Diet and Nutrition

Since ulcerative colitis can lead to reduced appetite, weight loss, and poor absorption of vitamins and minerals, maintaining a healthy diet and good nutrition are vital aspects of managing the disease. Depending on the severity of your condition, you may need to restrict certain aspects of your diet. Talk to your gastroenterologist or nutritionist about customizing a diet to your specific nutritional needs.

Good nutrition
Just like everyone else, people with ulcerative colitis need enough protein, calories, vitamins (A, D, C, B-12, and folic acid), minerals (calcium, iron, potassium, and magnesium), and other nutrients to stay healthy. However, in particular, people with ulcerative colitis may have increased nutritional requirements to make up for the calories and nutrients they lose.

To ensure that your nutrient intake is sufficient, it’s best to eat a balance of foods from the four food groups:

• Meat (or alternative sources of protein)
• Dairy
• Cereal and grains
• Fruits and vegetables

Your gastroenterologist or nutritionist may also recommend adding a multivitamin or other dietary supplement, such as calcium to protect against nutritional deficiencies, iron to counter the affects of anemia, and to round out your diet. It is important to note that because supplements contain no calories, they should not take the place of food. Also be sure to consult with your gastroenterologist before you begin taking any supplements.

Tips to make mealtime easier

You should take steps to avoid foods you are allergic to, such as eggs or nuts. Allergic reactions often cause inflammation, which could worsen your symptoms.

Here are a few other mealtime suggestions:

• Instead of eating large meals, eat small meals throughout the day (every three to four hours).
• Don't restrict your eating for fear of pain or diarrhea — this may cause bloating and pain when you finally do eat.
• Eat when you're hungry, not when you're “supposed to,” although you might try just a bite or two at meal times.
• Take small bites, chew your food thoroughly, and relax when you eat. (Don’t eat on the run.)
• Drink fluids with your meals.
• Don't add more than one new food at a time to your diet.

Stay hydrated

In addition to eating enough, you also need to drink enough fluids to keep your body well hydrated. The diarrhea and intestinal inflammation associated with ulcerative colitis can cause fluid loss, and when you are not feeling well, you may eat and drink less, limiting the amount of fluid you take in. To make sure you take in adequate fluids, try drinking small amounts several times a day, ideally whenever you eat. A good goal to strive for is drinking half an ounce of liquid (preferably water) for every pound of your body weight.

Foods you might need to avoid

Some people with ulcerative colitis find that eating certain foods makes their symptoms worse. With the help of your gastroenterologist or nutritionist, you can determine what foods you can eat comfortably and find a healthy diet you will enjoy.

• Milk and milk products can lead to bloating, gas, and diarrhea, especially in people who are lactose intolerant. If you are lactose intolerant, minimize the amount of dairy products in your diet, eat dairy foods that have lower levels of lactose (such as yogurt and hard cheeses), or try taking a lactose enzyme capsule (like Lactaid^®*) when you eat dairy.
• Fatty foods such as butter, margarine, gravies, vegetable oil, processed snacks (like cookies and crackers), meats, fast food, some dairy products, and fried or battered food may trigger abdominal symptoms. If you develop gas and diarrhea after you eat fatty or greasy foods, you may be suffering from malabsorption, a condition in which fat is not easily absorbed and passes quickly through the intestine. Avoiding fatty foods and using easily absorbed fat can help.
• High-fiber foods can also cause abdominal discomfort. They increase diarrhea because they are not fully digested, and when these foods enter the intestine, they trigger contractions. Limiting fiber during a flare-up can keep symptoms in check. However, there is no concrete evidence that a long-term, low-fiber diet can permanently decrease the symptoms of ulcerative colitis.
• Alcohol and caffeine stimulate the intestines and can intensify diarrhea. Try to avoid them when your symptoms act up.

Maintaining a healthy diet with ulcerative colitis can be quite manageable with a little preparation. Find out how preparing ahead of time can also make things easier while traveling.

*Lactaid is a registered trademark of McNeil Consumer & Specialty Pharmaceuticals.

Some information adapted from the Crohn’s & Colitis Foundation of America website. For more information and resources on ulcerative colitis, or to find a local chapter in your area, please visit the Crohn's & Colitis Foundation of America website.