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Ulcerative colitis is a chronic inflammatory condition that affects the large bowel. Nutrition is an important part of your treatment and it is important to make changes to your diet to ensure you are well nourished but also to help minimise symptoms during a flare. Dietary advice depends on whether your disease is active; this is often called having a flare.
There is no specific diet for ulcerative colitis and you will only make short term modifications to your diet to preserve or promote your nutritional status or to improve symptoms. It is important to note that dietary changes can only help to improve symptoms and will not reduce inflammation in your bowel.
When you are in remission (no flare) then it is essential to make sure you are well nourished and regain any lost weight you may have experienced during a flare. Good nutritional status also helps to prevent vitamin and mineral deficiency and infection, and maintain disease remission.
When you are experiencing a flare you may need more energy and protein due to inflammation and healing. Also depending on where your inflammation is you may have difficulty digesting and absorbing the food you eat.
Although excluding certain foods whilst flaring can improve symptoms it is important to ensure you still maintain a balanced diet and replace any excluded food groups with suitable alternatives. Fibre is the only generally recommended food exclusion during a flare.
Fibre: Skins, seeds, and pith of fruits, vegetables, legumes and grains.
Excluding fibre during a flare is recommended to reduce symptoms such as diarrhoea, bloating, abdominal pain and bleeding. This is only a short term dietary change which should be changed once symptoms have resolved. Examples of high fibre foods include: beans, legumes, onions, peppers, broccoli, cauliflower, peas, sweetcorn, wholegrain breads, pastas and rice, raw/dried fruits and vegetables.
Dairy and gluten (protein found in wheat, rye and barley) are also commonly excluded foods by those with ulcerative colitis. It is not generally recommended to exclude these foods unless you have a diagnosis of lactose intolerance or coeliac disease.
Dairy: Milk, cheese, yoghurt
Dairy foods can sometimes cause symptoms and are sometimes excluded. It is important to remember to replace excluded dairy produce with suitable fortified alternatives (fortified with calcium and vitamin D) as they are a good source of calcium. Examples of non-dairy calcium containing foods include soya milk and yoghurt, breads, sardines, spinach, baked beans, orange, figs and orange juice.
Gluten: Bread, pasta, pastries and biscuits
Gluten is also another commonly excluded food constituent and gluten containing foods should be substituted with suitable replacements such as rice, potatoes, and gluten free bread and pasta.
Nutritional deficiencies are more common in those with ulcerative colitis and in particular calcium and iron deficiency, which can result in osteoporosis and anaemia respectively.
This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.
The information here is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.
Publication Date: June 2021
Review Date: March 2024