UC and Nutrition: What Is Your Diet Missing?

What you eat doesn't cause or cure ulcerative colitis. But eating a diet that’s good for you is always a wise idea. It may even help you spend more time in remission and feel better.

Malnutrition isn’t usually a problem. Your small intestine is where you absorb vitamins, minerals, and proteins. And UC usually doesn’t affect that part of your body.

Still, it can be tricky to eat a well-balanced diet. Many people with UC find certain foods don't agree with them. And loss of appetite or fear of eating can cause you to lose weight or miss out on nutrients.

The best time to think about nutrition is when you're not having a flare.

The Best Diet for Ulcerative Colitis?

Most experts say that people with UC should simply try to eat a well-balanced diet whenever possible. This should include a variety of foods:

  • Lean meat, fish, and poultry
  • Low-fat dairy products
  • Bread, cereal, and whole grains
  • Fruits and vegetables
  • Healthy fats such as vegetable oils

Keep a food diary to help you figure out which foods cause problems for you and whether or not you're getting enough nutrients.

If you lose weight because of your ulcerative colitis, try to eat five or six small meals and snacks during the day instead of two or three large meals.

When you have chronic diarrhea, drink plenty of water or other fluids to stay hydrated.

A dietitian can make a plan diet that meets your calorie and nutrient needs. Before you take any dietary supplements, talk to your doctor or dietitian.

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Avoid High-Fiber Foods?

You may not have to say goodbye to foods such as whole grains, fruits, and vegetables because you have UC. Besides its nutritional benefits, fiber soaks up extra water in your system and can firm stools.

Even if a high-fiber food seems to worsen your UC symptoms during a flare-up, it may be OK when the flare is over. The only way to know if a particular food is a problem for you is to remove it from your diet and then gradually start to eat it again.

Aim for 20 to 30 grams of fiber a day. Steaming, baking, or stewing fruits and vegetables before eating them may be easier on your digestive tract than eating them raw.

If your doctor has recommended a low-fiber diet, you may miss out on the vitamins and minerals that are naturally in many high-fiber foods. Ask your doctor or dietitian if you should take a supplement.

Fish and Flaxseed Oils

Fish oil -- found in salmon, mackerel, sardines, herring, and black cod, as well as supplements -- acts as an anti-inflammatory. Though early studies are mixed, fish and flaxseed oils may help tame colon inflammation.

Probiotic Supplements

Probiotics are "good" bacteria that live in your intestines. You can also find them in foods like yogurt and in supplements. Some researchers, as well as people with inflammatory bowel disease, think probiotics help ease symptoms.

Researchers think adding more probiotics to your digestive tract might help treat the disease. In European studies, the probiotic E. coli Nissle helped prevent UC flares, but it isn't available in the U.S. Other studies are testing different probiotics to help control UC. If you and your doctor decide to try probiotics, you'll need to keep taking enough of the right kind for it to work.

UC and Lactose Intolerance

People with UC often think they have lactose intolerance, which means they can't properly digest the sugar in milk and milk products, because some symptoms are similar. But UC doesn’t make you more likely to have lactose intolerance. Your doctor can do a simple test to find out.

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If you can, keep milk and dairy products in your diet. They are a very good source of calcium and vitamin D, which keep your bones healthy. Using steroids such as prednisone for a long time can thin your bones and make it harder for your body to absorb calcium, raising your chance of having osteoporosis.

If dairy products cause you discomfort, see if you can eat them in small amounts. Or try a lactase supplement to break down the lactose in dairy products.

If you just can't stomach dairy products, your doctor may want you to take calcium and vitamin D supplements.

Multivitamins and Supplements

People with UC need to be especially careful to get enough folate, iron, and potassium.

Folate helps prevent cancer and birth defects. Some 5-ASA medications such as sulfasalazine (Azulfidine) can make it harder for your body to absorb folate.

Blood loss due to inflammation and ulcers in the colon can cause low iron levels. A simple blood test can tell.

Diarrhea or taking steroids can cause low potassium and magnesium levels.

Talk to your doctor about whether these nutrients could be a problem for you. You may need to take vitamins just in case. Nutrition supplement drinks can also make up for missing nutrients, but they may cause diarrhea.

WebMD Medical Reference Reviewed by Neha Pathak, MD on November 15, 2019

Sources

SOURCES:

Fedorak, R. Gastroenterology & Hepatology, November 2010.

Institute of Medicine: "Dietary Reference Intakes for Calcium and Vitamin D."

Office of Dietary Supplements: "Dietary Supplement Fact Sheet: Calcium."

Bassaganya-Riera, J. PLOS One, Feb. 21, 2012.

Science Daily: "New Probiotic Combats Inflammatory Bowel Disease."

Science Daily: "Which Treatment is Effective in Maintaining Remission in Ulcerative Colitis: Probiotic or Placebo?"

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