What is colitis?
Colitis refers to inflammation of the inner lining of the colon (the large intestine). There are several types of colitis, including:
- Ulcerative colitis – Chronic inflammation of the colon that produces ulcers in its lining. This is the most common form of colitis.
- Crohn’s colitis – Crohn’s disease that is located in the colon. Crohn’s disease can occur throughout the gastrointestinal tract.
- Infectious colitis – Inflammation of the colon due to infectious causes, like bacteria, viruses, or parasites.
- Ischemic colitis – Inflammation of the colon caused by inadequate blood flow.
- Chemical colitis – Inflammation triggered by exposure to harsh chemicals, like certain antibiotics or chemotherapy medications.
The most characteristic symptoms of colitis are diarrhea, abdominal pain, and blood or pus in the stool. Symptoms can range from mild to severe. Some people have long periods of remission interspersed with periodic flares.
How does diet affect colitis?
Diet can have a big impact on colitis symptoms. Certain foods may trigger or worsen inflammation, while others may have protective effects.
Some general dietary recommendations for people with colitis include:
- Avoid trigger foods – Common triggers include dairy, high-fiber foods, spicy foods, and high-fat foods. Keep a food diary to identify your personal triggers.
- Eat small meals – Large meals can overstretch the colon and provoke symptoms. Eat smaller, more frequent meals.
- Stay hydrated – Drink plenty of fluids to avoid constipation and replace lost fluids from diarrhea.
- Limit alcohol and caffeine – These stimulants can worsen diarrhea and dehydrate you.
- Increase soluble fiber – Soluble fiber forms a gel, which can help regulate bowel movements. Good sources include oats, root vegetables, beans, and psyllium.
- Consider probiotics – Probiotic foods or supplements may help restore healthy bacteria to the gut.
- Talk to a dietitian – A registered dietitian can help create a customized diet plan for your needs.
What foods should you avoid during a colitis flare?
During a flare when symptoms worsen, it’s best to avoid foods that are difficult to digest. These may irritate the colon and provoke diarrhea, pain, and other symptoms. Foods to avoid or limit during a flare include:
- Fiber – Both insoluble and soluble fiber. While soluble fiber can be beneficial when symptoms are mild, large amounts of any fiber can exacerbate diarrhea and gas during a flare.
- Fatty foods – High-fat foods take longer to digest. Saturated fats and oils may be especially bothersome.
- Spicy foods – Spices contain irritating compounds that can further inflame the digestive tract.
- Certain raw fruits and vegetables – As these are higher in insoluble fiber. Cooked is easier to digest.
- Nuts, seeds, popcorn – These are difficult to break down and can aggravate diarrhea.
- Caffeinated drinks – Caffeine stimulates the gut and can worsen diarrhea.
- Alcohol – Alcohol inflames the stomach lining and causes diarrhea.
- Dairy – Lactose is difficult to digest for many people with colitis. Avoid milk, ice cream, soft cheeses.
- Gluten – For some individuals, gluten triggers digestive symptoms and inflammation.
Instead, focus on eating well-cooked vegetables, lean proteins, and low-fiber grains and starches during a flare.
What foods are beneficial during a flare?
Some foods are gentler on the digestive system and can help provide symptom relief during a colitis flare. Beneficial options include:
- Bone broth – Provides nutrients and electrolytes without fiber. The gelatin may help coat and protect the GI lining.
- Well-cooked vegetables – Cooked, peeled, or pureed vegetables are easier to digest. Carrots, winter squash, asparagus tips, spinach.
- Low fiber grains – White rice, bread, crackers, noodles, oats.
- Lean proteins – Skinless chicken or turkey, eggs, tofu, white fish.
- Canned fruit – The fiber has been broken down with processing.
- Low-lactose dairy – Hard cheeses, lactose-free milk, yogurt.
- Plant-based milks – Rice, almond, oat, coconut milk. Fortified with calcium and nutrients.
- Bananas – Starchy and low in fiber. Also replace potassium lost with diarrhea.
- Avocado – Well tolerated due to its high fat and low fiber content.
Season foods lightly. Include healthy fats like olive oil and avocado for calories. Stay hydrated with beverages like herbal tea, broth, and water.
Sample Menu for a Colitis Flare
Here is a sample one-day menu for a colitis flare:
Meal | Foods |
---|---|
Breakfast | Scrambled eggs with spinach, cooked pear, rice bread with jam |
Morning Snack | Rice cake with peanut butter, herbal tea |
Lunch | Turkey sandwich on white bread, chicken noodle soup, cooked carrots |
Afternoon Snack | Low-fat yogurt with sliced bananas |
Dinner | Baked salmon, mashed potatoes, steamed asparagus tips |
Evening Snack | Oatmeal made with lactose-free milk and apple sauce |
This menu avoids trigger foods and provides gentle, low fiber choices that are less likely to exacerbate symptoms. The meal plan also incorporates nutritious foods for energy, protein, and nutrients.
What are good meal options during remission from colitis?
During periods of remission when symptoms are minimal, it’s important to continue eating a healthy, balanced diet to promote healing in the colon. Some beneficial foods and meal ideas include:
- Probiotic foods like yogurt, kefir, sauerkraut, kimchi, miso, and kombucha to replenish gut bacteria.
- Foods high in omega-3 fatty acids like salmon, tuna, walnuts, flax and chia seeds to help reduce inflammation.
- Fruits like blueberries, strawberries, bananas, and melons which provide antioxidants and nutrients.
- Vegetables like spinach, kale, broccoli, and carrots for added fiber, vitamins, and minerals.
- Legumes like lentils, beans, and chickpeas which are high in soluble fiber to support regularity.
- Whole grains like oats, quinoa, and brown rice for complex carbohydrates and fiber.
- Lean protein foods like poultry, fish, eggs, tofu and tempeh to support healing and energy.
- Healthy fats from olive oil, nuts, seeds, and avocados for anti-inflammatory benefits.
During remission, the digestive system can better tolerate fruits, vegetables, whole grains and fiber. But it’s still important to drink plenty of fluids and chew foods well. Some healthy meal ideas include:
- Breakfast – Oatmeal with blueberries and walnuts. Hardboiled egg on the side.
- Lunch – Turkey and avocado sandwich on whole grain bread with lettuce and tomato. Carrot sticks and hummus.
- Dinner – Baked salmon with quinoa and roasted Brussels sprouts.
- Snacks – Greek yogurt with granola. Apple with nut butter. Kale chips.
The goal is to incorporate nutritious foods from all the food groups – fruits, vegetables, proteins, whole grains, and dairy. Listen to your body and avoid any foods that seem to trigger symptoms.
Should people with colitis follow a special diet?
There is no one universal eating pattern that works for everyone with colitis. However, certain dietary approaches may be beneficial for managing symptoms and promoting healing:
- Elimination diets – Remove trigger foods like dairy, gluten, or high-fiber foods, then systematically reintroduce them.
- Low residue diet – Limits high fiber foods to reduce bulk and stool frequency.
- Low FODMAP diet – Eliminates fermentable carbohydrates that can produce gas and diarrhea.
- Anti-inflammatory diet – Focuses on fish, vegetables, fruits, and healthy fats to reduce inflammation.
- Specific carbohydrate diet (SCD) – Avoids complex carbs to starve troublesome gut bacteria.
There is some research supporting the effectiveness of diets like the SCD, low FODMAP, and elimination diets for colitis. But more studies are needed. Work with a registered dietitian to find the best approach for your individual case. The goal is to identify your trigger foods and adjust your diet to reduce inflammation and symptoms.
Should you take supplements for colitis?
Some supplements may help reduce symptoms and promote healing for colitis:
- Probiotics – Beneficial bacteria that can improve gut health and restore microbial balance. Look for multi-strain formulas.
- Omega-3 fatty acids – Help reduce inflammation. Fish oil, flax oil or algae oil supplements can increase omega-3 intake.
- Vitamin D – Many people with colitis are deficient in vitamin D, which has anti-inflammatory effects.
- Curcumin – The active compound in turmeric has antioxidant and anti-inflammatory properties.
- Zinc – Supports wound healing and immune function. Zinc deficiency is common with Crohn’s disease.
Check with your doctor before taking supplements, especially in high doses. They can interact with medications you’re taking. It’s ideal to meet nutrient needs primarily through food sources. Supplements can help fill any gaps.
Conclusion
Diet and nutrition play an important role in managing colitis symptoms and promoting healing of the inflamed colon. While no one eating pattern is right for everyone, focus on identifying your personal trigger foods and avoiding those during a flare. Increase foods that are gentler on the digestive system. During remission, emphasize anti-inflammatory foods rich in nutrients. Work with a registered dietitian to develop the best dietary approach for your individual needs. With the right modifications, most people with colitis can enjoy a varied, nourishing diet.