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Ulcerative Colitis: Diet, 19 Foods to Avoid, Treatment & Causes

What is ulcerative colitis?

What Causes Ulcerative Colitis?

The cause of ulcerative colitis is unknown.

Ulcerative colitis (UC) is a chronic condition that causes inflammation of the large intestine (colon) and the rectum and sores (ulcers) on the inner lining of the large intestine. Ulcerative colitis is thought to be an autoimmune disease, that is, one where the body attacks itself. It is a type of inflammatory bowel disease (IBD). It is not the same as Crohn's disease, another type of IBD, which can affect any part of the gastrointestinal tract, whereas ulcerative colitis only affects the colon and rectum. It is also not the same as irritable bowel syndrome (IBS), which affects how the colon functions and does not cause inflammation.

Ulcerative colitis is estimated to affect nearly 907,000 Americans, and it affects males slightly more often than females. The disease is most commonly diagnosed between the ages of 15 and 40.

What are the symptoms of ulcerative colitis?

Symptoms of ulcerative colitis include

What causes ulcerative colitis?

The cause of ulcerative colitis is unknown but it is believed to be caused by
a combination of several factors including an overactive immune system,
genetics, and the environment.

  • Overactive immune system: It is believed that in ulcerative colitis, the
    immune system is triggered to mistakenly attack the inner lining of the large
    intestine, causing inflammation and symptoms of ulcerative colitis.
  • Genetics: Ulcerative colitis
    can run in families. The genetic link is not entirely clear but studies show
    that up to 20% of people with ulcerative colitis have a close family member with the disease.
  • Environment: Certain environmental factors including taking certain medications
    (nonsteroidal anti-inflammatory drugs or NSAIDs, antibiotics, and oral
    contraceptives), and eating a high fat diet may slightly increase the risk of
    developing ulcerative colitis.

Physical or emotional stress, and certain foods do not cause ulcerative
colitis, however, they may trigger symptoms in a person who has ulcerative
colitis.

Ulcerative Colitis

Ulcerative Colitis Treatment Medications

Treatments for ulcerative colitis includes both medications and surgery; however, there is no medication that can cure ulcerative colitis. Medications
that treat ulcerative colitis are

  • anti-inflammatory agents, for example, 5-ASA compounds like sulfasalazine
    (Azulfidine), and olsalazine (Dipentum), and topical and systemic corticosteroids), and
  • immunomodulators, for example, 6-mercaptopurine (6-MP), azathioprine (Imuran), methotrexate (Rheumatrex, Trexall), cyclosporine (Gengraf, Neoral).

Treatment of ulcerative colitis with medications is similar, though not always identical, to treatment of Crohn’s disease.

Learn more about ulcerative colitis treatment medications »

What is an ulcerative colitis diet?

A person with ulcerative colitis may find they need to modify their diet to
help manage their symptoms. There is not a single diet or meal plan that fits
everyone with ulcerative colitis, and diets are individualized for each patient. Depending on
symptoms different types of diets may be recommended, such as:

  • A high-calorie diet: Many people with ulcerative colitis lose weight and can
    develop signs of malnutrition. A high calorie diet may prevent these problems.
  • A
    lactose-free diet:
    People with ulcerative colitis may also have lactose intolerance.
  • A low-fat
    diet:
    Ulcerative colitis may interfere with fat absorption and eating fatty
    foods may trigger symptoms. This is often recommended during an ulcerative
    colitis flare.
  • A
    low-fiber diet (low-residue
    diet
    ):
    This can help reduce the frequency of bowel movements and
    abdominal cramps.
  • A low-salt diet: This diet is used when patients are on
    corticosteroid therapy to help reduce water retention.
  • A low FODMAP diet: FODMAP
    stands for Fermentable Oligo-Di-Monosaccha-rides and Polyols, which are types of
    sugars found in certain carbohydrates and sugar alcohols. This diet is used in
    people who have intolerance to FODMAPS.
  • A gluten-free diet:
    People with ulcerative colitis may
    also be sensitive to gluten.

Attention to nutrition is important for patients with ulcerative colitis, as
the symptoms of diarrhea and bleeding can lead to dehydration, electrolyte
imbalance, and loss of nutrients. It may be necessary to take
nutritional supplements if your symptoms do not allow you to eat a nutritionally balanced
diet. Talk to your health-care professional about what supplements to take. Many people with
ulcerative colitis find it easiest to eat smaller, more frequent meals rather
than a few large ones. This can also help increase the nutrition absorbed from
the foods you eat.




QUESTION

Ulcerative colitis affects the colon. The colon is also referred to as the…
See Answer

19 trigger foods to avoid with an ulcerative colitis diet plan

Dietary choices do not cause ulcerative colitis, but certain foods can
trigger and worsen symptoms. Learning to identify trigger foods can help reduce
the frequency and severity of ulcerative colitis symptoms. Not all people with ulcerative
colitis have the same
triggers, but a list of some of the most common include:

  1. Alcohol can stimulate the intestine, triggering
    diarrhea. Some people
    tolerate alcohol better than others.

  2. Caffeine
    , found in coffee, tea,
    chocolate,
    and energy drinks, is a stimulant and can speed up the transit time in the
    colon, leading to more frequent trips to the bathroom.
  3. Carbonated
    beverages
    including sodas and beer contain carbonation that can irritate the
    digestive tract, and cause
    gas. Many contain
    sugar,
    caffeine, or artificial
    sweeteners, which can also be ulcerative colitis triggers.
  4. Dairy products should be avoided if
    you are lactose intolerant, as they can cause symptoms similar to ulcerative
    colitis. Not everyone with ulcerative colitis is lactose intolerant.
  5. Dried beans, peas, and
    legumes
    are all high in fiber and can increase bowel movements, abdominal
    cramping, and gas. If you are a
    vegetarian or vegan,
    you can try these foods in
    small amounts, or pureed to see if they do not trigger symptoms.
  6. Dried fruits,
    berries, fruits with pulp or seeds are other foods high in fiber that can
    trigger ulcerative colitis symptoms.
  7. Foods containing sulfur or sulfate can cause excess gas
    production. Sulfate may be found in many foods, including beer, wine, some
    juices, dairy milk, eggs, cheese, dates, dried apples and apricots, almonds,
    wheat pasta, breads, peanuts, cruciferous vegetables, raisins, prunes, red meat,
    and some supplements.
  8. High fiber foods, including whole-grains, can increase
    bowel movements, abdominal cramping, and gas.
  9. Meats, especially fatty meats, can
    trigger ulcerative colitis symptoms. Excess fat may not be properly absorbed during a flare, and
    this can make symptoms worse. Red meat can be high in sulfate, which triggers
    gas.
  10. Nuts and crunchy nut butters, and seeds that are not ground up (such as in
    smooth peanut butter or tahini) can cause worsening abdominal cramping, bloating, and diarrhea. During a flare, even tiny fruit seeds (such as those in
    strawberries or in jams) may trigger symptoms.
  11. Popcorn is another high fiber,
    bulky food that is not completely digested by the small intestine and can
    trigger diarrhea and bowel movement urgency.
  12. Sugar alcohols (such as
    sorbitol
    and mannitol) are found in sugar-free gum and candies, some ice creams, and some
    fruits and fruit juices (apples, pears, peaches, and prunes) and can cause
    diarrhea, bloating, and gas in some people.
  13. Chocolate contains caffeine and
    sugar, both of which can irritate the digestive tract and cause cramping and
    more frequent bowel movements.
  14. Vegetables, especially raw vegetables, are high
    in fiber and can be difficult to digest, causing bloating, gas, and abdominal
    cramps. This is particularly true for stringy vegetables such as broccoli,
    celery, cabbage, onions, and Brussels sprouts. Many people with ulcerative
    colitis also find it
    hard to digest corn and mushrooms because they are hard to digest to begin with.
  15. Refined sugar can pull more water into the gut and cause diarrhea.
  16. Spicy foods,
    hot sauces, and pepper
    can cause diarrhea in many people, and in someone with
    ulcerative colitis experiencing a flare spicy hot foods may trigger or worsen
    symptoms.
  17. Gluten, found in wheat, rye, barley, and some oats, can trigger
    symptoms similar to ulcerative colitis in people who have gluten sensitivity.

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What foods help manage and soothe ulcerative colitis flares?

Avoiding foods that trigger ulcerative colitis symptoms is one way to help
manage symptoms through diet. Another is knowing what foods to eat that may help
relieve flares. Following is a list of foods that may help soothe ulcerative
colitis flares:

  • Salmon and albacore tuna contain

    omega-3 fatty acids
    , which can help reduce inflammation during a flare and may
    help you to stay in remission. Other sources of omega-3s include mackerel,
    herring, sardines, flaxseed oil, ground flaxseed, and walnuts. Some people may
    be unable to eat whole nuts and flaxseeds during a flare, but they may be
    tolerated if ground up.
  • Lean meats and poultry are recommended
    following flares of ulcerative because proteins are often lost. Increasing your
    protein intake can help replenish the nutrients lost during a flare.
  • Eggs are another great source of
    protein, and are often well-tolerated even during flares. Some eggs are
    fortified with omega-3 fatty acids, which can help
    reduce inflammation.

  • Soy-based protein
    can be substituted
    for animal protein in vegetarians and vegans. Other good sources of non-animal
    proteins include legumes and whole grains.
  • Probiotics, usually found in yogurt,
    kefir, sauerkraut, and miso, are good bacteria that can aid in digestion. Choose
    yogurts that are low in added sugars, as sugar can aggravate ulcerative colitis
    symptoms.
  • Avocados are an excellent source of
    protein and
    healthy fats. They are calorie dense, but because they are about 70%
    water, they are easily digested.
  • Unsweetened applesauce is bland and may
    be tolerated after an ulcerative colitis flare, though some people may find it
    difficult to tolerate during a flare-up.
  • Instant oatmeal contains refined grains
    and is often easier than steel cut or old-fashioned oatmeal because it has a
    little less fiber.
  • Squash is a healthy choice that is
    usually well-tolerated during an ulcerative colitis flare. It's full of fiber,
    vitamin C, and beta carotene. Any variety of squash (butternut, zucchini,
    spaghetti, acorn, winter, and summer) are best tolerated cooked. Raw squash may
    aggravate ulcerative colitis symptoms during a flare.
  • Juice and smoothies can be tolerated by
    some during a flare, and can help you maintain good nutrition. Carrot juice is
    chock full of vitamin A and antioxidants and many
    people with ulcerative colitis find it easy to
    tolerate.
  • Plantains, which are a variety of
    banana, can help aid digestion.

How can I track foods that cause flare-ups and trigger symptoms of my
ulcerative colitis?

The Crohn's and Colitis Foundation of America recommends people with
ulcerative colitis to keep a food journal to keep track of what they eat. Note
what you eat and drink, and how you feel afterwards, noting any symptoms that
arise. Start to keep a list of any foods you suspect may trigger or aggravate
your ulcerative colitis symptoms. A food diary will also help you figure out if
you are getting adequate nutrition, and can help your doctor or dietician
determine the right diet for you to manage your symptoms and prevent flares.

The Crohn's and Colitis Foundation of America also has an interactive food
tracking tool. It is available online or as a mobile app.
www.ccfa.org/gibuddy

What other things trigger ulcerative colitis symptoms and flare-ups?

In addition to foods that trigger ulcerative colitis flare-ups, there are
certain environmental risk factors that may also trigger flares.

  • Nonsteroidal anti-inflammatory drugs, or NSAIDs (aspirin, ibuprofen
    [Advil, Motrin, Nuprin],
    naproxen
    [Naproxen]) may cause colitis or worsen the condition. NSAIDs increase the
    occurrence of bloody diarrhea, weight loss, iron deficiency anemia, and
    abdominal pain.
  • Where you live may predispose you to a higher incidence of
    ulcerative colitis. Ulcerative colitis is found more commonly in developed countries, urban
    areas, and northern climates. The highest rates for ulcerative colitis are reported in the
    United States, Denmark, and Iceland.
  • Stress does not cause ulcerative colitis
    but it can make symptoms worse. Stress management techniques can be important in
    managing your ulcerative colitis symptoms.
  • Not taking medications or improper dosing of
    medications that are used to treat ulcerative colitis can bring on a flare.
    Medications for ulcerative colitis must be taken regularly, even when you feel well. Take
    medications as prescribed. Do not skip doses, cut doses, or increase doses.
  • Antibiotics may cause diarrhea in some people. If you have an infection, tell
    your doctor to figure out the right antibiotic for you. You may also take a
    probiotic along with the antibiotic to help prevent diarrhea.

Which specialties of health-care professionals prescribe an ulcerative
colitis diet?

A gastroenterologist is a specialist in disorders of the digestive tract and
can prescribe a diet for ulcerative colitis. In addition, dietitians and
nutritionists who are familiar with the disorder may also help create a diet and
meal plan to manage ulcerative colitis.

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