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 managed with medications and, in some cases, surgery. Diet does not cause UC, but clinical guidance and research—including recent reviews and guideline updates—show that food choices can affect symptoms, the gut microbiome, and relapse risk. As of 2025, evidence supports using dietary patterns alongside medical therapy, personalized to 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 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 range of colorful vegetables and fruits to boost fiber, antioxidants, and 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 with protective effects; useful as protein substitutes for red and processed meats.
• Whole grains (when tolerated)
• Provide fiber and prebiotic nutrients; reintroduce gradually once inflammation subsides.
• Tea (regular tea consumption has been linked to protective effects)
• Olive oil and other unsaturated fats
• Preferred instead of 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 frameworks; specific choices should be individualized.

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

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

• Red and processed meats
• Includes beef, processed deli meats, hot dogs and sausages. Several studies link these with higher incidence and relapse risk.
• Ultra‑processed foods and convenience items
• Packaged, highly processed foods are associated with dysbiosis and worse outcomes.
• Margarine and some hydrogenated/industrial fats
• Associated with higher disease risk in population studies; swap for olive oil where 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 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—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 (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 brief periods during moderate–severe flares and should be transitioned back to more fiber-containing foods as inflammation resolves to support long‑term gut health.

Foods to reintroduce gradually after a flare

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

• Begin with cooked vegetables and soft fruits, then work toward raw produce as tolerated
• Slowly add whole grains, legumes, and seeds
• Record responses in a diary and share findings 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 medication changes. Use the log continuously and bring it to clinic visits to help spot 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 tailor 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 integrate them with medications.

Foods and nutrients with mixed or preliminary evidence

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

• Eggs: animal studies suggest anti-inflammatory components, but human evidence is inconsistent. Eggs can be included 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 input.
• Specialized diets (AID, Mediterranean, low-FODMAP, SCD, 4-SURE)
• Some interventions (Anti‑Inflammatory Diet, Mediterranean) show promise; others need more research. No single diet is proven universally to induce or maintain remission for all patients—individualization matters.

Working with your medical team

Dietary measures complement medical care; they are 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.