Dietary measures such as eating or avoiding certain foods may help manage symptoms of ulcerative colitis (UC).


Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that causes inflammation and ulcers in the colon.

Currently, there is no exact cause for this disease. However, doctors believe it has links to:

  • environmental factors
  • Westernized dietary patterns and lifestyles
  • genetics

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

This article looks at which foods to avoid or consume to help people with ulcerative colitis manage their symptoms.

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.

Someone may find it difficult to digest certain nutrients, such as fiber, 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.

It’s important that someone with ulcerative colitis eats foods high in vitamins and minerals, including iron, calcium, and vitamin A, to help ensure they get enough nutrients.

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

Omega-3-rich foods

The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) recommends a higher intake of omega-3 fatty acids for those with the condition.

Some of these foods may include:

Probiotic foods

These foods include yogurt, which contains active probiotics. The “good” bacteria in probiotics can aid digestion. Some research suggests that using probiotics regularly may help reduce ulcerative colitis flare-ups and symptoms.

Low fiber fruits

Fruits such as bananas and cantaloupes and cooked fruits may be suitable for people with ulcerative colitis.

Refined grains

These may be easier to digest than whole grains, and may include:

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:

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 like 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, it is recommended that a person consult a doctor before they start taking supplements.

Dietary patterns 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 in dairy products like milk, cheese, and yogurt. Lactose is not problematic for all people with ulcerative colitis, but lactose-containing 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 help 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 involving people living in Saudi Arabia suggested a link between drinking carbonated soft drinks and a higher risk of developing ulcerative colitis.

Sugar alcohols

Consumed sugar alcohols, such as sorbitol and xylitol, are not absorbed in the digestive tract and may trigger symptoms. These are found mainly in sugar-free products like chewing gum, mints, and candies. However, sugar alcohols also occur naturally in lower amounts in certain fruits.

Insoluble fiber foods

These include raw green vegetables like broccoli, whole nuts, whole grains, and fruits with skin on. They may increase abdominal cramping, the number of bowel movements, and the amount of gas experienced.

Sugary foods

Some sugary foods can trigger an ulcerative colitis flare-up, including:

  • cakes
  • pastries
  • candy
  • juices

High fat foods

The IOIBD recommends that people with UC limit consuming foods high in saturated fat, such as:

  • full fat dairy
  • coconut
  • processed foods containing palm oil

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. In a 2014 study, almost 66% of participants who tried a gluten-free diet reported an improvement in IBD symptoms, and 38% reported fewer or less severe IBD flares.

Dietary emulsifiers

According to the IOIBD, it may be helpful for people with ulcerative colitis to limit their intake of emulsifiers such as carboxymethylcellulose and polysorbate-80. Manufacturers add these to many processed foods. However, to be transparent, the IOIBD notes that this recommendation is based on limited evidence.

Nutrition resources

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

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Keeping a daily food journal may help someone with ulcerative colitis identify potential dietary triggers and make informed decisions about their diet.

Some useful information to include are:

  • the date
  • which foods a person ate, including a list of extras like 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.

A person can also share their food journal with a doctor for further insight.

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

Dietary plans should include the following:

  • Foods to eat: This will consist of foods a person knows will typically not aggravate their symptoms.
  • Foods to avoid: A dietary 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. A person with UC might consider looking for ways to modify foods rather than avoiding them as one way to help increase access to nutritional benefits. For example, peeling or cooking a fruit or vegetable might make it more tolerable.
  • Supplements: 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. Someone is more likely to stick to eating better foods if their meals are well planned in advance.
  • 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.

It is important that people continue logging their foods and symptoms, even after establishing a dietary plan. Ulcerative colitis symptoms can change over time, so it is essential to track and record any dietary-related changes.

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

Some premade dietary plans, such as the low FODMAP diet, are available. However, these dietary programs may not be suitable for everyone with ulcerative colitis. If someone is looking to switch eating patterns or follow a premade plan, it is recommended that they 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 part of the Medical News Today brand and is available via AppStore and Google Play. Download it here.

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

A 2021 review of studies suggests 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 eating patterns are not appropriate options for those at risk of nutritional deficiency.

The review also suggests 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 literature review found that about 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.

It is important to note that 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.

It may be difficult for people with ulcerative colitis to find the dietary plan that works for them.

This may be frustrating and can negatively affect the way a person interacts with food, people, and themselves.

Disordered eating

In a 2021 review of 29 studies, participants living with IBD reported patterns of disordered eating, such as restrictive dietary behavior and avoiding food altogether, after receiving a diagnosis.

Disordered eating refers to a wide range of eating patterns that may affect a person’s physical and mental well-being. Examples may include:

  • skipping meals or fasting
  • restricting certain foods even if it has not been recommended to do so by a doctor
  • constantly thinking about food, diet, and their effects on the body
  • binge eating
  • feeling guilty for eating certain foods

Disordered eating may actually worsen symptoms of IBD and have negative outcomes.

Help is available

Eating disorders can severely affect the quality of life of people living with these conditions and those close to them. Early intervention and treatment greatly improve the likelihood of recovery.

Anyone who suspects they or a loved one may have an eating disorder can contact the National Alliance for Eating Disorders, which offers a daytime helpline staffed by licensed therapists and an online search tool for treatment options.

For general mental health support at any time, people can call the Substance Abuse and Mental Health Services Administration 24 hours a day at 1-800-662-4357 (or 1-800-487-4889 for TTY).

Many other resources are also available, including:

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Culture and diet

Some people with ulcerative colitis may find that certain traditional foods from their culture may cause symptoms of IBD, which may be frustrating.

However, a person may not have to completely remove all cultural foods from their dietary plan. They can try keeping as many traditional foods as possible and only replacing those that trigger their UC symptoms.

For example, if a dish contains common trigger foods like red meat, cheese, or gluten, a person can try swapping these for another protein source like chicken, a lactose-free cheese, or a gluten-free alternative.

If spicy foods are the trigger, a person may consider retaining the mild spices in the dish or cutting back on the amount of hot spices used.

Body image and diet

People with ulcerative colitis may experience weight gain due to increased hunger resulting from taking certain medications or arising when their symptoms settle down.

This may cause some people to think more negatively about their physical appearance, which may lead to disordered eating or negative feelings about themselves.

It is important to remember that the body is always changing for a variety of reasons. Societal expectations of how to “look” or what to eat are not always scientifically supported and do not always support positive health outcomes.

Weight management resources

To discover more evidence-based information and resources for weight management, visit our dedicated hub.

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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.
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What foods are best for ulcerative colitis?

Some types of foods that are recommended for people with ulcerative colitis include:

  • omega-3-rich foods like salmon and walnuts
  • probiotic foods like yogurt
  • low fiber foods like cantaloupes and bananas
  • refined grains like potato and white pasta
  • lean protein like fish and chicken
  • noncruciferous vegetables like cucumbers and squash

It is important to note that fiber, whole grains, and cruciferous vegetables should only be avoided during flares. Over the long term, high fiber diets may help improve UC symptoms.

What foods to avoid if you have ulcerative colitis?

Trigger foods vary for everyone who has ulcerative colitis. However, some common trigger foods to avoid may include:

  • lactose products, such as milk and cheese
  • red meat and processed meat
  • alcohol
  • carbonated drinks
  • sugar alcohols, such as those found in sugar-free products like chewing gum, mints, and candies
  • insoluble fibers, such as in broccoli and whole nuts
  • high fat foods
  • sugary foods
  • gluten
  • spicy foods

Can you eat pizza with ulcerative colitis?

There are many types of pizza that people can and cannot eat. It depends on the types of food that trigger a person’s ulcerative colitis symptoms. If gluten and dairy both trigger symptoms, a person may consider eating a pizza made using a gluten-free dough and either having no cheese or lactose-free cheese.

There is no single dietary 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 UC may want to avoid 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 trigger foods. A doctor or dietitian can also assist a person in finding a dietary plan that works best.