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What to Know About Diet and Nutrition When You Have Ulcerative Colitis
By Ingrid Strauch
Medically Reviewed by Kareem Sassi, MD
There's no need to avoid certain foods — unless they make your symptoms worse.
Stick to a healthy, balanced diet to keep UC symptoms at bay.
Ulcerative colitis, a chronic inflammatory disease of the large intestine (colon), isn't known to be caused by any particular food or diet. (1)
Some studies suggest that people who consume more saturated fat and sugar and eat fewer fruits and vegetables are at greater risk for the disease. (2) But these results aren't conclusive.
Changing your diet won't cure ulcerative colitis. But during a disease flare, some foods may aggravate your symptoms more than others. (2)
In addition, because ulcerative colitis tends to cause diarrhea, it's important to replace lost fluids and stay hydrated when a flare happens. (3)
When the disease is in remission — not causing symptoms — experts suggest simply following a balanced diet that provides the basic nutrients needed for good health. The fewer foods you restrict, the easier this is to accomplish. (4)
What Foods Can You Eat When You Have Ulcerative Colitis?
There is no one-size-fits-all diet for people living with ulcerative colitis. Your diet will also likely vary from times you are in remission to when you have disease flares.
During remission, it's important to maintain a nutrient-rich diet to stay healthy.
Foods you may want to include:
Fiber-rich food, such as beans, barley, nuts, oat bran, and whole grains. But if you have an ostomy or intestinal narrowing or have had a recent surgery, a low-fiber diet is advised.
Foods high in protein like lean meats, eggs, fish, and tofu
Fruits and vegetables — include as many different "colors" in your diet as you can.
Calcium-rich foods like yogurt, collard greens, and milk (if you are not lactose-intolerant)
Foods to Eat When You Are Having a Flare
During a disease flare, it's often helpful to stick to bland foods that are easy to digest, according to the Crohn's & Colitis Foundation. (3)
You may want to try the following foods:
White or sourdough bread
Crackers made with white flour (not whole-grain flour)
White rice (not brown rice)
Cheese (if you're not lactose intolerant)
Diluted fruit juices and sports drinks
Smooth peanut butter
Plain cereal
Refined pasta (not whole grain)
Potatoes without skin
Broiled or steamed fish
Plain turkey, chicken, or eggs (3,4)
Keeping a food journal can help you figure out which foods bother you and which ones don't.
Consuming more omega-3 fatty acids may help reduce inflammation in ulcerative colitis, according to UCSF Health in San Francisco. (4)
Foods high in omega-3 fatty acids include:
RELATED: 4 Simple Dinner Ideas for Ulcerative Colitis
What Foods Should You Avoid When You Have Ulcerative Colitis?
While no foods have been clearly found to worsen inflammation or ulceration in ulcerative colitis, some foods may make symptoms — such as cramping and diarrhea — worse.
During a flare, it's often best to avoid high-fiber foods, which are harder to digest than low-fiber foods. (5)
High-fiber foods include:
Legumes like dried beans and lentils
Uncooked vegetables, or vegetables with skin
Cruciferous vegetables, like broccoli and cabbage
Greasy, fried, or high-fat foods — such as butter, margarine, and cream — may also cause diarrhea.
Other foods and beverages to approach cautiously include:
Alcoholic beverages Drinking alcohol can make diarrhea worse.
Caffeine This substance — found in coffee, tea, chocolate, and many soft drinks — can trigger diarrhea.
Carbonated beverages Fizzy drinks can cause bloating and gas in some people.
Grains Some grains may cause abdominal discomfort and diarrhea, especially if you're sensitive to gluten.
Dairy products These foods may cause bloating and diarrhea, especially if you're lactose intolerant. But they can be a good source of protein and other nutrients.
Spicy foods These foods may trigger diarrhea.
Sweets High-sugar foods and beverages, like candy and juices, can contribute to water loss and dehydration. (3)
Some people will have more trouble with certain foods and beverages than others. It's important to find out which foods cause you digestive discomfort, and then avoid them.
Getting Enough Fluids When You Have Ulcerative Colitis
The job of the large intestine (colon) is to absorb water from digested food and move solid waste out of the body.
When your colon is inflamed during an active bout of ulcerative colitis, it doesn't absorb water properly, which can lead to diarrhea and dehydration.
That's why it is so important to drink enough fluids when your ulcerative colitis is active.
A good rule of thumb is to consume half an ounce (oz) of fluid per pound (lb) of body weight per day, according to UCSF Health. (3)
If you weigh 150 lb, for example, you need at least 75 oz of fluid a day, or more than 9 cups.
Most beverages, and even some high-water foods like watermelon and cucumbers, count toward this total.
Since drinking ice-cold liquids or consuming too much fluid at once can worsen diarrhea, it's best to take sips of warm or cool beverages throughout the day.
Avoid gulping fluids, since this can aggravate diarrhea and cause you to swallow air along with the fluid.
A good way to gauge your fluid intake is to monitor the color of your urine. If it's pale or clear, you're probably getting enough fluids. (6 PDF)
RELATED: Why It's Important for People With IBD to Stay Hydrated
Getting Enough Nutrients When You Have Ulcerative Colitis
Ulcerative colitis can make it difficult to get the nutrition you need — both in terms of major components of your diet, like protein, and specific vitamins and minerals.
You may need to take vitamin or mineral supplements to make up for nutrient deficiencies caused by ulcerative colitis, your diet, or the medication you take to treat the disease.
Talk to your doctor or nutritionist about what supplements, if any, you may need.
Major nutrition categories to focus on include:
Total calories Since ulcerative colitis can reduce your appetite while increasing your calorie needs, you may need to focus on consuming more calories than you're used to.
Protein When you're in remission, an adequate intake of protein is usually considered 1 gram (g) each day for each kilogram (kg) — about 2.2 lb — of body weight. (4)
This means that if you weigh 150 lb (68 kg), you should consume 68 g of protein daily.
But your protein needs may increase by as much as 50 percent right after a flare, according to UCSF Health. (4)
People with ulcerative colitis are at increased risk for deficiency of the following vitamins and minerals:
Folate, especially if you take sulfasalazine
Magnesium, especially if you have chronic diarrhea
Calcium, especially if you take prednisone
Iron, especially with greater blood loss from severe disease
Potassium, a higher risk with chronic vomiting or diarrhea, or if you take prednisone (4)
Eating during a disease flare may cause abdominal cramping. One way to minimize this discomfort is by eating frequent, small meals of bland foods.
If you're having trouble finding foods that don't worsen your symptoms, or if you're losing weight because of that difficulty, consult a registered dietitian who is knowledgeable about inflammatory bowel disease.
Your dietitian may recommend liquid supplements if you can't tolerate solid foods. (4)
Additional reporting by Quinn Phillips.
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Ulcerative Colitis. Mayo Clinic. December 24, 2019.
Ulcerative Colitis. Penn State Hershey. August 6, 2015.
What Should I Eat? Crohn's & Colitis Foundation.
Nutrition Tips for Inflammatory Bowel Disease. UCSF Health.
Ulcerative Colitis: Diagnosis & Treatment. Mayo Clinic. December 24, 2019.
Diet, Nutrition, and Inflammatory Bowel Disease. [PDF] Crohn's & Colitis Foundation. November 2013.
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