Foods to Avoid With Ulcerative Colitis

Your diet doesn't cause ulcerative colitis – but it can worsen its symptoms.

While researchers don’t know what causes ulcerative colitis, there's no mystery about how bad its symptoms are.

People with ulcerative colitis typically initially suffer from bloody diarrhea, says Dr. Ece A. Mutlu, a professor of medicine and an IBD specialist at Rush University Medical Center in Chicago. The disease can also cause abdominal cramping, pain and significant urgency to run to the bathroom for bowel movements. In severe cases, someone with ulcerative colitis may have up to 30 bowel movements a day. "It's a very unpleasant illness," Mutlu says.

Ulcerative colitis is an autoimmune disease of the large intestine, or colon. Crohn's disease is a similar but different autoimmune disease. With ulcerative colitis, the body’s immune system, which is supposed to protect the body from microbes, instead attacks the intestine. This can cause swelling, redness and ulcerations in the colon, Mutlu says. While its exact cause is unknown, researchers believe ulcerative colitis is caused by a combination of environmental factors and genetics.

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Adjusting your eating regimen can mitigate ulcerative colitis symptoms during flare-ups.

While ulcerative colitis is a chronic disease, its symptoms come and go, Mutlu says. During an inactive phase, the symptoms may be minor or nonexistent. The symptoms appear, in varying degrees, during flare-ups.

In the remission phase, while there are reports of some patients benefiting from various kinds of diets, there's no medically approved eating regimen that's been shown to definitively reduce flare-ups. But once the disease is active, you can mitigate symptoms by eliminating certain foods from your diet, Mutlu says.

Here are 10 types of foods you should abstain from during an ulcerative colitis flare-up:

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1. Whole-grain foods.

Typically, it's a good idea to eat whole-grain foods that have lots of fiber, says Christina D'Angelo, a registered dietitian nutritionist with the Jersey Shore University Medical Center in Neptune, New Jersey. But consuming foods high in fiber can exacerbate ulcerative colitis symptoms, she says. If you're experiencing a flare-up, avoid brown rice, popcorn, oatmeal, shredded wheat and whole-grain breads that contain 2 grams or more of fiber per serving, D'Angelo says. "If you're experiencing symptoms, high-fiber grains may not be tolerated," she says.

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2. Raw fruits and vegetables.

While it's usually a good idea to eat lots of fresh fruits and veggies as part of a healthy diet, you should abstain from them if you're having an ulcerative colitis flare-up, says Emily Hamm, a registered dietitian at Northside Hospital Atlanta in Atlanta. "High-fiber foods like raw fruits and raw vegetables can irritate the small intestine due to the high amount of insoluble fiber they contain," Hamm says. "These fibers are not easily broken down and can be rough when moving through the gastrointestinal tract, causing abdominal pain and cramping." Such foods can also scratch the lining of the intestines, which can result in a bloody stool, she says. If you’re going to eat fruits and vegetables, cook them well enough that they can be easily mashed with a fork, and remove the skins and any seeds. "This can break down the fiber and make it easier for your GI tract to digest," she says.

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3. Sugar alcohols.

Sugar alcohols including sorbitol, mannitol and xylitol can cause diarrhea, Hamm says. These ingredients are commonly found in sugarless gums, candies, desserts (like ice cream) and soft drinks. They can also be found in some over-the-counter medications like cough drops and in some vitamins (particularly chewable tablets and gummies) and minerals. If you're experiencing an ulcerative colitis flare-up, read OTC labels carefully or talk to a pharmacist about medication ingredients. Sugar alcohols are created from plant products, like berries and other fruits, according to the Joslin Diabetes Center. A chemical process alters the carbohydrates in the fruits, creating sugar substitutes. These products have "somewhat fewer" calories than table sugar, according to the center.

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4. Carbonated beverages.

Drinks with carbonation – sodas, seltzers and sparkling waters – promote gas production in the gastrointestinal tract, Hamm says. That can exacerbate abdominal pain, cramping and diarrhea.

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5. Beans and legumes.

Because they're rich in fiber, it's a good idea to avoid beans and legumes, like chickpeas, peas and lentils, during an ulcerative colitis flare-up, D'Angelo says. You should also abstain from consuming hummus, which is made from chickpeas. "The high fiber content of these vegetable sources of protein may exacerbate your symptoms when you’re having a flare-up," she says.

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6. Fermentable foods.

Offerings that quickly ferment in the gut will produce large amounts of gas, which increase cramping and bloating, says Nancy Hadley, a board-certified family nurse practitioner who is a core faculty member at Walden University in Minneapolis. She teaches in the master of science in nursing program. Fermentable foods include cabbage, sauerkraut and dried fruits. "During a flare-up, eating foods that you normally would enjoy will cause more pain and prolong your symptoms," Hadley says. "During those flare-ups, you need to eliminate these items from your diet to eliminate short-term worsening of your symptoms."

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7. Seeds and nuts.

Because they're hard to digest, seeds and nuts can worsen symptoms of an ulcerative colitis flare-up, such as bloating, cramping and increased bowel urgency, D'Angelo says. Popcorn can do the same, so it's best to abstain from these common snack foods.

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8. Fatty meats.

Consuming fatty meats such as bacon, sausage and hot dogs takes more time for your body to digest than lean meats, poultry and fish, D’Angelo says. Your gastrointestinal tract has to work harder to digest fatty meats, which can exacerbate your symptoms.

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9. Spicy foods.

Offerings that are spicy, like peppery foods or sauces, can tax the digestive system and exacerbate diarrhea, bloating or bleeding, says Dr. Bincy Abraham, director of the inflammatory bowel disease program at Houston Methodist Hospital in Houston.

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10. Dairy products.

Lactose, which is found in dairy products like milk, ice cream, butter, yogurt and cheeses, can exacerbate symptoms during an ulcerative colitis flare-up, says Pam Wooster, a registered dietitian nutritionist at UCHealth Yampa Valley Medical Center in Steamboat Springs, Colorado. Eliminating or reducing consumption of lactose can help reduce diarrhea, abdominal cramping and gas. "Lactose intolerance can be temporary, so once an ulcerative colitis flare has resolved, slowly add dairy products back into your diet," she says. If you continue to an intolerance to dairy, you could try some of the many plant-based milks on the market. Soy, pea and oat milks are among the many plant-based alternatives to whole milk that are available.

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To recap, here are 10 types of foods to avoid during an ulcerative colitis flare-up:

  • Whole-grain foods.
  • Raw fruits and vegetables.
  • Sugar alcohols.
  • Carbonated beverages.
  • Beans and legumes.
  • Fermentable foods.
  • Seeds and nuts.
  • Fatty meats.
  • Spicy foods.
  • Dairy products.

 

Ece Mutlu, MD, MS, MBAChristina D'Angelo, RDN, MSEmily Hamm, RDN, LDNancy Hadley, DNPBincy P. Abraham, MD, MSPam Wooster, RD

https://health.usnews.com/conditions/digestive-disease/ulcerative-colitis/slideshows/foods-to-avoid-during-an-ulcerative-colitis-flare-up?onepage

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