- What is ulcerative colitis?
- What causes ulcerative colitis?
- How is colitis treated?
- What foods can trigger a colitis flare-up?
- What about a low FODMAP or other diets?
- How can I live with chronic ulcerative colitis?
Ulcerative colitis is a chronic type of inflammation in the bowel. Today, about 750,000 people in the U.S. are living with this disease. To improve this potentially debilitating condition, colitis sufferers must closely watch their food consumption to help maintain a healthier colon and avoid triggering a disease flare-up. This article will help you understand colitis and how to avoid symptoms by changing what you eat.
What Is Ulcerative Colitis?
Ulcerative colitis is a chronically inflamed colon. The colon is at the end of the digestive tract and connects to the rectum. The colon is hugely important for absorbing nutrition and eliminating waste in the body. When it becomes chronically inflamed, the cause may be ulcerative colitis.
Colitis is interrelated to another disease called Crohn’s. A person can have both Crohn’s and ulcerative colitis as part of an overarching diagnosis of irritable bowel disease (IBD). Colitis and Crohn’s are both long-term and chronic disorders affecting the gastrointestinal tract. Colitis, however, centers in the lining of the large bowel, or colon. Several diagnoses can be made to pinpoint the type of colitis you may have:
- Left-sided colitis is inflammation that starts in the rectum and extends to the left colon
- Pancolitis, also called universal colitis, affects the entire organ (rectum, left and right colon, and transverse colon)
- Fulminant colitis is a rare but serious form of pancolitis
- Proctosigmoiditis inflames the rectum and a short section of the nearby colon called the sigmoid colon
- Ulcerative proctitis is a type of inflammation that only affects the rectum
What Causes Ulcerative Colitis?
The sad reality is we don’t know what causes ulcerative colitis. What we do know is that the immune system triggers a response in the colon causing inflammation. Normally, the immune system defends us against harmful viruses and bacteria. In colitis, the immune system triggers and attacks the colon, but no known invader is destroyed. So the body’s defense system causes inflammation.
There is a genetic predisposition to developing ulcerative colitis. If you have a parent with the disease, you are more likely to inherit it. Scientists have identified several genes and chromosomes that seem to be related to developing colitis, but more research needs to be done.
How Is Colitis Treated?
Medications and surgeries have both helped colitis patients. However, no medication can cure the disease. Colitis typically undergoes several changes during the illness where the patient may experience remission of symptoms where they feel better or flare-ups that cause them to relapse. One of the best ways to manage these ups and downs is to closely monitor the diet to control disease symptoms.
What Foods Can Trigger a Colitis Flare Up?
Food doesn’t cause colitis, but it can cause disease symptoms to flare up. While there are medications that can help with symptoms, it’s important to develop a diet that is right for you to keep your flare-ups to a minimum.
Unfortunately, there is no single diet that we can recommend. Every person is different and over time the disease can change so that the diet stops working even if it was previously keeping you on track. So, where can you start to even figure out what foods trigger a colitis flare-up?
We recommend that patients living with this uncomfortable disease start with a food diary as part of their treatment plan. Staying away from processed foods while preparing whole grains, fresh fruit and vegetables, and lean proteins is a good idea. You may simply need to tweak what you’re eating. For example, instead of eating a raw salad, try steamed vegetables. Ease up on spicy foods. Instead of high-fat dairy products, consider a milk substitute such as almond milk. If fiber is causing an increase in symptoms, try lessening your fiber intake to 10 to 15 grams a day. That could potentially help you visit the restroom a little less.
While these are good suggestions, unless you’re tracking your specific food intake against how you’re feeling, it can be hard to know exactly what will work. We’ve seen the following foods consistently cause flare-ups in many patients:
- Carbonated beverages
- Dried beans, legumes, and peas
- Dried foods, such as dried fruit
- High fiber foods
- Processed foods with sulfates
- Processed sugars
- Raw vegetables and fruits
- Seeds and nuts
- Sorbitol products, like sugar-free gum
- Spicy foods
Some research shows that certain types of nutrients can help fight the gut inflammation that is the source of your pain and suffering. For example, the linoleic acid in olive and coconut oil, egg yolks, and walnuts could help. Other studies show that eicosapentaenoic acid (EPA), which is a “good fat” to fight inflammation, can have positive effects. You’ll find EPA in fish oil. There’s even evidence that the probiotics in yogurt are beneficial.
What About a Low FODMAP or Other Diets?
FODMAP stands for fermentable oligosaccharides, di-saccharides, mono-saccharides, and polyols. They are the carbohydrates found in foods and they draw water into the colon, which can make you feel bloated and uncomfortable. FODMAPs also don’t pass through your gut quickly but can ferment and hang around for a time, which can cause colitis symptoms.
- Any foods with lactose, or dairy ingredients
- Foods with fructose, including natural fruits, honey, or processed high-fructose corn syrup
- Fructans like garlic, onions, or wheat
- Galactans, which are beans, lentils, or soybeans
- Polyols such as fruits with seeds like apples, avocados, cherries, figs, and peaches
There are other types of diets such as a specific carbohydrate diet that cuts starchy potatoes and grains. Some people have found relief on a Mediterranean diet that includes vegetables, whole grains, fruits, fish, and poultry. A gluten-free diet could also lessen your symptoms.
How Can I Live With Chronic Ulcerative Colitis?
If you are struggling with colitis or another type of irritable bowel disease, help is available at Gastroenterology Associates of Southwest Florida, PA. Our team provides compassionate, expert care to help patients suffering from these types of chronic conditions. Find out how we can help you live with chronic ulcerative colitis by scheduling your appointment.