Calming Ulcerative Colitis with Fiber

Inflammatory Bowel Disease (IBD) is a chronic and autoimmune disorder that affects a wide variety of people. Most people with IBD are diagnosed in their 20s and 30s; however, many people in their teenage years and even older years have been diagnosed with this illness. The two most common types of IBD include Crohn's disease (CD) and Ulcerative colitis (UC). In this blog post, we will focus on UC specifically and certain dietary components that can be helpful during the healing process.

It is common for IBD to be confused with other medical conditions which is why it's important to first get a proper diagnosis from your Gastroenterologist.

What is Ulcerative Colitis?

UC is a subtype of IBD where inflammation and ulceration are predominately found in the large intestine. The large intestine is comprised of the cecum, colon, appendix, and anal canal. Symptoms can vary between individuals with this disease. The different forms of UC include left-sided colitis, ulcerative proctitis, extensive colitis, proctosigmoiditis, and pancolitis. UC can be classified as mild, moderate, severe, or very severe. While there is no medical cure for UC, medications, and diet have been shown to help synergistically to alleviate flare-ups and improve quality of life.

Symptoms of UC can include:

• Abdominal pain

• Belly cramps

• Bloody stools with pus

• Diarrhea and/or constipation

• Fatigue

• Weight loss

Can diet play a role in IBD?

Dietary factors can contribute both directly and indirectly to UC outcomes and course of illness. Ongoing research has shown how a westernized diet that is high in saturated fats and lowers in fiber can perpetuate the inflammatory response of IBD. Furthermore, diets that are high in sugar and lack dietary fiber are lower in short-chain fatty acids (SCFA) which can increase the development of colitis.

Dietary fiber in the past was recommended to be avoided for fear of worsening IBD outcomes. Currently, it is not routinely recommended for fiber to be restricted unless strictures or narrowing of the intestine is present. During an active flare, it is best to focus on the foods that are well-tolerated, rather than eliminating unnecessary food groups. When we restrict certain food groups, we are at an increased risk of malnutrition and developing certain micro-nutrient deficiencies. Keeping a food journal on hand can be a great tool to understand your tolerances.

Fibrous foods to eat with UC during an active flare include:

• Avocado

• Bananas

• Acorn Squash

• Carrots

• Spinach

• Mushroom

• Onions

• Butternut Squash

Note: Make sure vegetables are fully cooked and pureed as needed. You may want to include other vegetables as tolerated.

What else do I need to know about fiber and UC?

It is important to continue enjoying foods that are well tolerated and that will not exacerbate your symptoms. Fiber can play a critical role in UC and the maintenance of active disease. Ongoing research has shown how incorporating fibrous foods such as whole grains, fruits, vegetables, and legumes can show an improvement in clinical disease and patients' quality of life.

Here is a great video from the American College Gastroenterology (ACG) "Ulcerative Colitis: A Guide for Patients."

Personally from Rebecca

As a Registered Dietitian who has ulcerative colitis, I focus on a diet that is minimally processed with a moderate to a high fiber intake as tolerated. There are times where I need to adjust the texture of my foods depending on my symptoms. For example, instead of having a salad, I will prepare soups. I also make sure to walk at least 5-6 times per week and meditate daily.

Rebecca Goodrich is a registered dietitian who specializes in certain gastrointestinal conditions such as irritable bowel syndrome and inflammatory bowel disease. Rebecca also specializes in kidney and heart health. You can contact Rebecca at RadNutrition.Health.