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Ulcerative Colitis: Talk to Your Doctor

Understanding ulcerative colitis symptoms and treatment can help you live easier with the condition.
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Ulcerative colitis can be a complicated, distressing, and confusing illness. Your doctor can help make sense of it. But the first step is knowing what questions to ask. Here's a checklist of questions suggested by experts in inflammatory bowel diseases (IBD), along with notes on what your doctor may discuss with you.

Should I change my diet because of ulcerative colitis?

"Diet doesn't cause ulcerative colitis, and special diets can't cure the disease," says Walter J. Coyle, MD, director of the Gastrointestinal Program at Scripps Clinic Medical Center. "But it can help to avoid foods that your body has trouble tolerating or foods that irritate your bowels."

Your doctor may give you a checklist of some foods that frequently cause problems, including "gassy" foods like broccoli, cauliflower, beans, and whole grains. Some dietitians recommend eating five or six small meals rather than two or three large ones. Drinking plenty of fluids, especially water, can also help.

But remember: No two ulcerative colitis sufferers are alike. A food that bothers one person may cause no problems at all in someone else. Although a variety of popular IBD diets have received a lot of hype, doctors say no one diet has been proven to effectively treat the disease.

Should I keep a diary of food and ulcerative colitis symptoms?

Doctors and dietitians encourage patients to keep a food-and-symptoms diary for several weeks. "By keeping track of what you eat and how you feel afterwards, you can identify specific foods that exacerbate your symptoms," says dietitian Tracie Dalessandro, RD, author of What to Eat With IBD.

A dietitian may also want to review your diary to make sure that you're eating a well-balanced diet that includes all the nutrition you need.

Many experts recommend keeping a diary for at least three weeks. Keep in mind that your goal should be to eat as wide a variety of foods as you can to assure well-balanced nutrition. "Diets that eliminate many foods are hard to follow and may result in nutrient deficiencies," says Dalessandro.

What should I eat during a flare-up of ulcerative colitis symptoms?

During a flare-up, the large intestines become inflamed, causing diarrhea and discomfort. Many experts recommend going on a non-residue diet -- one that eliminates foods that are hard to digest or that contain indigestible fiber. That means avoiding fruits and vegetables, nuts and seeds, and whole grains.

Some doctors recommend a liquid diet during severe flare-ups. With no food passing through the large intestines, the bowels have time to heal. A low-residue diet is also recommended for people who have developed a narrowing of the lower small intestine, called the ileum.

Again, keep in mind that no two people respond the same way. "Some patients do well on a low-fiber, low-residue diet, but every patient is different," says David T. Rubin, MD, co-director of the Inflammatory Bowel Disease Center at the University of Chicago.

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