Managing digestive symptoms when you have ulcerative colitis

If you have ulcerative colitis that is largely under control, small changes to your diet may help to maintain remission and manage other digestive symptoms like bloating.

Ulcerative colitis is an inflammatory bowel disease (IBD). The result of the colon and rectum becoming inflamed and creating ulcers in their lining. These can become irritated, or inflamed. Chronic diarrhoea is a common symptom, along with blood or mucus in your stool (always important to get checked out by your doctor). Many people experience fatigue and even weight loss.

Some experts think ulcerative colitis is an autoimmune condition, while others posit that environment plays a role – for example, many people with ulcerative colitis recall their illness starting with a stomach bug after travelling. Using ibuprofen regularly and high stress levels can make symptoms worse.

Medication and surgery are the most common medical approaches for ulcerative colitis. When your condition is in remission, a healthy diet may help prevent it from flaring up again and it will also ensure that you are getting the vitamins and minerals you need. It's important to find a balanced diet that works for you, but that can be difficult to do by yourself. And you may still experience frustrating digestive symptoms, for example bloating.

Here's an insight to how I help my clients with inactive ulcerative colitis manage frustrating digestive symptoms.

• Try to minimise dietary triggers of diarrhoea, including coffee, tea and high-fat foods. Eat smaller meal portions, spread across the day.

• If you’re having a flare-up, a temporary low fibre diet can help. Your GP or consultant will advise you on this. It's important to reintroduce fibre when you are able to, as it is important for digestive health (including reducing your risk of bowel cancer). I guide my clients to find the right type and amount of fibre for them, once their doctor gives the all-clear.

• Reducing alcohol, dried fruit, dairy and meat may help, by reducing hydrogen sulphide in the diet. This is a gas that can contribute to inflammation of the gut lining. I support people to trial a temporary reduction of these these foods, while enjoying tasty and nutritious alternatives.

• Early studies show that curcumin (found in turmeric) may help reduce flare-ups, and that probiotic supplements may support ulcerative colitis in remission. I provide guidance on evidence-based, appropriate and safe supplementation, in partnership with your doctor.

• Recent research has identified a link between the low FODMAP diet and a reduction in bloating and wind in people with inactive/in remission ulcerative colitis. It’s important to try this diet under guidance, as it can reduce your good gut bacteria levels if done long-term.

  
  

Everyone is different, but generally I recommend working together over a 3-6 month period to help you manage day-to-day digestive symptoms and feel confident keeping up beneficial changes. If you have inflammatory bowel disease, including ulcerative colitis or Crohn's, that is inactive or in remission, email me to book a complementary call and discuss how I might be able to support you as part of your coordinated care. A personalised approach to dietary changes can keep you motivated and ensure you're following the right advice for your body.

Originally written for Womens' Health magazine online.