If you have ulcerative colitis (UC), it's worth your while to pay attention to what you eat. Foods don't cause the disease, but some can set off your flares.
How can you keep away from those triggers but still get the nutrients you need? That's where a diet plan can be a huge help.
Colitis Diet: What Can I Eat?
If you have ulcerative colitis (UC), figuring out what you can eat may take some trial and error. Doctors know that eating certain foods can cause people with UC to have worse symptoms. However, the specific foods that make your UC worse may be different from the foods that trigger symptoms in another patient.
No specific diet has been proven to be the “best” for people with UC. However, you may want to consider trying a Mediterranean-style meal plan. In March 2024, the American Gastroenterological Association (AGA) published advice that most people with UC (and Crohn’s disease, a related condition) should eat a diet based on the foods commonly found on dinner tables in the Mediterranean regions of Europe, Asia, and Africa. That means eating lots of fruit and vegetables, whole grains, healthy fats such as olive oil, and lean protein, such as fish and skinless chicken breasts.
However, you may need to personalize the Mediterranean diet to avoid certain foods that you can’t tolerate. And, other diets may be more appropriate for some patients, though they should be supervised by a doctor or registered dietitian.
Ulcerative colitis flare-up
When you have UC, there will be times when your symptoms get really bad. Doctors call these frustrating episodes “flare-ups.” Certain foods seem to “trigger” flare-ups in people with UC. If you have UC, your food triggers may not be the same as those of a friend who also has the condition. However, there are some common food triggers, including:
- Foods that are very high in fiber, especially the insoluble kind, such as apple skin
- Milk, ice cream, and other foods that contain lactose
- Sugary foods and drinks, such as cookies and soda pop
- High-fat foods, such as butter, cheese, and fried dishes
- Spicy foods
- Coffee and other beverages with caffeine
- Alcohol
- Artificial sweeteners
Colitis Diet and Triggers
There is no single diet that will help everyone with UC, and this condition can also change over time. That means your diet plan will need to be flexible, too. The key is to find what works for you.
Keeping a food diary
To help identify your food triggers, keep a food diary (also called a food journal). You can use a notebook and pen or download an app for your phone. After every meal or snack, make a note of what you ate and drank. Separately, jot down any symptoms that you experience that day.
Keeping a food diary can help you detect patterns. For example, you may notice that every time you eat a spicy food such as pasta with marinara sauce, you feel lousy later on. That’s a strong clue that spicy foods are a trigger for you, so you may want to avoid them.
Maintaining a food diary takes a bit of time and patience, but it will help you track your condition and fine-tune your diet plan.
Ulcerative colitis foods to eat
You should discuss what foods to eat with your doctor. The American Gastroenterological Association recommends that people with UC should eat a Mediterranean-style diet, which includes plenty of:
- Fruits
- Vegetables
- Whole grains, such as brown rice
- Fish
- Olive oil
- Nuts and seeds
- Low-fat dairy
- Lean poultry
- Fish and shellfish
- Beans and legumes
The Crohn’s & Colitis Foundation recommends including foods that help lower inflammation in your diet, such as:
- Bananas, raspberries, and applesauce
- Cooked vegetables, such as 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 foods to avoid
The following foods and beverages are common triggers for people with UC:
- Alcohol
- Caffeine
- Carbonated drinks
- Dairy products, if you're lactose intolerant
- Dried beans, peas, and legumes
- Dried fruits
- Foods that have sulfur or sulfate
- Foods high in fiber
- Meat
- Nuts and crunchy nut butters
- Popcorn
- Products that have sorbitol (sugar-free gum and candies)
- Raw fruits and vegetables
- Refined sugar
- Seeds
- Spicy foods
Ulcerative colitis and alcohol
If you avoid booze because it makes your UC worse, you are not alone. Research suggests that alcohol is the most-avoided food or drink by people who have irritable bowel disease, which includes UC (and Crohn’s disease).
When you relax by sipping a beer or glass of wine, the alcohol in these beverages may be causing trouble as it gets absorbed in your gut. Specifically, it makes it easier for bacteria and other toxins to pass through the lining of your gut, which can increase inflammation that may lead to a flare-up. Abstaining from alcohol may help you reduce these unwelcome episodes.
Ulcerative colitis and caffeine
Some people with UC say that drinking coffee, which is high in caffeine, makes their symptoms worse. Doctors often tell patients with UC to avoid caffeine. However, some studies have failed to find a link between caffeine and UC. Still, if you think coffee and other caffeinated beverages trigger your UC, it’s best to avoid it.
Managing Ulcerative Colitis
Your doctor and dietitian can help you figure out what foods work best for you. Keep them in the loop on how you feel and what you eat. They can answer your questions and help you get the nutrition you need.
Supplements for ulcerative colitis
Ideally, you should try to get all of the vitamins, minerals, and other nutrients your body needs from eating a balanced diet. But sometimes, dealing with flares means you may have to avoid certain nutritious foods. In that case, your doctor may suggest that you take dietary supplements to help provide the nutrients you’re missing. Some common supplements that doctors recommend for UC patients include:
- Calcium
- Folic acid
- Iron
- Vitamin B12
- Vitamin D
- Vitamins A, E, and K
- Zinc
When you buy a dietary supplement, be sure to read the label and find out if the product is made with any ingredients that could cause a flare-up, such as lactose or sugar alcohols.
Eating habits for ulcerative colitis
Following some good eating habits can help you manage ulcerative colitis, including:
Think small. You may find that you do better with smaller meals throughout the day instead of three big ones.
Snack wisely. When you make your diet plan, think about foods that you can carry with you for healthy snacks.
Start slowly. If you have been avoiding fruit and vegetables, but you’re ready to increase your intake, add them to your diet in small amounts at a time to prevent your symptoms from flaring.
Stay hydrated. Drink plenty of water throughout the day, especially if you’re experiencing UC symptoms and going to the bathroom often, which can leave you dehydrated.
Plan ahead. If you’re dining out, check the restaurant’s menu online ahead of time so you can determine if it includes foods you can tolerate. When invited to a dinner party and you’re concerned that the meal may not agree with you, let the host know in advance that you plan to bring your own food.
Foods That May Fight Ulcerative Colitis
Some research shows that certain nutrients may help fight the irritation and swelling in your gut caused by UC.
Linoleic acid
Scientists have studied how linoleic acid (found in foods such as walnuts, olive oil, egg yolks, and coconut oil) affects people with the condition. Although everyone needs this “good” fat, don’t overdo it, as there is some evidence it may play a role in inflammation if you get too much.
Omega-3 fatty acids
The fat found in fish, known as omega-3 fatty acids, appears to quiet inflammation, which could help prevent flares. The major component of omega-3 fatty acids is eicosapentaenoic acid (EPA). In one small study, researchers had a group of UC patients take dietary supplements containing EPA for 6 months, while another group was given empty placebo pills. At the end of the study, the patients taking EPA supplements had lower levels of a substance called calprotectin, a sign of inflammation, in their poop than the patients taking placebos. The EPA users were also more likely to be in remission.
Docosahexaenoic acid (DHA) is another omega-3 found in fish oil that can fight inflammation and is used by some people with UC.
Probiotics
Scientists have found that people who have UC often have too much of the wrong kind of bacteria in their guts, which can promote inflammation. Probiotics are healthy bacteria, which are sold in the form of dietary supplements. A small 2022 study found that people with mild to moderate UC who took probiotic supplements were more likely to go into remission than others who were given placebos. Some research also shows that yogurt with gut-healthy probiotics eases inflammation. Scientists are still studying how probiotics may help people with UC and similar conditions.
Low-FODMAP diet
Some people also believe that a diet low in FODMAPs — a type of highly fermentable carbs found in meats, fruits, dairy, and lots of other foods — may help ease UC symptoms. But there is no clear evidence about it. And without close monitoring, any diet that restricts healthy foods such as fruit and dairy may lead to poor nutrition and other problems.
Takeaways
If you have UC, what you choose to put on your plate at every meal or when you snack can decide whether you enjoy a satisfying, productive day or end up in the bathroom for hours dealing with a flare-up. Doctors who treat UC suggest different diets, though recent recommendations are that many patients should eat a balanced, nutritious meal plan that promotes overall good health. Work with your doctor or a registered dietitian to find the UC diet that’s right for you.
Colitis Diet FAQs
What are the worst foods to eat if you have colitis?
If you have colitis, certain foods may worsen your symptoms. Your triggers are specific to you, but some common ones that cause trouble with the guts of many UC patients include high-fat foods, sugary treats and beverages (such as soda pop and sports drinks), high-fiber foods, spicy dishes, and additives such as sugar alcohols.
Do eggs trigger colitis?
Eggs are not a common trigger for colitis.
What foods are colitis-flare friendly?
When you’re having a flare, doctors recommend that you eat plenty of lean protein, as your need for this important macronutrient will rise. You may also want to eat some foods that may fight inflammation, such as bananas, applesauce, cooked squash, and salmon.