Ulcerative Colitis is an Inflammatory Bowel Disease (IBD) in which your immune system attacks the lining of your gut.\u00a0 This causes swelling and inflammation in your rectum and\/ or colon (large bowel).\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n
Why this happens is not clearly understood, but it is likely caused by a combination of factors such as genetics, gut microbiota, and environmental factors.\u00a0\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n
One of the most common questions I get asked in the clinic is \u2018Was it something I ate that caused the onset of ulcerative colitis, or triggered a flare of symptoms? This is absolutely not the case!<\/p>\r\n\r\n\r\n\r\n
UC is a lifelong (chronic) condition, but everyone is affected by it quite differently.\u00a0 Most people go through periods of flare up, and remission:<\/p>\r\n\r\n\r\n\r\n
Flare:<\/strong>\u00a0 A flare up is when your UC is in active inflammation. Symptoms can include diarrhoea, constipation, tiredness, tummy pains, and sometimes blood in your poo.\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Remission:<\/strong> No active inflammation, symptoms are relatively well controlled.\u00a0<\/p>\r\n\r\n\r\n\r\n Treatment for Ulcerative Colitis may be with medicines, surgery, or a combination of both.\u00a0 This can vary depending on the site (where in your colon), and severity (how deep the ulceration, or how spread the inflammation might be).\u00a0 Your IBD and surgical team will help you to decide the type of treatments that best suit you.<\/p>\r\n\r\n\r\n\r\n Due to inflammation, ulceration and above symptoms, UC can affect food choices, tolerance, and absorption of nutrients.\u00a0\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Below is some helpful advice to guide individuals through some nutritional considerations during a flare up period.\u00a0 Please bear in mind that this is general advice as every individual has different needs. This is why we would always encourage individuals to see a bowel specialist dietitian to ensure advice is tailored and provides an individual approach.<\/p>\r\n\r\n\r\n\r\n When UC is well controlled and there is no active inflammation, you should aim to follow a healthy, balanced diet, rich in plant-based goodness and diversity.\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Starchy carbohydrates \u2013 wholegrain, wholemeal or seeded where possible \u2013 breads, pastas, cereals, grains, rice, potatoes, and pastas.\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Lean protein \u2013 such as meat, chicken, fish, eggs, soya, tofu, tempeh etc.\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Plant-based foods \u2013 try to include a diverse range of the six plant-based foods each day.\u00a0 This includes nuts, seeds, fruits, vegetables, wholegrains and legumes, as you can tolerate.\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Your body needs vitamins and minerals to work and stay healthy. Having flare ups and gut symptoms can change our tolerance (and sometimes absorption) to certain foods.\u00a0 People with UC should take care to ensure adequate intakes of the following:\u00a0<\/p>\r\n\r\n\r\n\r\n Iron levels can become low due to reduced intake of iron containing foods, problems with absorbing iron, and blood loss in the stools.\u00a0 Try to include regular intakes of iron rich foods such as:\u00a0<\/p>\r\n\r\n\r\n\r\n Consider having a piece of fruit containing vitamin C, or a glass of orange juice, with iron containing foods to help with absorption.<\/p>\r\n\r\n\r\n\r\n Vitamin B12 is found in foods such as:<\/p>\r\n\r\n\r\n\r\n Mostly we get enough Vitamin B12 from our diets (though if you are following a vegan diet you may need to take a supplement).\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Vitamin B12 is absorbed in a part of the gut called the \u2018terminal ileum\u2019.\u00a0 If you have inflammation in this part of your gut, or you have to have it removed, you may need to supplement with Vitamin B12.\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Calcium and Vitamin D play important roles in maintaining healthy bones.\u00a0\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Dairy foods such as milk, cheese and yoghurts contain excellent sources of calcium, as well as being a source of protein and other minerals.\u00a0 If you are following a plant-based diet, or limiting dairy due to symptoms, fortified alternatives such as soya, oat, rice and nut milks are a great source of calcium too.\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Vitamin D is found in foods such as oily fish, eggs, fortified cereals and fortified spreads.\u00a0\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Your IBD team will monitor your bloods and from time to time, you may need to take supplements to help correct any low levels.\u00a0\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n Though diet, or individual foods are never the cause of a flare, making changes to your diet can help ease symptoms.\u00a0 There is no specific diet to follow per se, as often the advice you are given will be based on your symptoms.\u00a0\u00a0<\/p>\r\n\r\n\r\n\r\n You may find it helpful to:<\/p>\r\n\r\n\r\n\r\n If you are having surgery, or you have strictures (narrowings) in your gut, you may be asked to change your diet.\u00a0 It is best to discuss with your Specialist Dietitian, as there really is no \u2018one-size-fits all\u2019 for this. \u00a0In clinic, I like to work with clients and their IBD \/ Surgical teams, to ensure that they have a clear nutritional plan for before, during and after surgery.\u00a0 This may include focus on specific nutrients, use of supplements, liquid diets, or changes to fibre intake.\u00a0<\/p>\r\n\r\n\r\n\r\nTreatment<\/h2>\r\n\r\n\r\n\r\n
Dietary advice<\/h2>\r\n\r\n\r\n\r\n
In remission:<\/h2>\r\n\r\n\r\n\r\n
Be sure to include the following food groups:<\/strong><\/h5>\r\n\r\n\r\n\r\n
Vitamins and minerals:\u00a0<\/strong>\u00a0<\/h5>\r\n\r\n\r\n\r\n
Iron & Folate\u00a0<\/strong><\/h5>\r\n\r\n\r\n\r\n
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Vitamin B12\u00a0<\/strong><\/h5>\r\n\r\n\r\n\r\n
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Calcium<\/strong><\/h5>\r\n\r\n\r\n\r\n
Vitamin D<\/strong><\/h5>\r\n\r\n\r\n\r\n
In a flare up:<\/h2>\r\n\r\n\r\n\r\n
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Surgery & Strictures<\/h2>\r\n\r\n\r\n\r\n
A final note<\/h2>\r\n\r\n\r\n\r\n