Ulcerative colitis is an inflammatory disease of the large intestine (colon). It causes irritation, inflammation, and ulcers in the lining of the colon. Ulcerative colitis occurs when your immune system makes a mistake and attacks the healthy cells lining your large intestine. (The main symptom of ulcerative colitis is bloody diarrhea.)

There is no cure, and people usually have flare-ups—times when your symptoms get bad—on and off for life. However, the right treatments (diet and medications) can help you control the disease. There are two types of therapeutic ulcerative colitis diets, one for during the flare-ups and one for the rest of the time. Also key is keeping a food diary to identify your food triggers (specific foods that trigger a flare-up, and differ among individuals.)

Ulcerative colitis diet

There is no single diet that will help everyone with ulcerative colitis. However, the American Gastroenterological Association recommends that people with ulcerative colitis eat a nutritious Mediterranean-style diet. The Mediterranean diet is simple and the perfect diet for ulcerative colitis. Eating the Mediterranean way basically consists of consuming an abundance of fruits, vegetables, grains, legumes, and nuts. In addition, extra virgin olive oil is the main fat, and fish is emphasized as a protein source (an excellent way to obtain heart-healthy omega-3’s).

Anti-inflammatory foods

The Crohn’s & Colitis Foundation recommends including foods that help lower inflammation in your diet, such as:

  • Fruits: bananas, raspberries, and applesauce
  • Cooked vegetables: squash, carrots, and green beans
  • Potatoes, rice, and other starchy vegetables that have been cooked, cooled, then reheated
  • Fish that have high levels of healthy omega-3 fats, such as salmon, tuna, and mackerel
  • Other good sources of omega-3 fats, such as chia seeds, walnut butter, and flaxseed oil
  • Leafy green vegetables, preferably chopped into small pieces or blended into a smoothie

Ulcerative colitis diet for flare-ups

When you have a flare-up, your intestinal lining is irritated. The best ulcerative colitis diet during flare-ups is a nutritious low-residue diet that’s easy to digest and soothes the irritation. Aim for eating nutrient-rich foods to help you get the recommended vitamins and nutrients. Some foods that may be easier to tolerate during an ulcerative colitis flare-up include:

  • low fiber fruits, such as bananas, honeydew melon, and cooked fruits
  • lean protein, such as seafood, chicken, eggs, and firm tofu
  • refined grains, such as instant oatmeal, sourdough bread, and white rice, breads, and pastas
  • cooked vegetables without seeds or skins, such as asparagus tips, potatoes, and cucumbers

Keeping a food diary

After every meal or snack, jot down a note of what you ate and drank. Separately, record any symptoms that you experience that day and your bowel movements. Various phone apps were developed to help you stay on top of all these moving parts, one example is the LyfeMD app developed by gastroenterologists.

An example of identifying a trigger food would be if you notice that every time you eat a spicy food such as Mexican with chili peppers, you feel lousy later. That’s a strong clue that spicy foods are a trigger for you, so you may want to avoid them. Spicy foods can irritate the digestive tract and worsen symptoms like diarrhea and abdominal pain. Caffeinated drinks and alcohol can also common foods that trigger ulcerative colitis symptoms. High-fiber foods can trigger some people. These include raw kale, apple skin, Brussels sprouts, cabbage, and other cruciferous vegetables.

The takeaway: Ulcerative colitis can be managed with diet and medications. There is no ulcerative colitis diet for everyone. Aim for eating a nutrient-dense Mediterranean-style diet that works for you, avoid trigger foods and change up your diet during flare-ups.

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