Ulcerative colitis is an inflammatory disease of the colon, or large intestine which is often accompanied by bloody diarrhoea, and falls under the umbrella of Inflammatory Bowel Disease, or IBD for short. Extensive inflammation may eventually require surgery for removal of the affected area, hindering the absorption of nutrients, and therefore supplements may be required. Certain medications given to treat UC can also interfere with the nutrient absorption from foods, thus again requiring the use of supplements. However, making changes to the diet can have marked improvements on the severity of the condition, quality of life & a reduction in medication.
- Recurring diarrhoea, which may contain blood, mucus or pus
- Abdominal pain
- Frequent bowel movements
- Loss of appetite
- Weight loss
Benefits of Good Nutrition:
- Improved symptoms
- Increased effectiveness of medications
- Proper absorption of proteins, calories, water and other nutrients
- Lower risk of iron and calcium deficiencies
- Bone health
- Normal growth patterns (children and teens)
- A healthy body weight
- Regular hormone levels and menstrual cycles (women and girls)
- Good hydration
Poor Nutrition May Lead to:
- Flare ups
- Decreased effectiveness of medications
- Poor absorption of proteins, calories, water and other nutrients
- Iron and calcium deficiencies
- Bone loss
- Possible growth retardation (children and teens)
- Weight loss
- Fatigue and/or low energy
- Irregular hormone levels and menstrual cycles (women and girls)
- Risk of malnourishment
Diet for Flare ups:
- Plain cereals
- White rice
- White breads
- Refined pasta
- Fruits – deep coloured fruits have the most nutrients (no skin)
- Fruit juices (except prune)
- Apple sauce
- Vegetables – deep coloured vegetables have the most nutrients
- Potatoes (no skin)
- At least 25% of food should be protein – meat, fish, eggs, poultry and soy
- Dairy, as tolerated or alternate sources
- Increase omega-3 fatty acids – extra virgin olive oil, salmon, mackerel, herring and sardines
- Eat smaller, more frequent meals
- Drink 8-10 glasses of water per day
- Consider taking nutritional supplements – Folic acid, magnesium, calcium, iron, potassium, selenium, zinc, vitamins B12 and D, omega 3, aloe, probiotics
- If you have oily and foul-smelling stools, you may want to follow a low-fat diet
- Begin with well-tolerated liquids and advance to soft solids, then solids
- Introduce one or two items every few days and avoid any foods that cause symptoms
- Raw fruit or vegetables with skin or seeds
- Aubergine, cabbage, string beans, celery, cucumber, garlic, and onion
- Beans, nuts, and seeds
- Prunes and dried apricot
- Whole grains
- Spicy foods
- Fizzy drinks
- Artificial sweeteners
- Overly processed packet foods
Calories only need to be slightly increased
unless weight gain is desired
Possible Nutrient Deficiencies:
- Folate/Folic Acid — increased risk with sulfasalazine use; extensive inflammation in the jejunum (middle portion of the small intestine) or removal of the jejunum.
- Magnesium — increased risk with extensive inflammation and/or removal of large portions of the jejunum and ileum, fistula losses and chronic diarrhoea.
- Calcium — increased risk with avoidance of dairy foods for lactose intolerance, fat malabsorption, prednisone use, extensive inflammation or surgery throughout the entire small intestine.
- Iron — Increased risk with blood loss
- Potassium — Increased risk with chronic vomiting, diarrhoea, and prednisone use
- Vitamin D – Increased risk due to lack of Calcium (see above)
- Vitamin B12 — increased risk with extensive inflammation in the ileum (lower small intestine) or removal of the ileum, and blood loss
- Vitamins E and K — increased risk with fat malabsorption; inflammation of large portions of the jejunum and/or ileum or removal of portions of the jejunum and ileum.
- Vitamin A — increased risk with fat malabsorption; disease involvement of the duodenum (upper small intestine) and/or upper jejunum.
- Zinc — increased risk with extensive inflammation and/or removal of the jejunum, diarrhoea, fistula losses, prednisone use or measured low blood levels of zinc.
- Elimination Diet – keep a food or symptoms diary over several weeks, compiling a list of ‘safe’ foods to eat.
- Low Fibre with Low Residue Diet – Often used in sufferers with strictures or during flare ups; minimizes the intake of foods that add bulk residue to stool (raw fruits, vegetables, seeds, nuts).
- The Specific Carbohydrate Diet™ – Reducing poorly digestible carbohydrates to lessen symptoms of gas, cramps and diarrhoea. Consists mainly of meats, vegetables, oils, and honey.
- The Maker’s Diet – Focuses on four components of total health; physical, mental, spiritual, and emotional.
- Total Bowel Rest Period – Complete bowel rest (during which patients are nourished with fluids delivered intravenously) may decrease inflammation, but not shown to be particularly effective during studies.
- Elemental Diet – Limits carbohydrate intake to reduce microbes that might contribute to symptoms.
Amy Griffiths, Well Being Freedom Services Ltd ©