What is ulcerative colitis?

Ulcerative colitis is a chronic inflammatory disease that is limited to the mucosal layer of the colon and rectum. The cause is unknown, and although is does not have a hereditary component, there may be an increased occurrence in some families. The bowel lining becomes ulcerated, usually extending initially up from the lower end of the colon. The symptoms include diarrhea, blood in stool, cramping, fever, and/or weight loss.


How is it diagnosed?

Ulcerative colitis is diagnosed by clinical, colonoscopic, and histologic examinations. A colonoscope/sigmoidoscope is inserted into the large bowel and then a sample biopsy confirms the diagnosis. Clinical symptoms and blood tests can help to assess the blood losses and nutritional deficiencies in patients.


How is ulcerative colitis treated?

Ulcerative colitis is treated with medication and occasionally surgically. To reduce inflammation, medications like sulfasalazine, mesalamine, olsalazine, and corticosteroids are often used. Other medications that may be effective are budesonide, azathioprine and some antibiotics. People who have a severe case that cannot be medically treated may require surgery to remove part (or all) of their large bowel.


What are the diet recommendations for ulcerative colitis?

  1. People with ulcerative colitis often suffer from iron deficiency resulting from blood losses. This can be corrected with iron supplements or by eating high iron foods such as liver, beef, turkey, lamb, tofu, spinach, molasses, oatmeal, and eggs.
  2. Adequate fluids and low fibre foods may be of benefit in treating the diarrhea.
  3. Stimulants and irritants should be avoided according to individual tolerances, e.g. fatty foods, caffeine, spicy foods and/or bran products.
  4. Parenteral nutrition and elemental diets have not been shown to be more effective than an oral diet in preventing surgery or promoting remission.


Low Fibre Foods

Breads and Cereals (serving size: 1 slice or 1/2 cup)
Arrowroot cookie(2), Bagel, Bread (white, whole wheat, raisin, multigrain, pita), Cheerios, Cornflakes, Oatmeal, Pasta, Puffed Wheat, Rice (white, brown), Rice Krispies, Special K, Total
Fruits (serving size: 1 small or 1/2 cup)
Apple, Apricot, Banana, Cantaloupe, Cherries, Fruit salad (canned), Grapefruit, Grapes, Honeydew melon, Juice, Mandarin orange, Mango, Peach, Plum, Pineapple, Strawberries, Tangerine
Vegetables (serving size: 1 small or 1/2 cup)
Artichoke, Asparagus, Bean Sprouts, Beets, Cabbage, Cauliflower, Celery, Cucumber, Lettuce, Mushrooms, Onion, Potato, Green Pepper, Radish, Summer Squash, Tomato



Many people with ulcerative colitis can experience remission from their disease and do not need to follow a special diet at that time. Medication is the primary treatment during periods of active disease and diet can help alleviate some of the symptoms. Consult your physician if you have any further questions about ulcerative colitis.

Mary Flesher, Clinical Dietitian, The Richmond Hospital
First published in the Inside Tract® newsletter issue 142 – March/April 2004