Sometimes you may feel helpless when facing ulcerative colitis. But changes in your diet and lifestyle may help control your symptoms and lengthen the time between flare-ups.
There's no firm evidence that what you eat actually causes inflammatory bowel disease. But certain foods and beverages can aggravate your signs and symptoms, especially during a flare-up.
It can be helpful to keep a food diary to keep track of what you're eating, as well as how you feel. If you discover some foods are causing your symptoms to flare, you can try eliminating them. Here are some suggestions that may help:
Foods to limit or avoid
- Limit dairy products. Many people with inflammatory bowel disease find that problems such as diarrhea, abdominal pain and gas improve by limiting or eliminating dairy products. You may be lactose intolerant — that is, your body can't digest the milk sugar (lactose) in dairy foods. Using an enzyme product such as Lactaid may help as well.
- Try low-fat foods. If you have Crohn's disease of the small intestine, you may not be able to digest or absorb fat normally. Instead, fat passes through your intestine, making your diarrhea worse. Try avoiding butter, margarine, cream sauces and fried foods.
- Limit fiber, if it's a problem food. If you have inflammatory bowel disease, high-fiber foods, such as fresh fruits and vegetables and whole grains, may make your symptoms worse. If raw fruits and vegetables bother you, try steaming, baking or stewing them. In general, you may have more problems with foods in the cabbage family, such as broccoli and cauliflower, and nuts, seeds, corn and popcorn. You may be told to limit fiber or go on a low-residue diet if you have a narrowing of your bowel (stricture).
- Avoid other problem foods. Spicy foods, alcohol and caffeine may make your signs and symptoms worse.
Other dietary measures
- Eat small meals. You may find you feel better eating five or six small meals a day rather than two or three larger ones.
- Drink plenty of liquids. Try to drink plenty of fluids daily. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, while carbonated drinks frequently produce gas.
- Consider multivitamins. Because Crohn's disease can interfere with your ability to absorb nutrients and because your diet may be limited, multivitamin and mineral supplements are often helpful. Check with your doctor before taking any vitamins or supplements.
- Talk to a dietitian. If you begin to lose weight or your diet has become very limited, talk to a registered dietitian.
Although stress doesn't cause inflammatory bowel disease, it can make your signs and symptoms worse and may trigger flare-ups.
To help control stress, try:
Sept. 09, 2014
- Exercise. Even mild exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about an exercise plan that's right for you.
- Biofeedback. This stress-reduction technique helps you reduce muscle tension and slow your heart rate with the help of a feedback machine. The goal is to help you enter a relaxed state so that you can cope more easily with stress.
- Regular relaxation and breathing exercises. An effective way to cope with stress is to perform relaxation and breathing exercises. You can take classes in yoga and meditation or practice at home using books, CDs or DVDs.
- Ulcerative colitis. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/colitis/. Accessed June 16, 2014.
- Ulcerative colitis. The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/print/sec02/ch018/ch018c.html. Accessed June 16, 2014.
- What is ulcerative colitis? Crohn's and Colitis Foundation of America. http://www.ccfa.org/what-are-crohns-and-colitis/what-is-ulcerative-colitis/. Accessed June 16, 2014.
- Barrett KE, et al. Pharmacological aspects of therapy in inflammatory bowel diseases: Antidiarrheal agents. Journal of Clinical Gastroenterology. 1988;10:57.
- Dignass A, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1: Definitions and diagnosis. Journal of Crohn's and Colitis. 2012;6:965.
- Peppercorn MA, et al. Clinical manifestations, diagnosis, and prognosis of ulcerative colitis in adults. http://www.uptodate.com/home. Accessed June 16, 2014.
- Sandborn WJ, et al. Colectomy rate comparison after treatment of ulcerative colitis with placebo or infliximab. Gastroenterology. 2009;137:1250.
- Kornbluth A, et al. Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. American Journal of Gastroenterology. 2010;105:501.
- Dignass A, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: Current management. Journal of Crohn's and Colitis. 2012;6:991.
- Carter MJ, et al. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2004;53:v1.
- Cohen RD, et al. Approach to adults with steroid-refractory and steroid-dependent ulcerative colitis. http://www.uptodate.com/home. Accessed July 7, 2014.
- Inflammatory bowel disease. U.S. Centers for Disease Control and Prevention. http://www.cdc.gov/ibd/. Accessed June 9, 2014.
- Golden AK. Decision Support System. Mayo Clinic, Rochester, Minn. June 16, 2014.
- Colorectal cancer screening guidelines. U.S. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/colorectal/basic_info/screening/guidelines.htm. Accessed July 12, 2011.
- Living with Crohn's and Colitis. Crohn's and Colitis Foundation of America. http://www.ccfa.org/living-with-crohns-colitis/. Accessed June 2, 2014.
- What is complementary and alternative medicine (CAM)? International Foundation for Functional Gastrointestinal Disorders. http://www.iffgd.org/store/viewproduct/700. Accessed June 25, 2014.
- Sartor RB. Probiotics for gastrointestinal diseases. http://www.uptodate.com/home. Accessed June 10, 2014.
- Rakel D. Integrative Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed June 4, 2014.
- U.S. News best hospitals 2013-2014. U.S. News & World Report. http://health.usnews.com/best-hospitals/rankings/gastroenterology-and-gi-surgery. Accessed July 5, 2014.
- Etminan M, et al. Isotretinoin and risk for inflammatory bowel disease: A nested case-control study and meta-analysis of published and unpublished data. JAMA Dermatology. 2013;149:216.
- Leong RW, et al. Implementation of image enhanced endoscopy into solo and group practices for dysplasia detection in Crohn's disease and ulcerative colitis. Gastrointestinal Endoscopy Clinics of North America. 2014;24:419.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. July 12, 2014.
- Bruining DH, et al. Technology insight: New techniques for imaging the gut in patients with IBD. Nature Clinical Practice Gastroenterology & Hepatology. 2008;5:154.