When you have inflammatory bowel disease (IBD), your diet can play a role in your management plan. And the foods you eat—or avoid—may change depending on whether you’re in remission or in a flare. You should be working with your care team to determine whether or not you are in a flare of your IBD.
An exact diet for IBD flares doesn’t exist, and what’s well tolerated during a flare can vary from person to person. However, there are a few guidelines to keep in mind when planning a flare-friendly diet.
“When you’re in a flare, you want to avoid irritating your gut lining,” explains Laura Manning, MPH, RD, CDN, Clinical Nutrition Coordinator at the Susan and Leonard Feinstein IBD Clinical Center at Mount Sinai Medical Center in New York City.
Ready to plan out a flare-friendly diet for IBD? Here are a few tips.
Avoid trigger foods
For starters, you’ll want to swap foods that are likely to trigger your symptoms with foods that are easier on your digestive system.
“It’s important to avoid rough textures—like popcorn, corn, nuts, and seeds, as well as any raw vegetables or fruits that have a thick skin,” explains Manning. These foods are high in insoluble fiber, making them harder to digest.
Other foods to consider minimizing during a flare include those with lactose, like milk and cheese, those containing artificial sweeteners, like candy or ice cream, high-fat foods, like butter or fried foods, spicy foods, alcohol, and caffeine. Remember that these are general guidelines and your individual condition may differ and so dietary changes should be discussed with your care team.
Eat a gentle diet
Instead, you’ll want to focus on a diet full of easy-to-digest, well-tolerated foods, such as:
- Refined grains, like white bread, pasta, and rice
- Low-fiber fruits, like bananas, cantaloupe, and melon
- Cooked, skinless, non-cruciferous vegetables, like squash, potatoes, and green beans
- Protein, like fish, white meat chicken, eggs, and tofu
“If you have foods that are more bland, you’re less likely to exacerbate your symptoms,” explains Manning.
It is important to note that these recommendations are only for when you are in a flare and that your regular, healthy diet should be resumed once you are feeling better and back in remission.
Think before you cook
It’s also important to consider how you flavor and prepare your food during a flare. Consider fresh or dried herbs and spices in lieu of higher fat condiments or spicy items. “If you stick to baked, broiled, and grilled types of cooking methods, that’s also going to be easier to digest. And avoid dishes that have heavy sauces on them,” explains Manning.
Change how you eat
Eating smaller, more frequent meals is often recommended for people who have IBD. “It can be very individual, but generally speaking, when there is less for your body to process, there may be better tolerance toward the food,” says Manning, who recommends eating six times each day:
- Breakfast
- Snack
- Lunch
- Snack
- Dinner
- Snack
Drink water
When you’re experiencing an IBD flare, you’re at risk of becoming dehydrated, so it’s important to drink lots of water. Aim to get at least eight 8-ounce glasses of water each day. You know you’re well-hydrated by checking the color of your urine—it should be light yellow. If it’s very dark or bright yellow, that may be a sign you need to drink more water.
Consider caloric intake
Some people with IBD have increased caloric requirements. During a flare, symptoms like nausea can reduce your appetite, and when you’re dealing with diarrhea, you may shy away from eating in order to make it stop. However, avoiding food altogether increases your risk of malnutrition—and if your body isn’t getting the nutrients it needs to function, it can be harder to heal. Talk to your doctor about your ideal caloric intake, both during remission and in a flare. If necessary, your doctor or dietitian can help you find a nutrition supplement that can help you to meet your needs if you are struggling to eat enough.
Work with a registered dietitian
“Any person that has IBD should seek nutrition counseling at the beginning of their diagnosis,” says Manning. “You need to have the tools in place and tips to manage whatever comes your way in the beginning, instead of waiting for a flare to occur.” A registered dietitian can help to make sure you are getting the right amount of calories and help you put together a nutrition plan unique to your needs.
Medically reviewed by Matthew Hamilton, MD
Ulcerative colitis (UC) is a type of inflammatory bowel disease that can cause abdominal pain and cramping, diarrhea, and a reduced appetite. A person can manage it by eating or avoiding certain foods that can help reduce the risk of flare-ups and inflammation.
There is no single diet for people with ulcerative colitis, but identifying and eliminating the foods that trigger symptoms can help reduce discomfort.
Doctors do not know the exact cause of this disease, but they believe it has links to environmental factors, Westernized diets and lifestyles, and genetics. Managing the diet may help a person manage ulcerative colitis.
This article explores which foods may trigger ulcerative colitis. It also looks at which foods might benefit people with this form of inflammatory bowel disease (IBD).
A person’s diet may contain various potential triggers, so it can be difficult for someone with ulcerative colitis to know what is safe to eat.
Some nutrients, such as fiber, may be hard for someone to digest during a flare-up. They may be able to eat these foods outside of a flare-up but find they cause discomfort when symptoms occur.
Because they may not be able to consume various foods, people with ulcerative colitis are at a higher risk of nutrient deficiencies. Other factors, such as problems with nutrient absorption, may also contribute to this.
To ensure they get enough nutrients, someone with ulcerative colitis must eat foods high in vitamins and minerals, including iron, calcium, and vitamin A.
Some of the more suitable food choices for someone with ulcerative colitis may include:
- Omega-3-rich foods: Foods, such as salmon, mackerel, walnuts, flaxseed, hemp, and chia seeds, provide plenty of omega-3 fatty acids, which may have health benefits for people with ulcerative colitis. The International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) recommends a higher intake of these foods for those with the condition.
- Some probiotic foods: These include yogurts, which contain active probiotics. The “good” bacteria in these can aid digestion. Some studies have shown using probiotics regularly can help reduce ulcerative colitis flare-ups and symptoms.
- Low fiber fruits: Fruits, such as bananas, cantaloupes, and cooked fruits, may be suitable for people with ulcerative colitis.
- Refined grains: These may be easier to digest than whole grains. They include potato, white pasta, gluten-free bread, white rice, and oatmeal. Manufacturers enrich many white bread and grain products with extra minerals and vitamins.
- Lean protein: Sources of protein that exclude red meat may be suitable for someone with ulcerative colitis. These include fish, chicken, eggs, and firm tofu.
- Cooked vegetables: People with ulcerative colitis may tolerate noncruciferous cooked vegetables without the skin. These include cucumbers, squash, and asparagus tips.
- Plenty of fluids: People with conditions, such as ulcerative colitis, may need to drink extra fluids, as diarrhea can lead to dehydration.
- Dietary supplements: Oral vitamin supplements and protein shakes may help people with ulcerative colitis get enough nutrients. However, a person should consult a doctor before they start taking supplements.
Diet can affect ulcerative colitis flare-ups. However, this will vary from person to person, as not all people respond the same way to a particular food.
Some foods may act as potential triggers for ulcerative colitis. These include:
- Lactose products: Lactose is a sugar within dairy products such as milk, cheese, and yogurt. While lactose is not problematic for all people with ulcerative colitis, these products can trigger symptoms in some individuals.
- Red meat and processed meats: The IOIBD recommends people with ulcerative colitis limit their intake of these foods to avoid worsening symptoms.
- Alcohol: Alcoholic drinks, such as wine, beer, and liquor, may trigger ulcerative colitis symptoms in some people.
- Carbonated drinks: Some sodas and beers contain carbonation that can irritate the digestive tract and cause gas. A 2022 study also linked drinking carbonated soft drinks to a higher risk of developing ulcerative colitis in the Arabic population.
- Nonabsorbable sugars: Consuming artificial sweeteners, such as sorbitol and mannitol, could trigger symptoms. The sugars in some fruits, such as prunes, pears, and peaches, may also be difficult for the body to absorb and could worsen symptoms.
- Insoluble fiber foods: These include raw green vegetables such as broccoli, whole nuts, whole grains, and fruits with the skin. They may increase the number of bowel movements, the amount of gas, and abdominal cramping.
- Sugary foods: Cakes, pastries, candy, and juices could trigger an ulcerative colitis flare-up.
- High fat foods: A person with ulcerative colitis should avoid high fat foods, such as butter, fatty meats, and coconut, and fatty, fried, or greasy foods.
- Spicy foods: These include hot sauces, chilies, and hot peppers. Spicy foods may trigger or worsen a flare-up.
- Gluten: This is a protein present in wheat, rye, and barley. It can sometimes trigger symptoms in those with ulcerative colitis. A 2020 review article from New Zealand found that, in one 2014 study, a gluten-free diet significantly benefitted 66% of participants with IBD by reducing symptoms and flare-ups.
- Dietary emulsifiers: According to the IOIBD, people with ulcerative colitis should limit their intake of emulsifiers such as carboxymethylcellulose and polysorbate-80. Manufacturers add these to many processed foods.
Keeping a food journal is a suitable way for someone with ulcerative colitis to identify potential dietary triggers.
A daily food journal allows a person with the condition to make informed decisions about their diet. They should organize it so that it is easy to read and share with a doctor. Some useful information to include would be:
- the date
- which foods a person ate, including a list of extras, such as sauces
- the time of day at which a person ate the food
- any immediate reactions
- any flare-ups or worsening symptoms
Food journals are particularly helpful when people are looking to add additional types of food to their diets.
By adding one food at a time and recording it, a person can determine whether the food is a safe choice by assessing their symptoms.
Diet plans for people with ulcerative colitis will vary. The best tend to start with a food journal, which shapes the food choices and ideas in the plan.
Diet plans should include the following:
- Foods to eat: This will consist of foods a person knows will not aggravate their symptoms.
- Foods to avoid: A diet plan should also list the specific foods that are known triggers.
- Balanced nutrition: One of the most significant complications for people with ulcerative colitis is inadequate nutrition due to certain food tolerances. To avoid losing out on nutritional benefits, a person should look for ways to modify foods rather than avoid them. For example, peeling or cooking a fruit or vegetable might make it more tolerable.
- Supplements: Some otherwise nutritious foods that are high in nutrients may not be digestible for some people. A person may need to compensate for this shortfall in nutrition. In these cases, an individual can take supplements to replace nutrients they cannot get in their food. They can speak with a registered dietitian or doctor about which supplements may be best, as people’s needs will vary.
- Meal plans: These should consider a person’s schedule and include snacks. The better the planning of a meal, the more likely someone will stick to eating foods that do not aggravate their symptoms.
- Medical approval: It is a suitable idea to seek approval from a doctor or registered dietitian. These professionals can offer advice and suggest alternative food choices that an individual might not have considered.
People should continue logging their foods and symptoms, even after establishing a diet plan. Ulcerative colitis symptoms can change over time, so it is essential to track and record any diet-related changes.
Occasionally reviewing the diet plan will help account for any changes. It is also vital to inform a doctor if flare-ups worsen or occur more often.
Some premade diets and plans are available, such as the low FODMAP diet. However, these dietary programs may not be suitable for everyone with ulcerative colitis. Anyone looking to switch diets or follow a premade plan should talk with a doctor or dietitian first.
Some recent research has investigated new developments in how certain diets affect IBD and ulcerative colitis.
In a 2021 review of studies, researchers found that the Mediterranean diet may benefit people with IBD. However, the authors stated that more research is necessary to investigate this link.
Researchers also noted that plant-based and reduced-calorie diets might benefit those with IBD. However, they pointed out that reduced-calorie diets are not appropriate options for those at risk of nutritional deficiency.
The review also found that the low FODMAP diet did not appear to reduce IBD but may reduce certain gastrointestinal symptoms.
Additionally, a gluten-free diet did not seem to have a notable effect on IBD symptoms. However, one 2014 study in the review found that 66% of people reported an improvement in at least one IBD symptom following a gluten-free diet. Additionally, 38% of participants also reported having fewer or less severe flare-ups while on the diet.
However, the research into ulcerative colitis and diet is limited. Scientists need to do more research to provide well-informed dietary guidelines for those living with the condition.
There is no single diet plan that will work for all people with ulcerative colitis. However, identifying and eliminating any foods that may worsen an individual’s symptoms can help reduce discomfort.
Foods that a person with the condition may want to avoid may include lactose products, alcohol, gluten, spicy foods, and foods high in sugar and fats.
Some foods that may benefit individuals with ulcerative colitis include salmon, mackerel, chia seeds, walnuts, and other foods high in omega-3 oils.
Creating a food journal may help a person identify and limit problematic foods. A doctor or dietitian can also assist in finding a diet plan that works for someone.
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