Ulcerative colitis is a type of inflammatory bowel disease that causes long-lasting inflammation and ulcers in the digestive tract. It primarily affects the large intestine (colon) and rectum. People with ulcerative colitis may experience abdominal pain, diarrhea, rectal bleeding, weakness, fatigue and other symptoms.
There is no known cure for ulcerative colitis, but treatment can greatly reduce signs and symptoms and bring about long-term remission. Treatment for ulcerative colitis generally involves medication and in some cases, surgery.
Making appropriate lifestyle changes, such as modifying your diet, can also help manage ulcerative colitis. That’s why many people wonder: Does eating dairy products like cheese aggravate ulcerative colitis symptoms?
The potential impact of dairy on ulcerative colitis
Research on how dairy affects ulcerative colitis is limited and the results are mixed. However, some studies suggest that dairy may trigger symptoms in some people with ulcerative colitis.
One small study found that drinking milk triggered increased stool frequency, abdominal pain, cramping and bloating in people with ulcerative colitis who were in remission. Another study found similar effects when people with ulcerative colitis drank buttermilk.
Researchers speculate that the lactose and proteins found in dairy may be responsible for aggravating symptoms:
- Lactose: Many people with ulcerative colitis have some degree of lactose intolerance, meaning they have difficulty digesting the natural sugar (lactose) in milk. Consuming dairy products can lead to digestive symptoms like diarrhea and gas in lactose intolerant individuals.
- Milk proteins: The proteins found in dairy, particularly whey and casein, may also trigger an immune reaction in some cases, causing inflammation that exacerbates ulcerative colitis symptoms.
Should you avoid dairy with ulcerative colitis?
Due to the potential for dairy to aggravate ulcerative colitis symptoms in some people, many health professionals recommend limiting or avoiding dairy while flaring. This includes milk, cheese, yogurt and other dairy products.
However, the effect of dairy on ulcerative colitis really depends on the individual. While some people report dairy triggers their symptoms, others find they can tolerate it without issues.
If you have ulcerative colitis and want to keep dairy in your diet, experts suggest starting with small amounts of low-lactose dairy options, such as:
- Aged, hard cheeses like cheddar, Swiss and Parmesan
- Lactose-free milk
- Yogurt with live active cultures
You may also want to consider taking a lactase enzyme supplement to help break down and digest the lactose in dairy foods.
Monitor your symptoms carefully when reintroducing dairy foods. If you experience an increase in diarrhea, abdominal pain or other ulcerative colitis symptoms after eating dairy, you may need to avoid it entirely during symptom flares and limit portions when in remission.
Tips for managing ulcerative colitis
While diet changes like limiting dairy intake may help some people better manage ulcerative colitis, there are many other effective ways to keep your symptoms under control.
Work closely with your healthcare provider to find the right treatment approaches for you. Treatment options may include:
- Medications like aminosalicylates, corticosteroids, immunosuppressants and biologics to reduce inflammation and pain.
- Supplements like probiotics, turmeric, aloe vera and boswellia to help heal the gut.
- Stress management techniques to help induce remission.
- Surgery to remove part of the colon in severe cases.
Making specific dietary changes can also be very beneficial for managing ulcerative colitis flares, such as:
- Following a low fiber or low residue diet during flares to rest your colon.
- Staying hydrated by drinking 8-10 glasses of fluids daily.
- Limiting difficult to digest high fat foods.
- Keeping a food journal to identify any trigger foods.
The bottom line
Some limited research shows dairy may worsen symptoms in people with ulcerative colitis, likely due to the lactose and proteins milk contains. However, many people find they can tolerate small amounts of low lactose dairy options without issues.
The best approach is to work closely with your healthcare team to find an individualized treatment plan that helps you effectively manage ulcerative colitis. This may or may not include restricting dairy intake, depending on how your body responds.
By combining medication and lifestyle approaches, most people with ulcerative colitis can achieve remission or significantly improve their quality of life.
Frequently asked questions
Is cheese bad for ulcerative colitis?
Cheese may be problematic for some people with ulcerative colitis but not others. The proteins and lactose in cheese could potentially aggravate symptoms in those sensitive to dairy. However, aged, hard cheeses like cheddar and Parmesan tend to be lower in lactose, so they may be better tolerated.
Can you eat cheese if you have ulcerative colitis?
You may be able to eat small amounts of low-lactose cheeses like cheddar, Swiss and Parmesan if you have ulcerative colitis. However, dairy intake needs to be tailored to the individual. Monitor your symptoms carefully and avoid cheese if you notice it worsening diarrhea, pain or other ulcerative colitis issues.
What foods should ulcerative colitis patients avoid?
Foods ulcerative colitis patients typically want to avoid or limit include:
- High fiber foods – raw fruits, vegetables, whole grains
- Fatty, greasy, fried foods
- Spicy foods
- Alcohol and caffeine
- Carbonated beverages
- Dairy products
- Certain meats like smoked, cured and processed meats
- Seeds and nuts
Keep in mind trigger foods can vary greatly person to person. Work with a dietitian knowledgeable about ulcerative colitis to identify your individual dietary triggers.
What foods are good for ulcerative colitis?
Some examples of foods that tend to be better tolerated during ulcerative colitis flares include:
- Cooked vegetables like carrots, spinach, squash
- Canned or cooked fruits like applesauce, bananas
- Protein sources like eggs, poultry, fish, tofu
- Starchy foods like white bread, rice, quinoa, oats
- Low fiber juices and beverages
- Broths and soups
Focus on getting enough calories and nutrients from foods you tolerate well. Work closely with a dietitian to develop a customized ulcerative colitis diet.
Sample 3-day menu for ulcerative colitis
Here is a 3-day sample menu with ulcerative colitis-friendly meal and snack ideas:
Day 1
Breakfast:
- Oatmeal made with lactose-free milk and sliced bananas
- Poached egg
- Herbal tea
Lunch:
- Chicken noodle soup
- Saltine crackers
- Cooked carrots
- Apple sauce
- Water
Dinner:
- Baked salmon
- White rice
- Steamed spinach
- Canned peaches
Snacks:
- Peanut butter on rice cakes
- Yogurt with live active cultures
- Jello
- Baby carrots
Day 2
Breakfast:
- Eggs scrambled with spinach
- Hash browns
- Decaf coffee
Lunch:
- Turkey sandwich on white bread with lettuce and tomato
- Baked potato chips
- Fresh peach
- Herbal tea
Dinner:
- Chicken stir fry with white rice and cooked veggies
- Fortified nutritional beverage
Snacks:
- Low fiber cereal bar
- Celery sticks with peanut butter
- Canned pears
- Sprite
Day 3
Breakfast:
- Cream of wheat made with lactose-free milk
- Poached egg
- Canned peaches
- Decaf coffee
Lunch:
- Grilled chicken sandwich on white bread
- Cooked broccoli
- Applesauce
- Ginger ale
Dinner:
- Baked cod
- Mashed potatoes
- Cooked carrots
- Rice pudding
Snacks:
- Low fiber crackers
- String cheese
- Hard boiled egg
- Fruit smoothie made with lactose-free milk
Focus on getting enough calories from foods that you tolerate well. Work closely with a dietitian knowledgeable about ulcerative colitis to develop a personalized diet plan.
Lifestyle changes for managing ulcerative colitis
In addition to dietary strategies, making certain lifestyle changes can help manage ulcerative colitis symptoms and induce remission, including:
- Quit smoking – Smoking has been shown to worsen ulcerative colitis symptoms.
- Manage stress – High stress levels can trigger ulcerative colitis flares. Try relaxation techniques like meditation, yoga, deep breathing.
- Stay active – Get regular moderate exercise like brisk walking when possible.
- Get enough sleep – Aim for 7-9 hours per night to support healing.
- Take supplements – Vitamin D, probiotics, turmeric and boswellia may help some people.
- Consider counseling – Talk therapy can help with stress management.
Discuss lifestyle approaches with your healthcare team to create a comprehensive ulcerative colitis wellness plan.
When to seek medical advice
Make sure to consult your doctor or gastroenterologist if:
- Your ulcerative colitis symptoms are worsening or becoming unmanageable with your current treatment protocol
- You experience severe pain, bleeding or dehydration from diarrhea
- You have a fever over 101 F
- You have persistent vomiting or cannot keep food down
- You lose weight unexpectedly
- Your symptoms are impacting your quality of life
Severe ulcerative colitis flare ups may require hospitalization to treat dehydration, malnutrition and other complications. Report any concerning symptoms to your healthcare provider.
The takeaway
Research on whether dairy products like cheese impact ulcerative colitis is limited, but some findings suggest dairy may aggravate symptoms in those sensitive. Many people find they can tolerate small amounts of low-lactose cheeses.
The best approach is to work with your healthcare team to identify trigger foods and customize your diet. Avoiding dietary triggers along with medication, lifestyle changes, and stress management can help control ulcerative colitis.