Inflammatory Bowel Disease (IBD) is a chronic autoimmune disorder affecting many 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 specific dietary components that can be helpful during the healing process.
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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 comprises 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 severe. While there is no 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 directly and indirectly to UC outcomes and 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. Fiber restriction is not routinely recommended unless strictures or intestine narrowing are present. Focusing on well-tolerated foods during an active flare is best 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 an excellent tool for understanding 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 well-tolerated foods 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 improve clinical illness and patients' quality of life.
A great American College Gastroenterology (ACG) video, "Ulcerative Colitis: A Guide for Patients."
Personally from Rebecca
As a Registered Dietitian with ulcerative colitis, I focus on a minimally processed diet with a moderate to high fiber intake as tolerated. Sometimes, 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 walk 5-6 times weekly 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.
Personally
I eat a high-fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.
"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"
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