What to eat during ulcerative colitis flare up. 8 Optimal Foods for Managing Ulcerative Colitis Flares: A Comprehensive Guide

23.09.202308.07.2023 by alexxlab

What foods can help alleviate symptoms during an ulcerative colitis flare. How can dietary choices impact the management of ulcerative colitis. Which easily digestible options provide essential nutrients without exacerbating inflammation.

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Understanding Ulcerative Colitis and Dietary Considerations

Ulcerative colitis is a chronic inflammatory bowel disease that affects the colon and rectum. During flare-ups, patients often experience symptoms such as abdominal pain, diarrhea, and rectal bleeding. Proper nutrition plays a crucial role in managing these flares and maintaining overall health. But which foods are best suited for consumption during these challenging periods?

Experts generally recommend limiting fiber intake during ulcerative colitis flares. This approach involves replacing high-fiber foods like nuts, seeds, and raw fruits and vegetables with more easily digestible alternatives. The goal is to provide essential nutrients without aggravating the already irritated gastrointestinal system.

Applesauce: A Gentle Option for Digestive Comfort

Applesauce stands out as an excellent food choice during ulcerative colitis flares. Its soft texture and easy digestibility make it an ideal option for an irritated gastrointestinal system. However, it’s crucial to opt for unsweetened varieties to avoid exacerbating inflammation with added sugars.

Creating your own sugar-free applesauce can be a simple and beneficial alternative. How can you make homemade applesauce? Simply cook peeled, sliced apples with a small amount of water, then puree the mixture to achieve the desired consistency. This method allows for complete control over ingredients and ensures a gut-friendly option.

The Benefits of Homemade Applesauce

Control over sugar content
Customizable texture
No artificial additives
Fresh, natural flavor

Ripe Bananas and Canned Fruits: Soft Solutions for Nutrient Intake

While raw fruits are generally discouraged during flares, very ripe, soft bananas are often well-tolerated by individuals with ulcerative colitis. Bananas serve as an excellent source of easily digestible carbohydrates, which, along with proteins and fats, provide essential energy to the body.

Canned fruits, particularly soft varieties like pears or peaches, can also be included in the diet during flares. These options offer a way to incorporate fruits without the potential irritation caused by raw, fibrous alternatives.

Selecting the Right Canned Fruits

Choose fruits canned in water or natural juices
Avoid varieties with added sugars or syrups
Opt for softer fruits like peaches, pears, or fruit cocktails
Drain and rinse the fruits to remove excess sugars if necessary

Cooked Vegetables: Ensuring Nutrient Intake Without Irritation

Vegetables are essential for maintaining a balanced diet, even during ulcerative colitis flares. However, raw vegetables can be difficult to digest and may exacerbate symptoms. The solution? Thoroughly cooked vegetables.

Soft, well-cooked vegetables like carrots and spinach can provide important nutrients such as vitamins A and K without causing undue stress on the digestive system. But how do you know when vegetables are cooked enough? According to Shannon Szeles, RDN, vegetables should be cooked until they can be easily mashed with a fork. This level of cooking breaks down potentially irritating fibers, making the vegetables more easily digestible.

Cooking Methods for Vegetables During Flares

Steaming: Preserves nutrients while softening the vegetable
Boiling: Ensures thorough cooking, though some nutrients may be lost in the water
Roasting: Can enhance flavor while achieving a soft texture
Pureeing: Creates a smooth consistency that’s easy on the digestive system

Probiotics: Harnessing Beneficial Bacteria for Gut Health

Probiotics, or live beneficial bacteria, can play a significant role in supporting digestive health during ulcerative colitis flares. For those who are not lactose intolerant, yogurt can be an excellent source of both probiotics and protein.

When selecting yogurt, it’s crucial to choose varieties that explicitly state “live and active cultures” on the label. This ensures that the product contains beneficial bacteria that can potentially aid the digestive system. However, it’s important to avoid yogurts with large chunks of fruit, as these can be difficult to digest during a flare.

For individuals who are lactose intolerant or prefer non-dairy options, probiotic supplements can be a viable alternative. These supplements come in various forms, including capsules, powders, and liquids, allowing for flexibility in consumption methods.

Choosing the Right Probiotic Supplement

Look for multi-strain formulations
Check for an adequate CFU (Colony Forming Units) count
Consider enteric-coated capsules for better survivability through stomach acid
Consult with a healthcare provider for personalized recommendations

Salmon: A Powerhouse of Protein and Anti-inflammatory Omega-3s

Salmon emerges as a superb food choice for individuals experiencing ulcerative colitis flares, particularly for those seeking to increase their protein intake or who are lactose intolerant. But what makes salmon such an excellent option?

Firstly, salmon is a rich source of high-quality protein, which is essential for maintaining and repairing body tissues. Moreover, it contains significant amounts of omega-3 fatty acids, specifically EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). These fatty acids have been shown to possess potent anti-inflammatory properties, which may help alleviate some of the inflammation associated with ulcerative colitis.

Optimal Cooking Methods for Salmon

Dr. Neilanjan Nandi, a gastroenterologist and assistant professor at Drexel University College of Medicine in Philadelphia, recommends specific cooking methods to maximize the nutritional benefits of salmon. He advises baking, broiling, or sautéing the fish rather than frying it. Why? Frying can cause the fish to lose a significant portion of its nutritional value, potentially diminishing its beneficial effects.

Baking: Helps retain moisture and nutrients
Broiling: Quick cooking method that can create a flavorful exterior
Sautéing: Allows for quick cooking with minimal added fats

If salmon isn’t to your liking, other fish high in omega-3 fatty acids can serve as alternatives. Options include tuna, mackerel, sardines, and herring. These fish provide similar nutritional benefits and can be prepared using the same methods recommended for salmon.

Nut Butters: Creamy Sources of Protein and Healthy Fats

Nut butters, such as peanut butter, almond butter, and cashew butter, offer a concentrated source of protein and healthy fats, making them valuable additions to the diet during ulcerative colitis flares. These spreads provide essential nutrients without the need to consume whole nuts, which can be difficult to digest during inflammation.

When selecting nut butters, opt for creamy varieties rather than chunky versions. The smooth texture of creamy nut butters is easier on the digestive system, helping to avoid further irritation during a flare. But how can you incorporate nut butters into your diet effectively?

Creative Ways to Consume Nut Butters During Flares

Spread on low-fiber bread or crackers
Blend into smoothies for added protein and creaminess
Use as a dip for soft, cooked vegetables
Incorporate into oatmeal or other cooked cereals

Dr. Nandi suggests pairing nut butters with bread or wrapping them in a tortilla for a satisfying and easily digestible meal. Another option is to spread nut butter on low-fiber crackers, such as saltines, which can provide a crunchy texture without excessive fiber content.

White Rice with Turmeric: A Soothing Combination with Potential Benefits

During severe ulcerative colitis flares, when most foods are poorly tolerated, white rice can serve as a gentle, easily digestible option. Its bland nature and low fiber content make it less likely to irritate the inflamed digestive tract. But how can we enhance this simple food to potentially provide additional benefits?

Enter turmeric, a yellow spice that has garnered attention for its potential therapeutic properties in managing ulcerative colitis. The key compound in turmeric, curcumin, has demonstrated some promise in the treatment of this condition. A meta-analysis published in the Annals of Gastroenterology in November 2019 found that combining curcumin with anti-inflammatory medication was more effective in treating ulcerative colitis than anti-inflammatory medication alone.

The Potential of Turmeric in Ulcerative Colitis Management

Dr. Arun Swaminath, director of the Inflammatory Bowel Diseases Program at Lenox Hill Hospital in New York City, notes an interesting observation: turmeric is widely used in India, where the incidence of inflammatory bowel disease is lower than in the United States or Europe. While this doesn’t prove causation, it suggests potential benefits that warrant further investigation.

Anti-inflammatory properties of curcumin
Potential synergistic effects with conventional medications
Low risk of side effects when consumed in food amounts
Easy incorporation into various dishes, including rice

Hydration: The Critical Role of Fluids During Flares

Proper hydration is paramount during ulcerative colitis flares, particularly due to the increased risk of fluid loss through diarrhea. But why is staying hydrated so crucial during these periods? Dr. Nandi explains, “When you’re dehydrated, every symptom you have is amplified.” This underscores the importance of not only replacing lost fluids but also replenishing electrolytes and carbohydrates.

Optimal Hydration Choices During Flares

Water: The foundation of hydration
Sports drinks: Provide electrolytes and carbohydrates
Fruit juices (without pulp): Offer hydration and some nutrients

Dr. Nandi recommends combining sports drinks with water in a 1:1 ratio to help replace lost carbohydrates and electrolytes effectively. This balanced approach ensures adequate hydration while also providing some of the energy and minerals that may have been lost due to diarrhea.

When considering fruit juices, opt for pulp-free varieties to minimize potential irritation to the digestive tract. However, it’s advisable to avoid prune juice due to its high fiber content, which could exacerbate symptoms during a flare.

Signs of Dehydration to Watch For

Increased thirst
Dry mouth and lips
Decreased urine output or dark-colored urine
Fatigue or dizziness
Rapid heartbeat

If you experience these symptoms, it’s crucial to increase your fluid intake and consider contacting your healthcare provider, especially if symptoms persist or worsen.

The Importance of Personalized Nutrition Plans

While these food recommendations can be helpful for many individuals with ulcerative colitis, it’s essential to recognize that dietary needs can vary significantly from person to person. Shannon Szeles, RDN, emphasizes the importance of working with a registered dietitian nutritionist to develop an individualized meal plan.

A personalized approach allows for the consideration of factors such as:

Individual nutritional needs
Specific food tolerances and intolerances
The severity and frequency of flares
Concurrent medical conditions or medications
Personal food preferences and cultural considerations

By collaborating with a nutrition professional, individuals with ulcerative colitis can develop a dietary strategy that not only helps manage symptoms during flares but also supports overall health and well-being. This personalized approach can help ensure adequate calorie and nutrient intake, which is crucial for maintaining strength and supporting the body’s healing processes.

Benefits of Working with a Registered Dietitian Nutritionist

Tailored dietary recommendations based on individual needs
Guidance on meal planning and preparation techniques
Support in identifying and addressing nutritional deficiencies
Assistance in navigating social situations and eating out
Ongoing support and adjustments as needs change over time

Remember, while diet plays a crucial role in managing ulcerative colitis, it should be considered part of a comprehensive treatment plan that includes medical management under the guidance of a healthcare provider. Regular communication with your healthcare team, including your gastroenterologist and dietitian, can help ensure that your dietary choices are supporting your overall treatment goals and contributing to improved quality of life.

8 Foods to Eat During an Ulcerative Colitis Flare

If you have ulcerative colitis, you may already know which foods worsen your flares. But figuring out what to include in your diet is equally important, because the right foods will provide you with key nutrients without aggravating your symptoms.

Most experts recommend that you limit your fiber intake when you’re having an ulcerative colitis flare. A general rule is to replace high-fiber foods, such as nuts, seeds, and raw fruits and vegetables, with more easily digestible fare. Here are eight foods to eat during an ulcerative colitis flare and the reasons they can help.

1. Applesauce: Since your gastrointestinal system is experiencing a lot of irritation during a flare, you may want to stick to soft, easily digestible foods like applesauce. Be sure to choose an unsweetened variety though, because added sugar can cause more inflammation. You can also make your own sugar-free applesauce by cooking peeled, sliced apples with some water and then pureeing the mixture.

2. Ripe bananas and canned fruits: Although dietitians generally recommend avoiding raw fruits during a flare, very ripe, soft bananas are often well tolerated. Bananas are also a good source of carbohydrates, which, along with protein and fats, provide energy. Also, soft fruits like canned pears or peaches may not be irritating, says Shannon Szeles, RDN, of York, Pennsylvania.

3. Cooked vegetables: Soft, cooked veggies like carrots and spinach can provide important nutrients, such as vitamins A and K. Just make sure the vegetables are thoroughly cooked— until they can be mashed with a fork, Szeles says — so that any potentially irritating fiber is broken down.

4. Probiotics: If you’re not lactose intolerant, yogurt can provide you with some protein and probiotics, which are live bacteria that may help the digestive system. Be sure to buy yogurt that says live and active cultures on the label, Szeles says. Avoid yogurt that contains large chunks of fruit, which could be hard to digest. “It’s fine if yogurt has fruit that’s soft, seedless, and blended in,” Szeles adds. Probiotic supplements are also an option if you are lactose intolerant.

5. Salmon: People with ulcerative colitisand are lactose intolerant or simply want to get more protein in your diet add salmon to the foods you eat during a flare. In addition to being a great source of protein, salmon has healthy omega-3 fatty acids that may help reduce inflammation. If you don’t like salmon, you can eat tuna, shrimp, or other fish that are high in omega-3 fatty acids.

Neilanjan Nandi, MD, a gastroenterologist and assistant professor at Drexel University College of Medicine in Philadelphia, recommends baking, broiling, or sautéing salmon rather than frying it. “Frying fish causes it to lose a lot of its nutritional value,” he says.

6. Nut butters: Peanut butter, almond butter, cashew butter, and other nut butters are another source of protein and healthy fats. Choose creamy peanut butter instead of chunky to avoid having to digest difficult nut pieces, which could cause further irritation during a flare. Try eating peanut butter with bread, Dr. Nandi advises, or wrap it in a tortilla. Another good choice is nut butter on a low fiber crackers like a saltine.

7. White rice with turmeric: If you can’t tolerate most foods during an ulcerative colitis flare, you may want to stick with bland choices, such as cooked white rice. If you want to add flavor, try sprinkling it with turmeric, a yellow spice whose key ingredient, curcumin, has shown some benefit in the treatment of ulcerative colitis.

A meta-analysis published in November 2019 in the Annals of Gastroenterology found that taking curcumin along with an anti-inflammatory was better for treating ulcerative colitis than only taking an anti-inflammatory medication.

Turmeric is widely used in India, where the incidence of inflammatory bowel disease is lower than in the United States or Europe, says Arun Swaminath, MD, director of the Inflammatory Bowel Diseases Program at Lenox Hill Hospital in New York City.

8. Water, sports drinks, and fruit juice: The diarrhea that often occurs during an ulcerative colitis flare can cause you to lose a lot of fluids, and replenishing them is important. “When you’re dehydrated, every symptom you have is amplified,” Nandi says. Sports drinks combined with water in a 1:1 ratio can help replace lost carbohydrates and electrolytes, he says. No-pulp fruit juice is also an option, Szeles says, but avoid prune juice because of its high fiber content.

“It’s important for people with ulcerative colitis to work with a registered dietitian nutritionist to develop an individualized meal plan,” says Szeles. “This can help provide specific calorie and nutrient goals since all bodies tolerate foods differently.”

Additional reporting by Nina Wasserman.

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Diet for chronic colitis | Sanatorium Gorny

Colitis is an inflammatory disease of the colon. Treatment of colitis is always complex. A prerequisite for successful treatment is diet.

If you have chronic colitis , you should regularly undergo preventive treatment .

General rules. duration of the diet.

Nutrition for colitis should be balanced in terms of nutrients. The main task of the diet is to reduce the load on the entire digestive tract.

General rules of nutrition for intestinal colitis:
Fractional nutrition. 5-6 times a day.
Give preference to mashed and semi-liquid foods.
Food should not be hot or cold. The optimal temperature of dishes is 30-40 C
Exclusion of products containing fiber
Reduce salt intake to 8-10 grams per day
Maintain drinking regimen (at least 1.5 liters per day)
Food can be boiled or steamed.

Nutrition for colitis during an exacerbation.

During an exacerbation of colitis, diet is very important. The task of the diet is to stop inflammation in the intestines, restore proper digestion and eliminate the processes of fermentation and putrefaction.

To do this, it is recommended to completely exclude food products that cause fermentation or decay. With diarrhea, it is necessary to exclude foods rich in fiber, vegetables and bran. With constipation, on the contrary, you need to increase peristalsis and eat a lot of vegetables and cereals.

Dishes should be steamed or boiled. Food must be ground, chopped or pureed. It is better to boil porridges strongly or use special porridges for baby food.

Nutrition for chronic colitis.

Outside of exacerbation, dieting for colitis avoids exacerbation.

The diet is based on cereals boiled in water and semi-liquid food. You can add butter to the porridge. Soups are prepared on the second broth from lean meat. Vegetables can be added in a small amount in pureed form.

You can eat eggs in the form of steam omelettes, steamed fish or minced beef cutlets.

You can drink weak black and green teas, herbal tea. Coffee is not recommended, but can be replaced with chicory. The daily volume of water consumed should be about 1.5 liters.

Diet types:

With an exacerbation of chronic colitis or with an acute form of colitis with loose stools (diarrhea), diet No. 4 is recommended. With this diet, foods rich in fiber are not recommended. All dishes that cause rotting and fermentation are also excluded.

If the disease proceeds with constipation, then diet No. 3 is recommended. With this diet, foods that enhance intestinal motility, rich in fiber, are recommended.

In chronic colitis without exacerbation, you must adhere to diet number 2.

List of approved products:

PORRIDGE AND CEREALS: Buckwheat, semolina, oatmeal, rice.
FRUITS: Pears, apples, quinces.
BERRIES: Blueberries, black currants, dogwoods.
DAIRY PRODUCTS: Acidophilus, low-fat cottage cheese, butter.
MEAT: Boiled beef, veal, rabbit, chicken, turkey.
BREAD: White bread rusks.
VEGETABLES: Carrots, cauliflower, potatoes as an addition to soups.

List of fully or partially restricted products.

VEGETABLES: White cabbage, legumes, horseradish.
FRUITS: Melons, bananas, grapes.
MEAT: Pork, sausage, sausages, ham, duck, goose.
DAIRY PRODUCTS: Milk, kefir, sour cream, full-fat cottage cheese, cheese.
SOFT DRINKS: Kvass, grape juice, carbonated sweet drinks.
DESSERTS: Ice cream, cakes, shortcrust pastry, chocolate.

Colitis Nutrition Menu (Meal Mode)

Nutrition for colitis should be as sparing as possible.

Food should be fractional – 5-6 times a day. Last meal 3 hours before bed.

Recipes for dietary dishes with colitis.

Sample menu for a day from a diet for intestinal colitis:

Breakfast: Boiled oatmeal with butter. Apple compote.

Second breakfast: Beef steam cutlet. Kissel from blueberries.

Lunch: Rice soup with chicken meatballs. Boiled sea fish. Herb tea

Afternoon snack: Low-fat cottage cheese casserole. Apple compote.

Dinner: Meat casserole. Weak tea.

Before going to bed: Compote or jelly.

Nutritionists’ comments:

With colitis, therapeutic nutrition is a prerequisite for successful treatment. Properly chosen diet and its observance allow you to quickly get rid of the unpleasant symptoms of the disease.

“The right choice of a sanatorium is a significant step towards the preservation and enhancement of health. “Gorny” is a resort complex that combines the experience and knowledge of Russian and Soviet balneology. The availability of modern medical equipment and innovative installations, the professionalism of the staff and love for their work will serve as a guarantee for extending longevity,” – the head doctor of the sanatorium Karaulov Alexander Olegovich.

References:

Okorokov, A.N. Diagnosis of diseases of internal organs: T. 1. Diagnosis of diseases of the digestive system / A.N. Okorokov M.: Med. lit., 2000.
Vorobyov, G. I. Nonspecific inflammatory bowel diseases / G. I. Vorobyov, I. L. Khalif M.: Miklosh, 2008.

City Clinical Hospital No. 31 – IBD: Diet therapy for IBD (ulcerative colitis, Crohn’s disease)

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Guidelines for patients “Dietary nutrition in inflammatory bowel diseases (ulcerative colitis, Crohn’s disease)” were prepared at the Department of Gastroenterology and Dietetics, St. I.I. Mechnikov “(former SPbMAPE).

Authors:

professor A.Yu. Baranovsky, Professor L.I. Nazarenko, nutritionist A.G. Kharitonov

St. Petersburg

Introduction

ulcerative colitis.

Ulcerative colitis is a chronic inflammatory disease characterized by ulcerative changes in the colon mucosa. Women and men get ulcerative colitis equally often. People of different ages get sick, but there are two peaks of incidence: 15-30 and 50-70 years. During the course of the disease, an exacerbation is distinguished (manifested by frequent stools mixed with mucus and blood, abdominal pain, fever, etc.) and remission (lack of activity of the inflammatory process). Ulcerative colitis is characterized by a progressive course and often – the development of complications.

In contrast to ulcerative colitis, Crohn’s disease inflammation may involve the entire digestive tube, from the oral cavity to the anus, but the ileum is most often affected. It is possible to develop complications both from the intestine (abscesses, fissures, fistulas, narrowing, etc.), and extraintestinal complications (cholelithiasis and urolithiasis, protein-energy deficiency, etc.).

For the treatment of IBD, anti-inflammatory drugs (5-aminosalicylic acid derivatives), hormonal drugs (prednisolone, methylprednisolone), antibacterial agents, immunosuppressors and immunomodulators, biological therapy drugs, and surgical methods of treatment are used. An integral part of the treatment of IBD is diet therapy.

The question of proper nutrition in Crohn’s disease and ulcerative colitis is still difficult for both the dietitian and the patient. Patients often note that such manifestations of the disease as pain or diarrhea occur immediately after eating. Therefore, most of them want clear recommendations about what they can eat and drink. However, unlike diseases that are strictly dependent on diet, such as diabetes mellitus or gout, there are no hard and fast dietary recommendations for Crohn’s disease and ulcerative colitis.

However, together with medications, surgery and lifestyle modifications, nutritional therapy forms the basis for successful treatment of the disease.

It should be remembered that dietary measures for Crohn’s disease are different from those for ulcerative colitis. The diet during an exacerbation is different from the diet during remission of the disease. Moreover, each patient reacts differently to food.