The Ulcerative Colitis Diet That’s Right For You

by Wanda - 2 years ago

Did you know that an ulcerative colitis diet is one of the highest recommended means of recovering from ulcerative colitis?

Receiving a diagnosis of ulcerative colitis can be frustrating and overwhelming, but it doesn’t have to be a life sentence and it doesn’t have to become your identity.

With a few lifestyle changes, you can rediscover your health—starting with food.

Our team at Athletic Greens has learned a good deal about ulcerative colitis diet plans. We’ve found alternative recipes, lists of anti-inflammatory foods, and assistive supplements.

Although select medication can be absolutely necessary to healing, both medical and personal testimonies reaffirm our belief that diet is at the heart of well-being.

And, as each individual has their own experience of ulcerative colitis, we’ll discuss ways you can judge what plan works best for you.

1. Ulcerative Colitis—Maggie’s Story Of Doctors And Diets
2. What Is Ulcerative Colitis?
3. The Symptoms Of Ulcerative Colitis
4. Treating Ulcerative Colitis—Diet, Medication, Peace Of Mind
5. Ulcerative Colitis Diets—Tried And True
6. A Happy Ending To Ulcerative Colitis

Ulcerative Colitis—Maggie’s Story Of Doctors And Diets

At Athletic Greens, we got a chance to chat with Maggie, the mother of a teenage boy who was recently diagnosed with ulcerative colitis. She has been kind enough to share her experience with us.

She told us how her son had a sudden flare-up of symptoms, possibly triggered by a virus.

Luckily, during diagnosis and treatment, Maggie was able to tap into the very best physicians at Boston Children’s Hospital and learn how to help her son navigate this condition in the best possible way.

Careful observation of his particular experience of ulcerative colitis has enabled them to move forward. This is because ulcerative colitis is unique to the individual and a personal management plan is required.

Ulcerative Colitis – Not A One Size Fits All Disease

The biggest takeaway for us was when Maggie relayed how important it was to recognize ulcerative colitis as an individualized disease.

There are medications prescribed to reduce inflammation, but it is not recommended that you rely on that alone. It is best to work toward a daily management plan, with your diet as the most important component.

There is no single diet guaranteed to work for everyone or to be immediately effective. You will most likely have to piece together your own diet as you work through a list of suggested foods, build on your successes, and give your body time to heal.

It might surprise you to find how some foods can be ideal for one patient and spell disaster for another.

Ulcerative colitis treatment is complicated, because even though we know the mechanisms by which it creates issues, the cause is not entirely understood.

What Is Ulcerative Colitis?

Ulcerative colitis is an autoimmune disease that attacks the large intestine (colon) and rectum. It is grouped under the title of Inflammatory Bowel Disease (IBD), along with Crohn’s disease.

The condition involves inflammation in the digestive tract, resulting in abdominal pain, discomfort, and the urgent need to empty the colon.

The body’s immune system responds abnormally to food and bacteria, reacting to it as though it were an infection or a foreign substance invading the system.

White blood cells jump to action and trigger inflammation, which can become chronic. This may also result in ulcers in the lining of the intestines.

To respond to a familiar substance as though it were foreign or for your immune system to overreact and treat a mildly annoying substance as though it were life-threatening is typical of allergic reactions.

For this silly reason, your body sets its immune system on overdrive trying to protect itself.

The main trouble with chronic ulcerative colitis (as opposed to acute ulcerative colitis, which is elaborated on below) is that the immune system has a very hard time knowing when to turn off.

Another thing that makes it difficult to anticipate or prevent symptoms is that the disease can lie dormant. You may have heard terms such as, “flares” or “flare-ups”, to describe when negative symptoms are being experienced in a seemingly spontaneous way.

If you experience symptoms, the best approach is to look at your lifestyle and begin stripping away potential irritants. Look at what you eat, what causes you stress, and what makes you tired.

Controlling the autoimmune response is key to managing this disease and returning to a place of remission.

Slowly and with the support of resources like this one, an IBD specialist, and maybe your cat, you can begin to make changes.

No one is pretending that it’s easy, but the potential benefits mean it’s certainly worth a try.

What Causes Ulcerative Colitis?

There are a few possible causes.

Stanford Health Care produced the following list of factors found in connection with ulcerative colitis:

  • Toxin-producing bacteria
  • Food sensitivity
  • Hereditary genetic makeup
  • Accidental irritation of the colon lining (eg. by the overuse of ibuprofen or acidic diet
  •  Depletion of probiotics
  • Viruses

In addition, many of the above can be triggered and/or aggravated by stress.

Who Gets Ulcerative Colitis?

The disease is not gender or age specific. Most adults with ulcerative colitis know their diagnosis by the time they’re in their 30s and onset can occur as early as childhood.

It’s estimated that around 20% of patients who have a form of IBD, also have a close relative that suffers from the condition.

Because the disease is an immune response, it can awaken at any time and any age. People who suffer ongoing symptoms should seek medical care, right away.

Untreated ulcerative colitis can lead to very serious conditions such as colon cancer and malnutrition.

The Symptoms Of Ulcerative Colitis

According to the Crohn’s & Colitis Foundation, many patients only have moderate to mild symptoms and may not be aware they even have this disorder. Warning signs and symptoms of ulcerative colitis include:

  • Non-stop diarrhea
  • Abdominal pain and cramps
  • Blood in stool
  • Loose and immediate bowel movements

When you experience extreme symptoms, reduced appetite and weight loss occur quickly.

The periods during which ulcerative colitis is causing symptoms are referred to as flares or flare-ups. You may go months or years with no signs of the disease, at all.

Other side effects of a flare include low energy and lack of focus due to dehydration (loss of nutrients and electrolytes from excessive elimination).

Medical care is needed immediately at the onset of a serious flare.

Diagnosing Ulcerative Colitis

The first step to the treatment of ulcerative colitis is receiving a proper diagnosis. If you have the symptoms, you need to be evaluated first by a gastroenterologist through a series of tests that include:

  • Review of personal and family health history
  • Review of symptoms
  • Full blood tests (looking for inflammation markers)
  • Upper and lower GI endoscopy
  • Colonoscopy
  • MRI/CAT scan
  • Biopsy tissue sample

The endoscopy and colonoscopy determine how far the inflammation has spread in the upper gastrointestinal tract determining if it’s Crohn’s disease or ulcerative colitis.

There are different types of colitis, and the diagnostic process will help your doctor discover which variety you are experiencing.

There are several classifications based on the location and amount of inflammation in both the rectum and colon; irritation is usually concentrated in the same area throughout the condition.

These classifications of colitis include:

  • Ulcerative Proctitis – affects mainly the rectum and symptoms include rectal bleeding, pain associated with the need to defecate urgently, and rectal pain.
  • Proctosigmoiditis – affects a small part of the colon on the left side (sigmoid colon) that connects to the rectum. Symptoms include the need to defecate, bloody diarrhea, cramps, and rectal bleeding.
  • Left-sided Colitis – affects the left side (sigmoid colon) as well as the descending colon. Symptoms vary and include cramps, bloody diarrhea, weight loss, and pain on the left side.
  • Universal Colitis (Pancolitis) – affects the whole colon and the rectum. Symptoms vary and include fatigue, night sweats, abdominal pain, fever, bloody diarrhea, and cramps.
  • Fulminant Colitis – the worst form of universal colitis and an urgent medical problem that requires treatment in the hospital. This form can cause a perforation in the colon as well as dehydration. Surgery on the colon or removal may be necessary.

Acute Ulcerative Colitis

Acute colitis is what it’s called when you have symptoms of ulcerative colitis, but suddenly and only for a short period.

Acute colitis is still an inflammatory reaction of the colon and rectum, but it is triggered by an infection (bacterial or viral), irritant, drug, or chemical. It is not a chronic condition and in most cases heals on its own, naturally.

Symptoms can include diarrhea, bloating, abdominal pain, bloody or watery stools, and fever.

If necessary, the administration of drugs in the treatment of acute colitis includes non-steroidal anti-inflammatories and antibiotics.

In some cases, drugs are encouraged as a way of preventing bouts of acute ulcerative colitis from developing into a chronic condition.

Patients that struggle with Irritable Bowel Syndrome (IBS) may from time to time develop acute colitis symptoms.

In some cases, acute colitis is connected to diverticulitis but usually resolves once the treatment of diverticulitis is successful.

Crohn’s Disease vs. Ulcerative Colitis

Differentiating Crohn’s disease from ulcerative colitis is essential, particularly because it is common for the definitions to be wrongly interchanged.

Crohn’s disease can attack any section of the gastrointestinal tract, including multiple layers of the bowel wall, while ulcerative colitis only affects the lining of the colon and rectum.

Both conditions fall under the category of Inflammatory Bowel Disease (IBD). This is not to be confused with the condition known as irritable bowel syndrome (IBS), which is to do with the muscle responses in the colon.

Symptoms of Crohn’s disease include abdominal pain, weight loss, joint pain and swelling, fatigue, mouth sores, and anemia (iron deficiency).

For more information on Crohn’s disease and the Crohn’s diet visit University of Chicago Medicine.

Treating Ulcerative Colitis—Diet, Medication, Peace Of Mind

Finding the right doctor is essential to recovering from ulcerative colitis. A gastroenterologist can teach you how to regulate and monitor your immune system.

There is currently no simple cure for a chronic case, but staying on top of your treatment and doing everything you can to manage your symptoms will help you to lead a healthy and normal life.

Treatments include medications, nutrition and diet, and in severe cases, surgery to repair or remove parts of the gastrointestinal tract.

Doctors often begin with therapy to get the patient into the remission process, then later develop management strategies specific to each patient.


Medication is used for ulcerative colitis to first suppress and control the inflammation in the colon and allow for the tissues and lining to heal. This is called, “inducing remission”.

Doctors also use medications that relieve symptoms such as bleeding, abdominal pain, and diarrhea.

There are also immunosuppressives including Prednisone, Uceris, or biologics such as Humira, which are used for treatment, depending on the severity of the case.

Doctors may also choose to combine therapies for treatment by using a biologic added with an immunomodulator.

Stress Management

It is understood that symptoms can be triggered or exacerbated by stress.

This is because stress runs down our immune system and can lead us to behave in ways that then further compromise our health.

For example, say you have a very stressful week at work, catch a cold, and later eat a piece of pizza because you’re feeling lazy and—bam—your ulcerative colitis shows up.

Gerard E. Mullin, MD, director of integrative GI nutrition services at Johns Hopkins Hospital in Baltimore states:

Doctors recommend regular exercise, meditation, and yoga for managing stress.

The Crohn’s & Colitis Foundation offers support groups for those struggling with anxiety, isolation, or stress due to this condition. It’s important that we feel supported and remember that we’re not alone.

Ulcerative Colitis Diet—Why It’s So Important

Developing your ulcerative colitis diet will restore nutrients and reduce symptoms, allowing the body to heal.

During a flare, your body is not getting the nutrients it needs, due to tissue damage and excessive elimination.

An ulcerative colitis diet revitalizes you with minerals, vitamins, fats, proteins, carbohydrates, and water. Medication can help reduce inflammation, but targeting the foods that help and hinder you is vital for long-term recovery.

Ulcerative colitis is not a condition that develops due to the foods you eat, but flare-ups can be triggered by certain foods and remission can be achieved by eliminating the foods that act as irritants, and adding anti-inflammatory foods.

Ulcerative Colitis Diets—Tried And True

During a Flare Up

Remember Maggie? She went through an ulcerative colitis journey over the last year with her son. Well, during the height of their experience with ulcerative colitis, her son wasn’t able to eat much, at all.

So, they tried a bland diet of simple and starchy foods. One of the few meals Maggie’s son could absorb and maintain during his flares was plain chicken and rice.

Maggie explains that if you are experiencing a flare, you should go with a bland diet right away. At that point, your body is too damaged and tired to process more complex foods and a bland diet is all it can handle.

The combination of medications prescribed by his doctor and a bland diet meant Maggie’s son was able to regain his strength and heal.

Maggie says if you listen to your body it will tell you what to do… You don’t desire tacos with Habañero sauce when you feel that sick!

Consider the following foods:

  • Applesauce
  • White rice
  • Bananas and canned fruits (without seeds)
  • Steamed vegetables
  • Yogurt
  • Salmon (sautéed not fried)
  • Peanut butter

Your Ulcerative Colitis Diet May Change As You Go

Once Maggie’s son started to heal, he was slowly transitioned from a bland diet into a trial and error period with other foods. Boston Children’s Hospital recommended they try the Mediterranean Diet, with some exceptions and modifications.

Exceptions to the Mediterranean Diet meant eliminating known aggravators like popcorn and foods with small seeds such as, strawberries. Small seeds can irritate the lining of the colon and trigger a flare, so it’s best to avoid them.

Maggie slowly incorporated items from the Mediterranean Diet such as lean proteins, lettuce, and pasta to see which foods her son could or couldn’t tolerate.

They kept a food journal to record every response he had, as they built their unique ulcerative colitis diet.

For example, they found it helpful to avoid dairy and lactose, citrus, tomatoes, whole grains, and high-fiber foods.

Discovering the right mix of diet can be a prolonged process. You don’t want to make too many changes at once; it’s easier to track if you make them one at a time.

Maggie said one of the most supportive pieces of advice they received from their doctors was not to turn life upside down just because of the condition. They said to work on bringing normalcy back into her son’s life through the progress of creating a diet that mediated reconciliation of the everyday with ulcerative colitis.

It’s much easier to stay motivated and positive through the process of finding an ulcerative colitis diet if you remember not to assume what you can’t have—you really never know. And also, remember that there are many alternative recipes, which can make unconventional combinations really very good.

You don’t want to over-analyze your food. Just document it and figure out what works and what doesn’t, slowly and in tiny increments.

If you throw yourself into one ulcerative colitis diet, cold turkey, you might be eliminating things you could have tolerated.

For example, Maggie suggests doing something like this: If you’re curious about dairy, put just a small bit of cheese on your pasta and see how you feel.

That being said, it is probably wise to avoid typical aggravators like, nuts, seeds, spicy foods, and certain others your doctor may warn you about.

The Elimination Diet Method

One way to investigate what foods you can include in your ulcerative colitis diet is the elimination method, which bears similarities to what Maggie did.

There are a number of foods considered as common irritants, such as dairy, wheat, eggs, peanuts, alcohol, sugar, etc. However, you may know your primary irritants right off and find yourself needing to eliminate many potential culprits and reintroduce them at certain intervals.

It can take a couple of weeks for certain substances, like gluten, to leave your system. Truthfully, the process requires some patience.

But that patience can lead to some very definitive results. This is because the longer you go without an irritant in your system, the more sensitive you become to it. Therefore, if that irritant is reintroduced, even in a very small dose, you will have a stronger reaction.

In light of this, also be sure to have the help of an IBD specialist. You don’t want to risk a strong reaction without a medical consultant to walk you through the process and be there to answer all the questions that will, inevitably, arise.

Doctors do subscribe medication to help reduce inflammation, which can be very helpful and, in the case of an emergency, surgery may be an option.

However, the hope is always to be preventative and to embrace our ability to help our bodies by daily management, as much as possible.

Vigorous documentation of the rise and fall of symptoms and your daily food intake will help you a great deal.

And, since you may be forced to give up food you crave and love, it is important to remember that there are many alternative recipes that create outstandingly delicious food.

The University Of Colorado Recipe Resources:

It is undeniably true that meal preparation becomes more intense when you’re forced to eat an alternative diet. However, there are many resources to help you learn to minimize the time and pain of meal prep.

You can pop on a computer and search for something like, “fast vegan meal prep”, or even better, why not take a stroll to your local bookstore, next Sunday, and see what they have to offer? While you’re at it, go ahead and pick up that novel you’ve been thinking of reading as a reward for going out of your way.

Low Fiber Diet

Another potential framework for your ulcerative colitis diet is the Low Fiber Diet (Also known as, the “Low Residue Diet”).

The list below includes low fiber vegetables and tender meats, but keep in mind that even items on this list can trigger a flare, and foods should be added back slowly and in small increments, as Maggie suggested earlier.

Maggie and her son had initially eliminated dairy because they realized it was a trigger, but later on they tried lactose-free milk and this was fine.

A list of recommended foods to include in your low fiber diet might run as follows:

  • Dairy: Up to 2 cups of milk, cottage cheese, pudding, or yogurt per day
  • Grains: Refined white breads, pasta, crackers, and dry cereals that have less than 1/2 a gram of fiber per serving
  • Tender Meats: Meats and other proteins such as soft and tender cooked meats (eg. poultry), eggs, pork, fish, smooth peanut butter, and other nut butters
  • Fruits: Juices with no pulp; canned fruits and applesauce (not including pineapple), raw, ripe bananas, melon, cantaloupe, watermelon, plums, peaches, and apricots
  • Vegetables: Raw lettuce, cucumbers, zucchini, onion, cooked spinach, pumpkin, seedless yellow squash, carrots, eggplant, potatoes, and green and wax beans
  • Fats and Sauces: Butter, margarine, mayonnaise, oils, smooth sauces, dressings (not tomato), whipped cream, and smooth condiments (without high fructose corn syrup)

Maggie and her son had to avoid vegetables with seeds in them, such as cucumbers. Some people may be able to tolerate these vegetables, but because of the seeds, she chose to avoid them rather than risk a flare.

The Pillars Of Your Ulcerative Colitis Diet—Anti-inflammatory Supplements

Maggie’s gastroenterologists at Boston Children’s Hospital also suggested anti-inflammatory supplements.

And the suggestion came with a word of advice: If you’re not spending more than $20 on a probiotic then it probably doesn’t work.

Both Culturelle and Florastor are recommended probiotics that have proven successful.

Your GI tract needs all the help it can get. Effective probiotics can restore good bacteria that helps us digest food. We do get probiotics from certain foods such as yogurt, but when our system has been through this kind of ordeal, it’s a good idea to provide a supplemental boost to an ulcerative colitis diet—no matter how refined it might be.

Additional supplements Maggie used to treat her son’s ulcerative colitis include:

  • Vitamin D
  • Multivitamin
  • Fish Oil Omega 3 and 9
  • Turmeric/Black Pepper
  • Supplement suggestions may vary from patient to patient

Choosing the right supplements can be tricky, so we’ve created a free guide to help you find the highest quality options available. You can download your free copy below.

How To Track Your Ulcerative Colitis Diet

Maggie learned there is more than one way to track the results of your diet trials.

You can keep a small notepad and write everything down, or use a food tracker app.

The app Maggie found to be most helpful was GI Buddy. You can use it to record how you feel after you eat, how much sleep you’re getting, how many times you’ve gone to the bathroom, and stool descriptions.

GI Buddy is a full management system and food tracker app. for IBD conditions. It can be used to analyze a Crohn’s disease diet as well as an ulcerative colitis diet.

A Happy Ending To Ulcerative Colitis

In closing, Maggie happily shared that her son is in remission and slowly tapering off prescription medications. She reiterated that the careful tracking of food and making slow and modest dietary changes is crucial to success.

She also expressed her gratitude for having an incredible team of doctors to give her such excellent advice and treatment, warning against “analysis paralysis”—that anxiety and overwhelm which can come from reading too much of what’s available online.

She recommended you utilize resources that are trusted and come highly recommended by your medical team.

She elaborated that social media support groups, which at times may be informative and helpful, can also be overwhelming and exhibit too much conflicting noise on the topic.

Because of the support Maggie has received from Boston Children’s Hospital and her witnessing her son’s condition improve, she has been given hope. By sharing her’s and her son’s story with us, she offered her own support to any and all of us who are facing difficult health conditions.

You Are Not Defined By Ulcerative Colitis

Maggie feels it’s important for people to remember that an ulcerative colitis diagnosis does not have to define you. Just as the shape of your nose doesn’t decide your character and purpose, neither does your current health condition.

It’s hard to change your lifestyle so drastically, especially when it sometimes means giving up foods you love and crave. But it’s not the end of the world. With a carefully designed ulcerative colitis diet, you can lead a healthy life.

Boston Children’s Hospital recommends the Crohn’s & Colitis Foundation as a trusted and informative resource.

And at Athletic Greens, we’re always seeking out new ways to help you find your way to optimal wellness. Please, tell us your stories, so we can provide an informed support system for others who have begun their journey from flare to remission.