Foods to Include and Avoid 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 managed mainly with medications and, in some cases, surgery. Diet does not cause UC, but clinical guidance and research (including recent reviews and guideline updates) indicate that dietary choices can affect symptoms, the gut microbiome, and relapse risk. As of 2025, evidence supports using dietary patterns as an adjunct to medical treatment—tailored 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 support plant-forward and Mediterranean-style patterns for long-term gut health and remission support. 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 essential micronutrients.
• During a flare: choose well-cooked, peeled vegetables and canned fruits without seeds to limit mechanical irritation.
• Legumes and pulses (beans, lentils)
• Population studies associate these with protective effects; they are useful as alternatives to red and processed meats.
• Whole grains (when tolerated)
• Provide fiber and prebiotics; reintroduce gradually after inflammation subsides.
• Tea (regular tea consumption has been linked to protective effects)
• Olive oil and other unsaturated fats
• Prefer these over margarine and heavily processed fats.
• Fish and poultry, plant-based proteins
• Replacing red/processed meat with fish, poultry, or legumes is linked to 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 food choices should be individualized.

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

Population data 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
• This includes beef, deli meats, hot dogs, and sausages. Several studies link them to 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
• Population studies link these with higher disease risk; use 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 watch 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 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 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 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 assess tolerance and identify personal triggers:

• Start with cooked vegetables and soft fruits, then move toward raw produce as tolerated
• Gradually add whole grains, legumes, and seeds
• Keep a diary of responses 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 regularly and bring it to appointments to help pinpoint individual triggers.
• Read ingredient labels
• Steer clear of 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 heavy animal-protein patterns
• Work with an IBD-trained dietitian
• They can design a plan for nutrition adequacy, symptom control, and safe fiber reintroduction.
• 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 foods show inconsistent effects across studies or only have animal-model data. Use moderation and clinical judgment:

• Eggs: animal studies indicate anti-inflammatory components, but human data are inconsistent. Include eggs unless you have a personal intolerance.
• Specific fatty acids: the effects of high intakes of certain fats (myristic acid, very high ALA) are unresolved—avoid very large supplemental doses without clinician advice.
• Specialized diets (AID, Mediterranean, low-FODMAP, SCD, 4-SURE)
• Some approaches (Anti‑Inflammatory Diet, Mediterranean) show promise; others need more evidence. No single diet is proven to induce or maintain remission for everyone—individualize care.

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
• Combine dietary changes with prescribed medications and follow-up testing as recommended
• Monitor nutritional status and check 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 visits.
• Favor a plant‑forward or Mediterranean-style pattern in 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.