Diet Choices to Eat and Avoid for Ulcerative Colitis Symptoms in the United States

How diet fits into ulcerative colitis care

Ulcerative colitis (UC) is an inflammatory disorder of the colon managed mainly with medical treatments and sometimes surgery. Diet does not cause UC, but clinical guidelines and recent reviews 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 an individual’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 favor plant-forward and Mediterranean-style eating patterns for long-term gut health and supporting remission. These emphasize whole, minimally processed foods and healthy fats.

• Vegetables and fruit (in forms you tolerate)
• In remission: aim for a variety of colorful vegetables and fruits to boost fiber, antioxidants, and important micronutrients.
• During a flare: choose well‑cooked, peeled vegetables and canned fruits without seeds to limit mechanical irritation.
• Legumes and pulses (beans, lentils)
• Linked in population studies with protective effects; can substitute for red and processed meats as protein sources.
• Whole grains (when tolerated)
• Supply fiber and prebiotic nutrients; reintroduce gradually as inflammation improves.
• Tea (regular tea consumption has been associated with protective effects)
• Olive oil and other unsaturated fats
• Preferred over margarine and heavily processed fats.
• Fish and poultry, plant-based proteins
• Swapping red/processed meat for fish, poultry, or legumes is associated with lower relapse risk in some studies.
• Probiotics (as an adjunct)
• Certain probiotic formulations may help some people with UC when used alongside medical therapy; discuss strain, dose and timing with your clinician.

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

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

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

• Red and processed meats
• Includes beef, processed deli meats, hot dogs and sausages. Associated with higher incidence and relapse risk in several studies.
• Ultra‑processed foods and convenience items
• Packaged, highly processed foods are linked to dysbiosis and worse outcomes.
• Margarine and some hydrogenated/industrial fats
• Tied to higher disease risk in population studies; replace with olive oil where possible.
• Alcohol
• Regular alcohol intake 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 linked to microbiome disruption and increased inflammation in lab and some human studies.
• Very high intakes of certain fats or single nutrients
• Some studies show 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—lowering stool volume and mechanical irritation can reduce symptoms. Use short-term low-residue choices under clinical supervision:

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

Important: Low-residue/low-fiber diets are intended for short periods during moderate–severe flares and should be stepped back to more fiber-containing foods as inflammation resolves to maintain long‑term gut health.

Foods to reintroduce gradually after a flare

After symptoms and inflammation are controlled, slowly reintroduce fiber and a broader variety of plant foods to assess tolerance and find individual triggers:

• Begin with cooked vegetables and soft fruits, then move to raw produce as tolerated
• Gradually add whole grains, legumes, and seeds
• Keep a diary of reactions and share observations with your care team

Practical strategies: how to find what works for you

• Keep a daily food-and-symptom diary
• Note meals, portion sizes, timing, bowel symptoms, and any medication changes. Use the log 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
• Lowers 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 customize a plan for nutrition adequacy, symptom control, and safe reintroduction of fiber.
• Consider probiotics only with professional guidance
• Ask your GI or dietitian about evidence-backed strains, doses and how to combine them with medications.

Foods and nutrients with mixed or preliminary evidence

Some items show inconsistent results across studies or only animal-model support. Use moderation and clinical judgment:

• Eggs: animal studies show anti-inflammatory components, but human evidence is inconsistent. Eggs can be included unless you have a personal intolerance.
• Specific fatty acids: the effects of high intake of certain fats (myristic acid, very high ALA) are not settled—avoid very large supplemental intakes without clinician input.
• Specialized diets (AID, Mediterranean, low-FODMAP, SCD, 4-SURE)
• Some dietary interventions (Anti‑Inflammatory Diet, Mediterranean) have promising data; others need more research. No single diet is proven to induce or maintain remission for all patients—individualization is essential.

Working with your medical team

Dietary approaches are an adjunct to medical care, not a substitute. Always:

• Discuss planned major diet changes with your gastroenterologist and an IBD dietitian
• Coordinate low-residue therapy during active disease with clinical management
• Use dietary changes alongside 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 share it at clinic appointments.
• Favor a plant‑forward or Mediterranean-style pattern in remission.
• Reduce red/processed meats, ultra‑processed foods, margarine and alcohol.
• Avoid products with 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 starting them.
• Reintroduce fiber gradually as inflammation resolves.

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.