Managing Ulcerative Colitis With The Help of a Dietitian Nutritionist

Ulcerative colitis is a type of Irritable bowel disease that can be extremely difficult to manage alone. The intestines are prone to painful ulcers, which cause inflammation in the gut tissues and can lead to diarrhea. Some years can be worry-free, while others can be filled with flare-ups every few months. 

Getting help from an expert, an ulcerative colitis registered dietitian nutritionist, can boost your confidence in managing your health and help you get back on track. They can help you build a lifestyle that keeps your gut happy and your days worry-free; keep reading to learn how!  

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What Is Ulcerative Colitis 

Ulcerative colitis is an inflammatory condition affecting the lining of your large intestine, the colon, and even the rectum. It is a chronic condition that usually gets diagnosed around age 30, but onset can be sooner if there is a family history.¹ 

Fortunately, most people can manage through diet and live symptom-free. During a flare-up, you must make dietary changes and possibly take medications to help the gut settle. These events can be very painful, but your health will eventually return to normal with proper care.² 

A Flare-up Can Have These Symptoms: 

• Cramping in the lower abdomen. 
• Loose stool or diarrhea. 
• Presence of blood and mucus in the stool. 
• Fever may be present. 

If you have any of these symptoms, seek medical help immediately. The condition could worsen, and ongoing diarrhea is fatiguing for the body. 

What is Nutrition Therapy? 

Nutrition therapy is an approach to health management that focuses on diet. An ulcerative colitis dietitian nutritionist can offer interventions or suggest changes to help manage your condition. They can also help you heal your relationship with eating. Getting sick while eating can be traumatizing, and eating those foods again can be anxiety-inducing.

Fear of getting sick again from certain foods can limit your choices, and stripping away entire food groups can open you up to nutrient deficiencies and possibly malnutrition. Anxiety and stress at meal times can worsen your symptoms and prevent your gut from fully healing. Nutrition therapy can help you overcome these fears; it can be life-changing and significantly improve your quality of life. 

A typical nutrition therapy appointment should review the following information: 

• What are your current symptoms? 
• What are your key concerns? 
• How often are they presenting? 
• Have you identified any trigger foods? 
• What to eat with ulcerative colitis. 
• What to eat during a flare-up.
• Are you fearful of eating? 
• Do you feel confident making nutrition choices? 

This list is not extensive; you and your dietitian will review much more information during your sessions. It’s a great idea to write down questions you may have before your appointment. That way, you won’t forget to ask them. 

What to Eat During a Flare-up

A flare-up indicates that your colon is aggravated, and most people endure diarrhea. Your first goal is to limit foods and drinks that could worsen your diarrhea. These are usually products with sugar alcohols (artificial sweeteners), caffeinated drinks, and spicy or high-fat foods. 

Chronic diarrhea can increase your risk of dehydration. Try to choose water as your primary drink of choice whenever possible. You can enhance the appeal of water by adding natural flavor enhancers, such as fresh mint or basil. In the summer, you can also include cut-up pineapple, ginger, and mint leaves. 

Choose low-fiber foods during a flare-up to give your bowels a chance to heal. Boiled and softened vegetables will be your best friend during this time, combined with low-fiber carbohydrates, such as white flour bread. 

Dietitians don’t want you to only choose white bread and pasta indefinitely, only during the healing period. Missing out on whole-grain foods can increase your risk of cancers, diabetes, cardiovascular diseases, and unwanted weight gain.³ 

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What to Eat With Ulcerative Colitis 

During remission, or when you don’t have a flare-up, you should prioritize foods proven to support a thriving gut. These include high-fiber options such as fruits and vegetables, nuts and seeds, legumes, and whole grains. Fiber keeps you regular, stabilizes blood sugars, lowers cholesterol, and nourishes active health-promoting bacteria along your digestive tract. 

A study from 2021 found that Americans who ate low-fat diets with high fiber had better outcomes for ulcerative colitis. After approximately 18 months, participants following this diet reported better quality of life. Their blood work also showed lower levels of inflammatory markers in the blood.⁴ 

The Mediterranean diet is one of the most researched diets in the world. It is rich in fiber, vitamins, and minerals and dissuades ultra-processed foods. This diet can help you prevent a flare-up.⁴ 

Here are some tips on following the Medi Diet: 

• Eliminate processed and ultra-processed foods (chips, store-baked goods, french fries, TV dinners, etc.) 
• Add more vegetables and fruits to your meals. 
• Include whole grains whenever possible. 
• Eat beans three meals per day (chickpeas, kidney beans, black beans, etc.) 
• Avoid sugar-sweetened beverages. 
• Include dairy products if you are not lactose intolerant. 
• Choose olive oil over butter. 
• Pick salmon, trout, and other seafood at least three times a week. 
• Have a handful of mixed unsalted nuts every day.

Pros and Cons of Working with a Dietitian 

Let’s start positively and review the pros of working with a dietitian. 

• Expert advice that is tailored to your health. 
• A soundboard for questions. 
• Virtual options are available. 
• Learn about resources you never knew existed. 
• Achieve results faster. 
• Increased confidence in self-management. 
• All Nourish Dietitians are covered by insurance. 

Working with an ulcerative colitis dietitian nutritionist has limited potential cons. Sometimes people can feel shy or unsure of what to talk about during the first appointment. These nerves are normal, and it can be hard to open up to a stranger. The right dietitian will coach you through the session and help you feel relaxed. 

Plan Ahead 

To get the most out of your time together; you may want to write down your questions before you meet with your dietitian. If you have product-specific questions, you should bring the boxes to your session; this is acceptable and can be a great learning tool. The session's goal is to help you feel more confident about which foods to eat, so if cracker brands have you stumped, just bring both to the meeting and learn which one is better for you. 

Ask your dietitian if they can provide a summary at the end of your appointment. That way, you don’t have to worry about writing everything down during the session, and you can be more present during the discussion. 

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Work With A Registered Dietitian 

Managing a chronic condition is a lifelong commitment. Working with a registered dietitian specializing in IBD and gut health can help you see improvements faster. Together you can create a sustainable plan and ensure that your gut health is thriving and your quality of life remains high. 

Nourish has a team of dietitians who are covered by insurance. Use our directory to find a provider that can help you move forwards. Click here to get started! 

References

1. Kaenkumchorn, T., & Wahbeh, G. (2020). Ulcerative Colitis: Making the Diagnosis. 
2. Adams, S. M., & Bornemann, P. H. (2013). Ulcerative colitis. 
3. Mann, K. D., Pearce, M. S., McKevith, B., Thielecke, F., & Seal, C. J. (2015). Whole grain intake and its association with intakes of other foods, nutrients and markers of health in the National Diet and Nutrition Survey rolling programme 2008-11. 
4. Radziszewska, M., Smarkusz-Zarzecka, J., Ostrowska, L., & Pogodziński, D. (2022). Nutrition and Supplementation in Ulcerative Colitis.