While it’s not always possible to prevent ulcerative colitis (UC) symptoms, there are some strategies that may help.
One of those is figuring out which foods might be likely to prompt UC symptoms like abdominal cramps, frequent diarrhea, and fatigue.
There’s no single diet that works for everyone with UC. Although there are some foods that might be problematic for many people with UC — such as certain high-fiber foods like raw fruits and vegetables — others with the condition may eat them with no difficulties.
That’s why tracking foods is so important, says Rudolph Bedford, MD, a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California.
“To manage UC, it’s important to reduce symptoms as much as possible, because symptoms are an indication that inflammation levels are higher in the body, which can lead to damage within the colon,” he says. “Part of that management is discovering which foods seem to trigger UC issues. A food diary can be a valuable part of that process.”
What Is a Food Diary, and Why Could It Help if You Have Ulcerative Colitis?
A food diary is a daily record of everything you eat and drink, including all meals, snacks, and beverages, says Adiana Castro, RDN, a registered dietitian specializing in gut health and owner of Compass Nutrition in New York City. The diary should also include other information that may play a role in UC symptoms.
“Ideally, it’s best to track food, amounts, times of eating, stress, and symptoms,” she says. “The goal is to be as detailed as possible, because all that data can allow you to make mindful food choices that work well in terms of managing your condition and supporting your health.”
In addition to identifying triggers, a food diary can help spot patterns related to your UC, says Dr. Bedford. For example, you might realize that you’ve been nauseated for over a week, or that you get abdominal cramps after taking your medication on an empty stomach but not if you take it with food.
Seeing trends like these can help you and your healthcare provider make more informed choices about lifestyle changes and medications, he says.
As you get in the habit of writing down what you eat and drink, along with any physical symptoms like bowel issues, joint pain, or fatigue, it can lead to paying closer attention to your body on a day-to-day basis, says Castro.
“Think of this as a way to become more mindful,” she says. “That will benefit your body, and your UC management, in the long run.”
What Should You Eat When You Have Ulcerative Colitis?
Ira Breite, MD, a gastroenterologist at Mount Sinai Health System, discusses foods to avoid during an ulcerative colitis flare.
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How to Keep a Food Diary for Ulcerative Colitis
As the name implies, a food diary will track every single thing you eat and drink. But it’s most helpful if those meals, snacks, and beverages are put into context, connecting those food and beverage options to any subsequent symptoms or effects.
Consider these strategies to make the diary more helpful.
1. Choose a Format You’ll Actually Use
“The biggest challenges with a food diary tend to be forgetfulness, time, and consistency,” says Castro. Picking a tracking method that’s overly complicated for you could backfire, since it might become overwhelming and time-consuming, she says.
Instead, try a few options to see what sticks. It could be logging foods in an app, taking notes on your phone, creating a photo food journal, or writing in a paper-based notebook or calendar.
The goal is to make it easy, convenient, and fast, Castro says. That way, you’ll be more likely to use it every day.
2. Jot Down Symptoms Each Day
Even if UC symptoms are on the mild side, like minor discomfort, it’s useful to take note of them and when they happen, says Bedford. “In doing this, you might notice a trend, like having symptoms after a certain food within a few hours or the next day,” he says.
In terms of what to record, helpful information could include:
Which foods are consumed, how they’re prepared, and in what amounts (for example, a cup of cooked carrots or 3 ounces of baked salmon)
What time you ate or drank
Gastrointestinal symptoms, like abdominal pain, nausea, bloating, gas, or heartburn
Changes in bowel movements, like frequency, urgency, volume, and consistency
When doing this, be aware that it’s important not to anticipate that you’ll have symptoms, since that might make even minor issues feel worse, says Castro. You’re simply observing what you’re eating and how you’re feeling. “This should be a source of information, not anxiety,” she says.
3. Record Non-Gastrointestinal Issues, Too
In addition to noting how certain foods might affect your digestive processes, it’s helpful to be aware of other potential difficulties as well, says Bedford.
Some of these may include loss of appetite and fatigue or tiredness, especially within a few hours of eating.
Keeping track of symptoms like these can be useful for identifying trends and patterns that may be related to your UC management, Bedford says.
For instance, if these issues are worsening over time, it might not be your trigger foods. Instead, it could be an indication your treatment needs to be modified or there’s another health issue at play.
If you’re noticing these symptoms, be sure to let your doctor know, especially if they’re persistent.
The Takeaway
Healthcare providers often suggest a food diary for people with ulcerative colitis (UC) as a way to identify foods that lead to symptoms.
In addition to noting factors like which foods are eaten and how they’re prepared, a diary should also include symptoms that come up each day, if any.
Bring the food diary to appointments with your healthcare team, since it can offer useful information about possible issues with your UC management.
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Ira Daniel Breite, MD, is a board-certified internist and gastroenterologist. He is an associate professor at the Icahn School of Medicine at Mount Sinai, where he also sees patients and helps run an ambulatory surgery center.
Dr. Breite divides his time between technical procedures, reading about new topics, and helping patients with some of their most intimate problems. He finds the deepest fulfillment in the long-term relationships he develops and is thrilled when a patient with irritable bowel syndrome or inflammatory bowel disease improves on the regimen he worked with them to create.
Breite went to Albert Einstein College of Medicine for medical school, followed by a residency at NYU and Bellevue Hospital and a gastroenterology fellowship at Memorial Sloan Kettering Cancer Center. Working in city hospitals helped him become resourceful and taught him how to interact with people from different backgrounds.
Elizabeth Millard is a freelance writer based in northern Minnesota. She focuses on health, wellness, and fitness, and has written for Runner's World, Bicycling, Self, Women's Health, Men's Health, Prevention, Experience Life, and more. She is an American Council on Exercise–certified personal trainer and a Yoga Alliance-registered yoga teacher. She graduated from Harvard University with a bachelor's degree in English.
