6 Types of foods that could make your ulcerative colitis symptoms worse
Useful information for your next flare-up.
Tuning into how you feel after meals is an important part of managing ulcerative colitis. There’s no exhaustive list of foods to avoid with ulcerative colitis and also no definitive proof that foods cause chronic inflammatory bowel disease (IBD) like ulcerative colitis in the first place. But there are certain categories of foods you should be mindful of in case they aggravate symptoms—like bloating, diarrhea, or pain—during flare-ups.
That said, it’s best to avoid overly restrictive diets—which can be harmful, says Simon Hong, M.D., a gastroenterologist specializing in inflammatory bowel disorders and clinical assistant professor at NYU Grossman School of Medicine.
“One of the big issues with IBD is appropriate nutrition,” Dr. Hong tells SELF. “We don’t want people to start cutting out all these things and end up being malnourished.”
And it’s important to consider that diet is just one aspect of the condition. “For most patients with ulcerative colitis, when their inflammation is gone—which is achievable for many patients now with medicines—they generally can eat what they want unless it’s something that they’re intolerant to,” Russell Cohen, M.D., professor of medicine and director of the University of Chicago’s Inflammatory Bowel Disease Center, tells SELF.
So with those caveats in place, here are six types of foods that could make your ulcerative colitis symptoms worse:
1. Beans and high-fiber foods
Many people hail fiber as a magical nutrient that can lower your risk of developing heart disease, type 2 diabetes, and potentially offer some protection against Crohn’s disease—another type of IBD.
However, some people with ulcerative colitis may want to avoid a high-fiber diet, depending on their symptoms, suggests The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
People who have diarrhea may want to eat less insoluble fiber because it moves food through the intestine quickly—which only makes the problem worse. Consider reducing the amount of beans, cruciferous vegetables, nuts, and whole wheat flour in your diet to see if your symptoms improve.
Although high-fiber diets may affect some people with ulcerative colitis during a flare-up, experts generally recommend making sure to get enough fiber during remission. Some studies and reviews show that it may help prolong periods without inflammation—except for in people who have strictures, or a narrowing of the intestine. “In those patients, we do advise less fiber, because fibers can clump up and cause an obstruction or blockage,” says Dr. Hong.
FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.” These short-chain carbohydrates are difficult for our bodies to digest, can produce gas, and increase fluid to our colon—ultimately causing diarrhea and gastrointestinal distress in some people. They’re present in an abundance of foods, including onions, legumes, ice cream, apples, honey, and artificial sweeteners.
Experts commonly recommend a low-FODMAP plan to treat irritable bowel syndrome (IBS), a term that describes a collection of symptoms including abdominal pain, bloating, gas, and diarrhea or constipation. People with IBS do not always have inflammation in the digestive tract like people with IBD do. However, ulcerative colitis and IBS share some common symptoms, so your doctor may recommend trying a low-FODMAP diet if you have ulcerative colitis, says Dr. Hong.
Researchers are studying whether low-FODMAP diets can relieve ulcerative colitis symptoms, but so far studies have been small. A retrospective study in the journal Inflammatory Bowel Diseases found that a low-FODMAP diet reduced symptoms in 38 ulcerative colitis patients. More research studying larger numbers of people is necessary to determine whether FODMAPs are a critical factor in ulcerative colitis symptoms. However, anecdotally, some people with ulcerative colitis report that curbing their FODMAP intake seems to help their gut symptoms.
Initially, the low-FODMAP diet is very restrictive: The idea is to cut out all FODMAPs before slowly reintroducing some to determine which you can tolerate. It’s important to work with your health team when making any dietary change to avoid nutritional deficiencies.
3. Cheese, milk, and dairy products
“Dairy is a tricky one: Lactose intolerance can be perceived as a flare of ulcerative colitis,” says Dr. Hong. “One of the things we recommend is if you’re feeling unwell with things you’re eating, try cutting out the dairy. If that does help, then maybe get tested for lactose intolerance, which is an easy test to do and is warranted.”
Even if you don’t think you’re lactose intolerant, there’s another reason consuming dairy could make you feel sick. Lactose is a FODMAP, which might explain why it gives you G.I. symptoms. Everyone reacts to FODMAPs differently, so it’s worth getting tested for lactose intolerance and working through the process of elimination with your medical team.
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