Ulcerative colitis nutrition: What kind of diet should colitis patients have?
Many ulcerative colitis sufferers are looking for ways to influence the course of the disease on their own, and nutrition plays a big part in this: What foods can help keep the disease under control? Are there foods that encourage a flare-up? And what diet should be followed during a colitis flare-up?
Ulcerative colitis nutrition facts
- There is no specific ulcerative colitis diet.
- Keeping a food and symptom diary can help to determine individual dietary influences.
- Sufficient nutrients are particularly important to prevent vitamin and mineral deficiencies, which can weaken the body.
- A wholesome, varied diet is recommended, with an emphasis on the consumption of vegetables, vegetable fiber, and little consumption of meat and alcohol.
- Low total fat consumption has a positive effect on the course of the disease.
- Coconut and milk fats have a negative impact on the course of the disease.
- Easily digestible food should be chosen in the acute phase; in exceptional cases, feeding intravenously (parenteral nutrition) is even necessary.
What is ulcerative colitis?
This inflammatory bowel disease has a relapsing course, and typical symptoms include bloody-slimy diarrhea, abdominal pain, and fever. There may also be symptoms that do not affect the intestine (e.g. the joints, liver and skin). The disease is treated with medication. There are differences between active relapse treatment and maintenance treatment.
Is there a specific ulcerative colitis diet that is recommended?
No. There is no special diet for people with ulcerative colitis if the disease is not currently active. However, a healthy, wholesome diet is advisable. As the absorption of nutrients, vitamins, and minerals is reduced during inflammatory flare-ups, a high-quality diet that meets the needs of those suffering from ulcerative colitis is particularly important.
Sometimes, in addition to ulcerative colitis, there is also a food intolerance or lactose intolerance present. The corresponding products (dairy products in the case of lactose intolerance or high-fructose foods in the case of fructose intolerance) should then be removed from the diet.
Does keeping a food diary help?
If those affected want to find out individually how the diet affects ulcerative colitis, a food diary can be useful. The food and the severity of symptoms of ulcerative colitis and the medication taken are noted in the food diary. After a few months, the notes can be used to analyze whether some foods cause more symptoms than others. The help of trained experts is highly recommended here.
Which minerals are particularly important for people with colitis?
Colitis sufferers should place special emphasis on their iron and zinc supply as both minerals are very important for the recovery from the flare-ups and the maintenance of a good immune system.
What do studies say about ulcerative colitis and nutrition?
Studies on this topic sometimes come to conflicting results, or the studies are so small that the results would have to be confirmed by larger studies. Nevertheless, the results published so far may be useful in individual cases. Affected people can try out whether the recommended changes in diet have an impact on their own course of the disease.
What relationships between disease activity and diet in ulcerative colitis have been recognized so far?
- High consumption of myristic acid (mainly found in coconut oil) increases the risk of ulcerative colitis.
- High consumption of milk fats can also promote inflammation.
- Red meat, high total fat consumption, and alcohol often negatively affect ulcerative colitis.
- Vegetables and fiber have a positive effect on the course of ulcerative colitis.
- A very small study showed that the Specific Carbohydrate Diet (SCD) is useful and effective in the treatment of ulcerative colitis. However, the SCD is complex: Heavily processed foods, sugar (except honey), dairy products, and cereals are not consumed. The SCD mainly contains vegetables, fruits, and nuts.
- The low-FODMAP diet is becoming increasingly common.
Does the low-FODMAP diet help with ulcerative colitis?
The low-FODMAP diet has been very successful with IBS. The diet can also be successful with ulcerative colitis. However, it is important to adjust the diet individually. A trained nutritionist can help, here.
How does coffee affect ulcerative colitis?
According to the studies to date, coffee consumption has neither a positive nor a negative impact on the course of the disease. Coffee should be consumed without sugar and whole milk, but at most semi-fat milk or a milk alternative. According to current studies, tea has a positive effect on the course of the disease.
Is a vegan diet beneficial for ulcerative colitis?
According to current knowledge, ulcerative colitis patients should follow a diet that is healthy, wholesome, and focuses on vegetables, vegetable fiber, and fruits. High total fat consumption may have a negative impact on the course of the disease. There have been no studies so far that show that vegan nutrition offers more benefits than a wholesome diet that includes animal products. Rather, it is important that an adequate supply of nutrients is guaranteed and that the selection of products is fresh, wholesome and does not contain a lot of processed products.
What should the diet look like in an acute episode?
With acute ulcerative colitis, the medication must first be adjusted. In very severe episodes, hospitalization with medical treatment and intravenous nutrition may be necessary. In this way, the intestine is immobilized and the build-up of nutrition slowly begins again after the inflammation has subsided.
With milder flare-ups, those affected should pay attention to which dishes they tolerate well. Many people prefer easily digestible foods. These include oatmeal porridge, light and clear vegetable soups without flatulence-causing ingredients such as cabbage. Easily digestible food is low in fat, not overly seasoned, and cooked. Those affected should carefully try out which dishes are good for them and which ones tend to exacerbate the symptoms.
Suskind, D. L., Cohen, S. A., Brittnacher, M. J., Wahbeh, G., Lee, D., Shaffer, M. L., ... & Giefer, M. (2018). Clinical and fecal microbial changes with diet therapy in active inflammatory bowel disease. Journal of clinical gastroenterology, 52(2), 155-163., online: https://journals.lww.com/jcge/Fulltext/2018/02000/ClinicalandFecalMicrobialChangesWithDiet.13.aspx, downloaded on 27/05/2018
Jowett, S. L., Seal, C. J., Pearce, M. S., Phillips, E., Gregory, W., Barton, J. R., & Welfare, M. R. (2004). Influence of dietary factors on the clinical course of ulcerative colitis: a prospective cohort study. Gut, 53(10), 1479-1484., online: http://gut.bmj.com/content/53/10/1479.short, downloaded on 27/05/2018
Ganji‐Arjenaki, M., & Rafieian‐Kopaei, M. (2018). Probiotics are a good choice in remission of inflammatory bowel diseases: a meta analysis and systematic review. Journal of cellular physiology, 233(3), 2091-2103., online: https://onlinelibrary.wiley.com/doi/abs/10.1002/jcp.25911, downloaded on 27/05/2018
Hou, J. K., Abraham, B., & El-Serag, H. (2011). Dietary intake and risk of developing inflammatory bowel disease: a systematic review of the literature. The American journal of gastroenterology, 106(4), 563., online: https://www.nature.com/articles/ajg201144, downloaded on 31/05/2018
Nie, J. Y., & Zhao, Q. (2017). Beverage consumption and risk of ulcerative colitis: Systematic review and meta-analysis of epidemiological studies. Medicine, 96(49), online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728934/, downloaded on 31/05/2018