“A nutritious diet is very important for everyone, and when you have ulcerative colitis, it's important to work with your doctor and nutritionist to make sure you are consuming a high-quality diet that provides essential nutrients to the body,” says Tracie. “Although different people may have different dietary requirements, there are some general nutritional principles to consider in choosing various foods that will give you the nutrition you need and in avoiding those that may aggravate your condition.
“Here are some basic principles I suggest you talk about with your doctor and nutritionist to determine a dietary approach that is right for you. Remember, as a patient I fully understand that healthy eating takes time, planning, and energy; however, the rewards that come from eating well are worth the extra effort.”
Drink plenty of the right fluids
It’s not just what you eat, says Tracie; it’s also what you drink.
“That’s because when you have severe diarrhea during a flare, you could become dehydrated. It’s important for you to offset the loss of fluids by drinking plenty of water and nutritious drinks,” she says. “Some people with UC have found that a diluted sports drink can be helpful in replacing lost electrolytes. Talk to your doctor about what fluids he or she would recommend for you. And remember, alcoholic beverages and drinks with caffeine can cause or aggravate diarrhea. For most of us, it's probably best to avoid them altogether.”
Here are Tracie's suggestions about some food choices you should discuss with your doctor to ensure you're getting a healthy and nutritious diet.
Choose healthy foods in the right amounts
Carbohydrates:
- 6-11 servings are generally recommended per day—many people benefit from about 50% of their diet coming in the form of complex carbohydrates
- Low-sugar foods generally provide greater overall nutritional content
- Foods with more soluble fiber (well-cooked oatmeal, rice, barley) are helpful for some people
- Carbohydrates that are high in insoluble fiber, like very grainy wheat breads, may be problematic for some people with UC
Protein:
- 2-3 servings daily is a good goal for most people
- General guidelines say protein should be 25% of your diet
- Talk to your doctor about such choices as eggs, lean meats, fish, poultry, soy, and smooth nut butters
- High-fat meats are generally not considered a healthful choice for anyone, including people with UC
Dairy:
- 2-3 servings daily are recommended, but talk to your doctor about how much is right for your case
- If dairy is not tolerated, ask your doctor about alternative sources of calcium. Fortified soy milk is a great choice
Fats:
- Prepare meals with healthy fats such as olive or canola oil
- Flaxseed oil is a great source of omega-3 fatty acids; ask your doctor if he or she recommends it for you and use it in foods that are not cooked, like protein shakes
- Minimize unhealthy fats such as butter, lard, margarine, and fried foods
Fruits and vegetables:
- 5-9 servings daily is a healthful recommendation for everyone
- Choose deeply colored fruits and vegetables—they're packed with nutrients
- Fruits without the skin or seeds are also often helpful choices
- Cooked vegetables without skin or seeds may be easier to digest
- Some people find it helpful to avoid raw vegetables with skin or seeds
Fluids:
- 8-10 glasses daily are recommended for proper hydration
- Water is always a good choice; talk to your doctor about how much fluid you should consume and other options, such as diluted sports drinks, when diarrhea is severe
- It's probably a good idea to avoid caffeinated beverages and alcohol; ask your doctor his or her opinion about them for you
Avoiding high-fiber foods may be helpful during an ulcerative colitis flare
Reducing the amount of fiber you consume, and limiting dairy products, may be helpful in decreasing the amount of stool in your colon and can help reduce gas and bloating. According to Tracie, some doctors and their patients have found this approach can help to lessen the discomfort of an ulcerative colitis flare. Of course, not all dietary approaches work for all patients, so you should discuss the benefits of avoiding high-fiber foods. The following are some examples to discuss with your doctor.
Carbohydrates:
- Choose plain cereals, white rice, refined pasta, and oatmeal bread
- Avoid whole grains, seeds, and coarse fibers
Fruits:
- Applesauce and bananas have a lot of bowel-slowing soluble fiber and may be good choices when diarrhea is severe; bananas are also high in potassium—an electrolyte that may be lost when diarrhea is severe
- Avoid prune juice
- Most other fruits may be consumed, if peeled
- Avoid fruits with seeds
Vegetables:
- Choose well-cooked vegetables; avoid those with skins and seeds
Meat and protein:
- Choose well-cooked lean meats
- Eat fish more often
- Avoid beans, nuts, and seeds, except smooth nut butters
Dairy:
- Choose as tolerated
- Avoid if not tolerated
- Choose alternative calcium sources; some potential alternatives include fortified soy milk and juices, yogurt, and hard cheeses, or calcium supplements
Vitamin and mineral supplements
“Like other aspects of your diet plan, whether to take a supplement or vitamin is also an individual matter that depends on your particular needs,” says Tracie. “Depending on what you are eating, you could be missing various nutrients, so talk with your doctor about what supplements he or she recommends for you.”
We also asked Tracie for some of her top tips for avoiding foods that may aggravate your colon during a flare. Learn more about various dietary adjustments that may help.
This material is not intended to replace conversations with your health care professional team. If you have questions, comments, or concerns about your condition, please speak to your doctor or nurse.
