For Your Patients: Diet and Lifestyle Considerations

— Self-management is important for patients with ulcerative colitis

MedpageToday
Illustration of an egg, avocado and apple in a circle; bicycle and tennis racket in another circle over a colon with UC

If you're starting treatment for ulcerative colitis (UC), you should be aware that much of your future relationship with this disease is in your hands. Your doctor will prescribe drugs to bring the condition under control, but there is much you can do to keep it that way.

Rest assured that your dietary habits up to this point didn't cause your UC, but at the same time, what you eat can aggravate it, although that can differ from person to person. Most important is to listen to your body, and keep a food diary to see if there are common and consistent triggers for bowel symptoms. Be aware, however, that during a flare almost all foods can seem like they cause more diarrhea, so the ideal time for a food diary is when things are at or near remission.

Although caffeine does not necessarily cause inflammation, it can make things move faster through the intestine, so many experts recommend avoiding it during flares. Similarly with alcohol and dairy products (although in general lactose intolerance has the same frequency in UC and non-UC patients).

If you and your doctor suspect that you are allergic to or intolerant of certain foods (gluten is another common concern), you can try eliminating the food from your diet to see if that helps.

Other Measures

Ulcerative colitis can interfere with absorption of certain nutrients that your body relies on, so your doctor may recommend that you take supplements in pill or liquid form. Some of these include vitamins D and B12, calcium, iron, zinc, and folic acid.

Regular physical activity can improve both physical and mental status, even if you don't feel like exercising because of UC discomfort. Pelvic floor exercises can help directly with maintaining bowel control.

Your doctor may also recommend such things as yoga and mindfulness training to help you relax and feel more in control of your body.

You can try probiotics, but the evidence behind these products in UC is relatively scant. There is little risk of harm.

If you're a smoker, forget what you may have read about smoking cessation making your condition worse. It's certain that the harms from smoking outweigh whatever preventive effect it may have, and your overall long-term health will be better if you quit.

Read previous installments in this series:

What Is Ulcerative Colitis?

I've Had Diarrhea That Won't Go Away -- What Should I Do?

UC -- Why Me?

Starting Drug Therapy for Ulcerative Colitis

"Medical Journeys" is a set of clinical resources reviewed by physicians, meant for the medical team as well as the patients they serve. Each episode of this 12-part journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.

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    John Gever was Managing Editor from 2014 to 2021; he is now a regular contributor.