Diversion colitis can occur after surgical treatment for intestinal-related conditions such as fecal incontinence, bowel cancer, or spontaneous chronic constipation that is not related to an obvious underlying cause.

Ischemic colitis:

Ischemic colitis (IC) is an inflammatory condition of the large intestine, or colon. It develops when there isn’t enough blood flow to the colon. IC can occur at any age, but it’s most common among those over the age of 60.A buildup of plaque inside the arteries (atherosclerosis) can cause chronic, or long-term, IC. This condition may also go away with mild treatment, such as a short-term liquid diet and antibiotics.

Infectious colitis:

Colonic infection by bacteria, viruses, or parasites results in an inflammatory-type of diarrhea and accounts for the majority of cases presenting with acute diarrhea. These patients present with purulent, bloody, and mucoid loose bowel motions, fever, tenesmus, and abdominal pain.

Fulminant colitis:

Fulminant colitis is a somewhat rare but serious form of ulcerative colitis (UC). UC causes inflammation and sores in the lining of the colon. It doesn’t happen to most people who have UC. Less than 10% of people with it get fulminant colitis, usually during their first attack of symptoms. The whole lining of the colon becomes inflamed, causing severe symptoms like bloody diarrhea and belly pain. Fulminant colitis is a medical emergency. You'll need to go to a hospital right away for treatment with medicine, and possibly surgery.

Collagenous colitis:

Collagenous colitis (CC) is a condition that affects your large intestine. It leads to episodes of watery diarrhea and belly pain. Your large intestine is part of your digestive (gastrointestinal or GI) tract. The GI tract goes from your mouth all the way to your rectal opening. The large intestine includes both the colon and the rectum. The large intestine receives the broken-down products of food from the small intestine. One of its main jobs is to reabsorb water and electrolytes, such as salt. The colon leads to the rectum. The rectum stores your bowel movements before your body eliminates them. In Collagenous colitis, inflammatory cells from your immune system travel to your large intestine. There they cause swelling and inflammation. In rare cases, these cells also go into the latter part of your small intestine.

Chemical colitis:

Chemical colitis is a type of colitis, an inflammation of the large intestine or colon, caused by the introduction of harsh chemicals to the colon by an enema or other procedure. Chemical colitis can resemble ulcerative colitis, infectious colitis and pseudomembranous colitis endoscopically.

Microscopic colitis:

Microscopic colitis is an inflammation of the large intestine (colon) that causes persistent watery diarrhea. The disorder gets its name from the fact that it's necessary to examine colon tissue under a microscope to identify it, since the tissue may appear normal with a colonoscopy or flexible sigmoidoscopy. There are different subtypes of microscopic colitis: Collagenous colitis, in which a thick layer of protein (collagen) develops in colon tissue; Lymphocytic colitis, in which white blood cells (lymphocytes) increase in colon tissue; Incomplete microscopic colitis, in which there are mixed features of collagenous and lymphocytic colitis.

Lymphocytic colitis:

In lymphocytic colitis, inflammatory cells from your immune system travel to your large intestine. Here they cause swelling and inflammation of the tissues. In rare cases, these cells also invade the latter part of the small intestine. Immune cells (lymphocytes) may build up in the area as well. The inflammation may keep your large intestine from reabsorbing as much water as it should. This leads to diarrhea, belly pain, and other symptoms.