If you have ulcerative colitis (UC), food can have an unpredictable effect on your digestive system. Tomatoes or onions, for example, may irritate one person’s stomach, but not trigger the same symptoms in someone else.
Still, even though there is no specific UC diet, there are some foods, generally speaking, that can worsen a flare and should be avoided.
“Eating insoluble fiber like nuts, seeds, peels of fruits, and raw veggies only further irritates an ulcerated, inflamed colon [during a flare],” says Stacy Asimes, a registered dietitian for the Disease and Surgery Institute at Cleveland Clinic.
If you have UC, you may feel helpless against flare-ups, wondering if you’ll ever be able to enjoy normal food again. But, dietary and lifestyle modifications may help control your symptoms and extend the time between flares. Here are seven food swaps to help minimize symptoms and keep you in remission.
Add Flavor to Your Dishes With Cooked (Not Raw) Onions and Garlic
Raw onions and garlic are rich in fiber, which makes them difficult to digest and can contribute to gas. Cooking them can help break down the fiber, or you can add flavor to your food with onion- and garlic-infused oils or garlic powder instead, says Asimes.
To add more taste to your meals, experiment with other herbs, such as basil, parsley, oregano, and thyme. You may want to stay away from spices such as pepper and curry, though, which can irritate the gastrointestinal tract.
Swap Whole Nuts for Nut Butter Spread
Nuts and seeds are chock-full of fiber and healthy fats, but for people with UC, they can be hard to digest. The worst offenders are those with hard shells — almonds and hazelnuts, for example — but all nuts can be tough to digest if you’re sensitive to them, especially during a flare.
Fortunately, substitutes abound for nut lovers in the form of peanut butter (creamy, not chunky), almond butter, and cashew butter. “Keeping these in your diet is a plus, because they contain monounsaturated fats, which can soothe inflammation,” says Lillian Craggs-Dino, RDN, a licensed dietitian nutritionist for the American Society for Metabolic and Bariatric Surgery.
8 Foods to Eat During an Ulcerative Colitis Flare
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Choose Fruit Without Seeds
Berries such as strawberries, raspberries, and blackberries are high in antioxidants, which may help ease inflammation. But, they’re also possible UC triggers, because they contain seeds that “are tiny and difficult to strain out,” says Craggs-Dino.
Blueberries, which also contain antioxidants, don’t have this type of seed, but they do have skin that can be difficult to break down during more severe flares. To work them into your diet, try tossing them in a smoothie; blenders can break down insoluble fiber into smaller pieces.
You can also swap berries for applesauce, canned peaches or pears, or bananas.
Once you’re in remission, make room for fruit in your diet: A study published in 2021 in the journal Clinical Gastroenterology and Hepatology found that adding more produce to your diet can help lower inflammation and lead to a better quality of life.
Pick a Less Acidic Alternative to Tomatoes
Whether they’re juiced, cooked, or stewed, tomatoes can be hard on your gut. Not only are tomatoes acidic, which can irritate your intestinal lining, but their seeds can also be hard to digest.
If you’re not in the middle of a flare, you may be able to indulge in an occasional helping of tomato sauce — perhaps a quarter cup, suggests Craggs-Dino.
Wondering what to make instead of tomato soup? Opt for a bisque-style soup made from cooked and pureed squash instead.
Swap Cabbage for Vegetables That Don’t Cause Gas
Cabbage can be hard to digest — and not just because it’s full of fiber. Eating cabbage produces sulfur, which can cause bloating, abdominal discomfort, and flatulence, says Craggs-Dino.
Greens, such as spinach, bok choy, and collard greens, are all possible alternatives if you make sure they’re cooked well, says Asimes. “To make sure that it’s well cooked, cut it with a fork,” she cautions. “If you can’t cut into it, then it’s not cooked enough.”
Swap Wheat Bran With Oatmeal or Corn Flakes
Wheat bran and bran flakes are high in insoluble fiber, which passes through the gut undigested. Heart-healthy oatmeal, though, is “a good source of soluble fiber, which dissolves in water, so it’s good to eat, even during a flare,” says Asimes. “Plain, less processed oats are better. Avoid prepared oatmeal packs.”
Other cereals worth trying are cornflakes, Cheerios, and Rice Krispies. For hot cereals other than oatmeal, try grits or Cream of Wheat.
Try Low-Lactose or Dairy-Free Products Instead of Traditional Dairy
It’s not uncommon for people with UC to also be lactose intolerant, which means having trouble digesting lactose, a sugar in milk and milk products. Although you may need to avoid milk, one type of dairy that’s often well tolerated, even during flares, is yogurt.
“Yogurt is a low-lactose food,” says Craggs-Dino, “and because it’s fermented, it has good bacteria, which is helpful to the digestive system.”
You can also try milk, cheese, and yogurt products made from soy, she says. But, start out slowly, because soy can cause gas and bloating. Almond, cashew, and coconut products are also good nondairy alternatives to milk, yogurt, and ice cream.
Additional reporting by Linda Thrasybule.
Lynn Grieger, RDN, CDCES
Medical Reviewer
Lynn Grieger is a registered dietitian-nutritionist, certified diabetes care and education specialist, certified personal trainer, and certified health and wellness coach. She completed requirements to become a registered dietitian at Valparaiso University in 1987 and completed a dietetic internship at Ingalls Memorial Hospital in Harvey, Illinois, in 1988.
Lynn brings her expertise in nutrition, exercise, and behavior change to her work in helping people reach their individual health and fitness goals. In addition to writing for Everyday Health, she has also written for websites and publications like Food and Health Communications, Today's Dietitian, iVillage.com, and Rodale Press. She has a passion for healthy, nutrient-dense, great-tasting food and for being outdoors as much as possible — she can often be found running or hiking, and has completed a marathon in every state.
Charlotte Libov
Author
Charlotte Libov is an award-winning health book author and journalist whose work has appeared in many newspapers and magazines throughout the country. Her books include Cancer Survival Guide, The Liver Cure, Fight Back: How to Beat the Coronavirus, A Woman's Guide to Heart Attack Recovery, and Beat Your Risk Factors.
She was working as a freelance contributor to The New York Times when she was diagnosed with a hole in her heart in 1990. Following successful open-heart surgery, she co-authored The Woman’s Heart Book, which was one of the first to focus on heart disease in women. The book became the basis for the award-winning PBS documentary Women’s Hearts at Risk, which Libov helped produced.
Libov became a popular speaker on women’s health issues and traveled across the country to deliver keynote talks on women’s health for hospitals, schools, and businesses, including the American Heart Association, Duke University Medical School, Bio International, Toyota, and the U.S. Army. Libov has a bachelor’s degree with honors from the University of Connecticut and a master’s degree in mental health counseling from the University of Oregon. She is passionate about photography and recently debuted in her own cabaret show.