Ulcerative Colitis Diet: Food To Eat and Avoid

If you’re living with ulcerative colitis, you know all too well that food often affects how you feel.

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“Anything you eat can affect your ulcerative colitis symptoms,” says gastroenterologist Suresh Pola, MD. “Food always plays a role, but triggers change from person to person.”

As food triggers are so individualized, grocery shopping and meal planning can be difficult if you’re not clued in to what worsens your symptoms, especially during a flare-up.

Dr. Pola explains what foods can help or hurt when you’re living with ulcerative colitis, how to identify foods that make it worse and how to make the most out of every meal.

What to eat during a flare-up

During an ulcerative colitis flare-up, you’ll want to continue eating a well-balanced diet that includes the following — minus any personal triggers you have:

Protein, like chicken, fish and quinoa
Cooked, peeled and seedless veggies, like carrots, eggplant and zucchini
Skinless fruits and fruit products, like applesauce, bananas or melon
Easily digestible grains, like white rice and oats
Small amounts of healthy fats, like olive oil or avocado

“When you’re in a flare-up, you tend to want to cut back on the amount of food you’re eating. That impulse comes from the idea that the more food you eat, the more symptoms you’ll have, as you’ll be pooping more,” notes Dr. Pola.

“If your colon is inflamed, it can bleed, it can be painful and you often end up with diarrhea. Although food can trigger more symptoms, the danger in cutting out too many calories or whole food groups is not getting adequate nutrition.”

Instead of skipping meals or cutting foods out completely, consider making some of the following adjustments until the flare is over.

Stay hydrated

Diarrhea leaves you dehydrated, so drinking plenty of water throughout the day is key to keeping your body healthy.

“Drink water, have broth, try out different soups,” advises Dr. Pola. “Oral rehydration solutions, like Pedialyte® or Liquid I.V.®, can also help.”

Stock up on protein

“When you’re in a flare-up, your body tends to burn more calories,” says Dr. Pola. “Losing weight is a concern when you’re living with ulcerative colitis, so you want to do what you can to make up for what’s lost.”

If you’re losing weight as a result of the disease, add more protein to each meal with options like:

Lean meats
Eggs
Nut butters
Fish

Cut back on dairy and certain types of high-fiber foods only if they’re triggering

Lots of fruits and veggies are packed with fiber, which for some people isn’t ideal during a flare.

“We used to tell people to avoid fiber altogether during a flare, but this is no longer the case,” clarifies Dr. Pola. “You don’t want to cut fruits and veggies out completely, as they’re rich in nutrients you need to stay healthy.”

Instead, consider limiting your intake of insoluble fiber. You can find it in:

The skin of raw fruits, like apples
Whole grains like popcorn
Root vegetables and leafy greens

“Insoluble fiber can be harder to digest and may be more of a trigger during a flare-up,” he continues. “So, consider eating smaller portions of these foods, or focus on different fruits and vegetables during a flare-up.”

Dairy is also a common food trigger. So, if it worsens your symptoms, cut back during a flare.

What to eat when in remission

“When you’re in remission, you can still have the goal of eating a healthy, well-balanced diet, and remove the restrictions on trigger foods if you can handle them,” says Dr. Pola. “Try to decrease inflammatory foods and increase anti-inflammatory foods.”

One way to do that is to focus on a well-balanced diet that leans more Mediterranean with lots of:

Fruits
Vegetables
Nuts
Seeds
Whole grains

“Try to avoid processed foods and additives, whether you’re in a flare-up or remission,” he adds.

That means you may want to avoid or limit:

Processed and red meats
Palm oils, like coconut oil
Artificial sweeteners
Food additives, like maltodextrin, carrageenans and maltodextrins

Dr. Pola has seen promise with supplements like curcumin and Qing Dai (a traditional Chinese medicine herb) that can help with ulcerative colitis.

“When it comes to supplements, talk with your healthcare provider first to see what they recommend and make sure they won’t conflict with other medications and foods you’re consuming,” he advises.

Healthy eating tips

What to eat and avoid when you have a flare and when you're in remission with ulcerative colitis

Flare-ups can last for days or weeks, so treating symptoms early is key. Your healthcare team can give you anti-inflammatories, biologics or other medications. But eating healthy also goes a long way to settling flare-ups and supporting long-term gut health.

Here are some strategies for setting yourself up for success with your next meal.

Take inventory of what you eat

Keeping a food diary helps track your triggers by taking a closer look at:

The amount of food you eat
How often you eat
The foods and ingredients you’re eating
The symptoms you experience after eating

“Writing your reaction to certain foods is important because it’s different for everybody,” says Dr. Pola. “Your triggers may also change day to day, depending on whether you’re in a flare or in remission. So, it helps to increase your awareness about what your body can and can’t handle.”

Work with an IBD dietitian

Dietitians who specialize in inflammatory bowel diseases (IBD) like ulcerative colitis can help craft a meal plan that gets you all the nutrients you need. Once you have that appointment, take your list of food triggers and their recommendations with you next time you shop for groceries.

“We get in the habit of eating certain foods without considering all the ingredients we’re putting into our bodies,” recognizes Dr. Pola. “When you’re living with ulcerative colitis, it’s important to start reading labels and think about how you feel when you eat certain foods.”

Monitor any changes in your symptoms

For some, ulcerative colitis flares start with mild symptoms, like:

Increased bowel movements
Diarrhea
Mild cramping

If you’re eating a healthy, well-balanced diet during a flare and your symptoms subside, you might not have to make major changes. But observe what’s happening, take note of when your symptoms spike and make changes as you need to in order to improve your quality of life.

“If your symptoms progress, let your care team know,” advises Dr. Pola. “They may order additional tests and can help you determine what to do with your diet and medications.”