Ulcerative colitis isn't caused by anything you eat or drink, but certain foods or beverages can exacerbate symptoms, especially during flare-ups. Making even small changes in your diet may help prevent, or at least minimize, flare-ups.
"It is very individual," says Suzanne Farrell, M.S., R.D., spokesperson for the American Dietetic Association (ADA). To find your triggers, keep a food journal for at least 3 to 5 days. "Include a column for what you eat, when you eat it, the amount and any symptoms," Farrell advises. The ADA also recommends these general ulcerative colitis guidelines:
- Avoid high-fat foods such as fried foods, full-fat ice creams and cheeses, and fatty meats such as bacon. Excess fat in your diet can promote diarrhea.
- Limit caffeinated beverages like soft drinks, coffee and tea. Caffeine can have a laxative effect, which worsens symptoms.
- Be careful about fiber. Some is good; a lot, not. Avoid popcorn, very high-fiber cereals and fruits with lots of seeds. Opt instead for cooked vegetables (which are easier to digest than raw) and a breakfast cereal with 3 grams of fiber per serving (rather than 12 or 13 grams). Spread out the fiber you consume over the course of a day. For example, if you have an apple or a salad at lunch, have cooked vegetables at dinner.
- Go easy on sugarless gums and candies. They contain sugar alcohols - such as sorbitol, mannitol and xylitol - which may cause diarrhea when consumed in large amounts.
- Go light on sugar, too. Highly concentrated sugar in soft drinks, fruit juice, dried fruits and candy can increase risks for diarrhea.
- Consider taking a multivitamin daily and possibly adding other supplements, such as calcium or vitamin D. Talk to your doctor about nutrients you might be losing during flare-ups, and find out if you are at an increased risk for certain conditions because of nutrient deficiencies. Ask your doctor if he or she advises a referral to a registered dietitian.
- Eat smaller, more frequent meals rather than three large ones. Eating a small amount of food every three hours makes it easier for your body to digest food and reduces the risk of diarrhea.
- Drink water to counteract the dehydrating effects of diarrhea. Sip it slowly throughout the day; don't gulp, which can increase gastric emptying.
- Make substitutions. Have trouble digesting dairy products? Try calcium-fortified soy milk. If you can't eat cheese, you may be able to tolerate yogurt - which has not only calcium and protein, but also contains probiotics that may actually aid with digestion. If wheat products are a problem, look for pastas made with rice or quinoa, or opt for corn breads and tortillas.
- Take time to enjoy your food. Eat slowly and mindfully. "Digestion begins with chewing," says Farrell. "By taking small bites and chewing them thoroughly, you're really helping the digestion process. Being relaxed and calm when you're eating can aid digestion as well."