Foods to Include and Limit for Ulcerative Colitis Symptoms in the United States

How diet fits into ulcerative colitis care

Ulcerative colitis (UC) is an inflammatory disease of the colon primarily treated with medications and, in some cases, surgery. Diet is not a cause of UC, yet clinical guidance and research (including recent reviews and guideline updates) indicate that food choices can affect symptoms, the gut microbiome, and relapse risk. As of 2025, evidence supports using dietary patterns as a complement to medical therapy—customized to each person’s disease activity, tolerances, and nutritional needs.

Key practical principle: coordinate any major dietary changes with your gastroenterology team and, ideally, an IBD-trained dietitian.

Foods commonly recommended to include (helpful patterns)

Population studies and clinical trials back plant-forward and Mediterranean-style eating for long-term gut health and supporting remission. These patterns emphasize whole, minimally processed foods and healthy fats.

• Vegetables and fruit (in forms you tolerate)
• In remission: aim for a range of colorful vegetables and fruits to boost fiber, antioxidants, and beneficial micronutrients.
• During a flare: choose well-cooked, peeled vegetables and canned fruits without seeds to lower mechanical irritation.
• Legumes and pulses (beans, lentils)
• Linked in population studies to protective effects; useful as protein alternatives to red and processed meats.
• Whole grains (when tolerated)
• Provide fiber and prebiotics; reintroduce gradually after inflammation subsides.
• Tea (regular consumption has been associated with protective effects)
• Olive oil and other unsaturated fats
• Prefer these over margarine and heavily processed fats.
• Fish and poultry, plant-based proteins
• Substituting red/processed meat with fish, poultry, or legumes is associated with lower relapse risk in some studies.
• Probiotics (as an adjunct)
• Specific probiotic formulations may help some people with UC when used alongside medical therapy; consult your clinician about strain, dose, and timing.

Note: “Plant-forward” and Mediterranean patterns are broad frameworks; specific food choices should be individualized.

Foods and ingredients commonly linked to worse outcomes or higher relapse risk

Population research and mechanistic studies point to several food groups and additives tied to higher UC risk or relapse. Limiting or avoiding these may reduce inflammatory triggers.

• Red and processed meats
• Includes beef, deli meats, hot dogs, and sausages. Several studies associate these with higher incidence and relapse risk.
• Ultra‑processed foods and convenience items
• Packaged, highly processed products are linked to dysbiosis and poorer outcomes.
• Margarine and some hydrogenated/industrial fats
• Population studies associate these with higher disease risk; opt for olive oil when possible.
• Alcohol
• Regular alcohol use has been associated with increased relapse risk in some studies; cutting back or avoiding alcohol may help.
• Food additives to read labels for and avoid when possible
• Maltodextrin, certain artificial sweeteners (e.g., sucralose-type), and carrageenan have been tied to microbiome disruption and increased inflammation in lab and some human studies.
• Very high intakes of certain fats or single nutrients
• Some research shows mixed or preliminary links between myristic acid or very high alpha‑linolenic acid (ALA) intake and relapse risk — discuss supplement-level intakes with your clinician.

What to eat during active flares (short-term, symptom-focused)

When UC is active—especially with frequent bleeding, urgent diarrhea, or severe cramping—reducing stool volume and mechanical irritation can relieve symptoms. Use short-term low-residue choices under clinical supervision:

• Refined grains: white rice, refined breads, plain pasta
• Well‑cooked, peeled vegetables (avoid skins and seeds)
• Canned fruit without seeds or peels
• Lean proteins: well-cooked chicken, fish, eggs
• Plain low‑fat dairy if tolerated (or appropriate alternatives if intolerant)
• Avoid raw vegetables, seeds, nuts, corn, and high-fiber raw fruit until inflammation improves

Important: Low-residue/low-fiber diets are designed for brief periods during moderate–severe flares and should be phased back to more fiber-containing foods as inflammation settles to support long‑term gut health.

Foods to reintroduce gradually after a flare

After symptoms and inflammation are controlled, slowly reintroduce fiber and a wider range of plant foods to assess tolerance and identify individual triggers:

• Begin with cooked vegetables and soft fruits, then move toward raw produce as tolerated
• Gradually incorporate whole grains, legumes, and seeds
• Keep a diary of responses and review findings with your care team

Practical strategies: how to find what works for you

• Keep a daily food-and-symptom diary
• Log meals, portion sizes, timing, bowel symptoms, and any medication changes. Use it continuously and bring it to clinic visits to help pinpoint individualized triggers.
• Read ingredient labels
• Avoid products listing maltodextrin, carrageenan, or artificial sweeteners if you react to processed foods.
• Cook more whole foods at home
• This reduces exposure to hidden additives and ultra‑processed ingredients.
• Replace red/processed meats with fish, poultry, legumes, or plant-based proteins
• Limit alcohol and high‑animal-protein patterns
• Work with an IBD-trained dietitian
• They can create a plan for nutritional adequacy, symptom control, and safe fiber reintroduction.
• Consider probiotics only with professional guidance
• Ask your GI or dietitian about evidence-based strains, doses, and how to use them with medications.

Foods and nutrients with mixed or preliminary evidence

Some items show inconsistent results across studies or are backed mainly by animal data. Use moderation and clinical judgment:

• Eggs: animal data suggest anti-inflammatory components, but human evidence is mixed. Include eggs unless you have a personal intolerance.
• Specific fatty acids: effects of high intake of certain fats (myristic acid, very high ALA) remain unsettled—avoid very large supplemental doses without clinician advice.
• Specialized diets (AID, Mediterranean, low-FODMAP, SCD, 4-SURE)
• Certain diets (Anti‑Inflammatory Diet, Mediterranean) show promise; others need more research. No single diet has been proven to induce or maintain remission for everyone—individualization is essential.

Working with your medical team

Dietary approaches are adjuncts to medical treatment, not replacements. Always:

• Discuss major diet changes with your gastroenterologist and an IBD dietitian
• Coordinate low-residue therapy during active disease with clinical care
• Use dietary changes together with prescribed medications and recommended follow-up testing
• Monitor nutritional status and screen for deficiencies when foods or groups are restricted

Summary checklist to start using today

• Start a daily food-and-symptom diary and bring it to clinic appointments.
• Favor a plant‑forward or Mediterranean-style pattern during remission.
• Cut back on red/processed meats, ultra‑processed foods, margarine, and alcohol.
• Avoid products containing maltodextrin, carrageenan, and certain artificial sweeteners when possible.
• Use short-term low‑residue diets during moderate–severe flares under clinician supervision.
• Consult an IBD-trained dietitian and discuss probiotics before beginning them.
• Reintroduce fiber gradually as inflammation improves.

Sources

• Mayo Clinic — Ulcerative colitis: diagnosis and treatment (Mayo Clinic patient information)
• Cleveland Clinic — Colitis overview and management
• Kakhki et al., “Dietary content and eating behavior in ulcerative colitis: a narrative review and future perspective,” Frontiers/PMC (2024–2025 review)

Note: This article summarizes general findings from clinical reviews and population studies as of 2025. Individual responses to foods vary; dietary choices should be personalized in partnership with your gastroenterology team and a registered dietitian.