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Digestive Disorders > IBD > Ulcerative Colitis

Ulcerative Colitis Diets and Nutrition: The Complete Guide

Elizabeth Oliver, PhD

Elizabeth Oliver, PhD

There is no specific diet for ulcerative colitis. Many individuals with ulcerative colitis find that modifying their diet can help them manage their symptoms and lengthen the amount of time between flare-ups.

Ulcerative colitis diet facts and tips

  • There is no specific ulcerative colitis diet
  • Overall a healthy well-balanced diet is recommended
  • Limit dairy products containing lactose if you’re lactose intolerant
  • Avoid high fat foods such as butter, coconut, margarine, and cream, as well as fried, or greasy food
  • Keep a food and symptom diary to help create an individual diet plan
  • Be aware your dietary needs may change during a flare-up and throughout the course of your condition

Is there a specific ulcerative colitis diet?

There is no specific diet for ulcerative colitis. A healthy well-balanced diet containing all food groups (carbohydrates, protein, and fat) is recommended.

Foods containing sulphites such as processed foods should be avoided as well as high fat foods such as butter and cream, and fried or greasy food.

Often food intolerances accompany ulcerative colitis. If this is the case then the corresponding foods (for example dairy products in the case of lactose intolerance or high-fructose foods in the case of fructose intolerance) should be excluded from the diet.

Does keeping a food diary help?

It may be helpful to keep a food diary in order to help you and your nutritionist plan out a diet plan.

Keeping a food diary involves recording what you eat and any symptoms you may experience in the hours after. This can then be used to narrow down any specific foods or food groups that trigger your symptoms.

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Often finding the right diet plan is a process of elimination. This can be done by cutting out one particular food from the diet for a period of time and observing whether symptoms resolve during that time. Alternatively many food groups can be eliminated and individual foods introduced back one at a time to try and identify those that trigger your symptoms.

What do studies say about ulcerative colitis and diet?

Studies investigating the impact of various diet types on ulcerative colitis are often conflicting, and too small to generate any meaningful data. Larger studies with a greater number of patient numbers will be necessary to confirm the data. Nevertheless these studies may still be useful in individual cases.

Ulcerative colitis diet types

Specific carbohydrate diet (SCD) and ulcerative colitis

The specific carbohydrate diet (SCD) was created to reduce the amount of carbohydrates in the intestines. There is some evidence that the SCD may improve ulcerative colitis symptoms.

The SCD is based on the idea that microbes in the gut that contribute to ulcerative colitis use carbohydrates as an energy source leading to the production of toxins that damage the intestine.

The SCD restricts all sugars except for monosaccharides (glucose, fructose, galactose). The SCD allows you to eat most fruits and vegetables, meat, eggs, and nuts. Processed foods, sugar, cereals and dairy products containing the sugar lactose are not allowed.

Low-FODMAP diet and ulcerative colitis

The low-FODMAP diet is becoming increasingly common and has been shown to reduce symptoms in IBS. The diet can also be successful with ulcerative colitis.

The low-FODMAP diet involves eliminating fermentable carbohydrates. Fermentable carbohydrates are poorly absorbed and lead to abdominal bloating and pain.

While the low-FODMAP diet may reduce symptoms, research so far does not support a role for the low-FODMAP diet in reducing the inflammation associated with inflammatory bowel disease (IBD).

Vegan diet and ulcerative colitis

A healthy well-balanced diet containing all food groups is recommended for ulcerative colitis. While high fat foods such as butter and cream may impact on ulcerative colitis there have been no studies so far that show vegan nutrition offers more benefits than a balanced diet including animal products.

How does coffee affect ulcerative colitis?

No studies to date support either a positive or negative impact of coffee on the course of ulcerative colitis. Coffee should be consumed without sugar using a low fat milk or a milk alternative. Tea has been shown to decrease the risk of ulcerative colitis.

Ulcerative colitis flare-up diet

Your dietary needs may change during a flare-up. In general, easily digestible foods are recommended. Avoiding foods that can trigger abdominal cramping, bloating and diarrhea is advised. It is important to remember that there is no single diet plan and each person reacts to food and drink differently. The key is to find out what works best for you.

Some suggestions that may help during a flare-up include:

  • Limiting fiber. Focus on low fiber fruits (bananas, cantaloupe and honeydew melons), cooked, non-cruciferous vegetables (asparagus tips, potatoes, and squash), and refined grains (white pasta, white rice, and oatmeal)
  • Reducing dairy products containing lactose (sugar found in milk, cream cheese, and soft cheeses)
  • Sticking to lean protein such as lean cuts of pork, white meat poultry, and eggs.
  • Avoiding high fat foods such as butter, coconut, margarine, and cream, as well as fried, or greasy food

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Nie, J. Y., & Zhao, Q. (2017). Beverage consumption and risk of ulcerative colitis: Systematic review and meta-analysis of epidemiological studies. Medicine, 96(49), online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728934/, downloaded on 31/05/2018

Eswaran, S. L., Chey, W. D., Han-Markey, T., Ball, S., & Jackson, K. (2016). A randomized controlled trial comparing the low FODMAD diet vs. modified NICE guidelines in US adults with IBS-D. The American journal of gastroenterology, 111(12), 1824-1832., online: https://pubmed.ncbi.nlm.nih.gov/27725652/, downloaded on 29/05/2020.

Nieves, R., & Jackson, R. T. (2004). Specific carbohydrate diet in treatment of inflammatory bowel disease. Tennessee medicine: journal of the Tennessee Medical Association, 97(9), 407., online https://pubmed.ncbi.nlm.nih.gov/15497569/, downloaded on 29/05/2020.

Elizabeth Oliver, PhD

Elizabeth Oliver, PhD

Elizabeth Oliver is a researcher and freelance writer with a passion for health sciences. She completed her degree in pharmacology at the University of Edinburgh and PhD in reproductive health at Imperial College London. She currently works as a researcher at the Karolinska Institutet Stockholm.

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