
Ulcerative colitis (UC) may have numerous triggers causing flare-ups and aggravation of the disease. Diet plays a crucial role in the patient’s overall health and quality of life. Diet is important in maintaining healthy colon and gut bacteria. An appropriate diet can help in easy digestion, reducing inflammation, reducing complications, recovery from flare-ups, and recovery after surgery.
What is ulcerative colitis?
Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that affects the inner lining of the large intestine (large bowel) leading to erosion and ulcers. It is a lifelong illness with no specific cause or cure. Patients have repeated cycles of flare-ups and remission (symptom-free periods) with potential manifestations outside the gut (extraintestinal manifestations). There is a profound emotional and social impact on the affected patients.
What are the causes of ulcerative colitis?
The exact cause of ulcerative colitis (UC) is unknown, and the possible causes are as follows:
- Genetics
- Immune reactions
- The body’s immune system attacks the inner lining of the large intestine (an autoimmune disorder)
- Environmental factors
- Diet rich in fat, sulfur, and meat
- Alcohol and substance abuse
- Psychological stress
- Medications
- Diet
- Consumption of certain foods may worsen the disease and trigger flare-ups.
What are the signs and symptoms of ulcerative colitis?
Patients commonly present with the following signs and symptoms:
- Rectal bleeding
- Tenesmus (constant feeling of the need to empty the bowels)
- Dehydration
- Diarrhea
- Cramps
- Fever
- Abdominal distention/bloating and pain
- Weight loss
- Inflammation of the eyes, joints, skin, and lungs
What foods trigger colitis?
Ulcerative colitis (UC) may have numerous triggers causing flare-ups and aggravation of the disease. Diet plays a crucial role in the patient’s overall health and quality of life. Diet is important in maintaining healthy colon and gut bacteria. An appropriate diet can help in easy digestion, reducing inflammation, reducing complications, recovery from flare-ups, and recovery after surgery.
To increase the chances of remission, reduce digestive irritation and flare-ups, it is recommended that patients avoid or reduce the following foods:
Whole-grain foods:
Foods that contain high fiber such as whole-grain flour may trigger flare-ups. They are also more difficult to digest during a flare-up of UC, hence should be avoided.
Foods that contain whole grain flour are as follows:
- Cereals
- Whole grain bread, pasta, and noodles
- Brown rice
- Broken wheat or quinoa
- Oats
- Millets
- Barley
- Wheat berries
Seeds:
Seeds can aggravate flare-ups and are difficult to digest. They contain insoluble fiber, which may cause bloating and diarrhea. Following seeds should be avoided:
- Millets
- Flax seeds
- Millet
- Sesame seeds
- Sunflower seeds
- Pine nuts
- Pumpkin seeds
Legumes:
- Legumes, including beans, lentils, soy, and peas, contain high fiber and protein. They cause bloating and gas.
Nuts
Nuts, including nut-based flours and cheese, should be avoided because the high fiber in nuts can be difficult to digest. It’s usually advised to avoid the following nuts:
- Hazelnuts
- Walnuts
- Almonds
- Peanuts
- Pecans
- Cashews
- Pistachios
- Almonds
Sulfate and sulfides:
Sulfate is a nutrient that assists in many body processes. However, in patients with UC, excess sulfates and sulfides in the diet may produce a toxic gas called hydrogen sulfide causing bloating, abdominal pain, irritation, and foul-smelling gas.
Sulfate- and sulfide-rich food consumption should be reduced:
- Red meat
- Dairy
- Beer and wine
- Apple and grape juice
- Cruciferous vegetables
- Eggs
- Cheese
- Dried fruits
Fruits:
Fruits contain high fiber that is difficult to digest. Fruits can be consumed if they have been peeled, cooked or as a juice. Fruits should be avoided if they
- are raw,
- are canned,
- are dried and
- contain seeds.
Vegetables:
Vegetables are an important source of nutrients in UC, but they also contain high fiber. Vegetables can be consumed if the skin has been peeled, and the vegetables are cooked. Canned vegetables can be consumed. Pureed vegetables should be preferred because they are easy to digest.
Gluten is a protein found in wheat, rye, and barley. Gluten is a common cause of digestive intolerance causing gastric irritation. Gluten is found in the following food products:
- Bread
- Pasta
- Prepared products such as condiments, sauces, soups, and proteins.
Dairy:
Intolerance to dairy products such as milk, butter, yogurt, and cheese is common in patients with UC.
Which foods are safe in ulcerative colitis?
The following foods are usually tolerated well in patients with ulcerative colitis (UC) and can be consumed provided the patients do not have any allergies or intolerance to them:
- White bread, noodles, and pasta made from refined white flour
- Boiled white rice
- Crackers and cereals made of white flour
- Cooked fruits
- Fruit without peels and seeds
- Cooked vegetables without skins and seeds
- Pureed vegetable and vegetable soups
- Tender, soft meats without skin
- Fish
- Nut butter like peanut butter
- Oils like coconut oil or olive oil

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