Your Fall Food and Drink Guide for Ulcerative Colitis
Autumn brings dazzling foliage, cozy sweaters, wood-burning fires, and pumpkins, too. It also signals the return of savory comfort foods and spicy drinks. But people who have ulcerative colitis (UC)—an autoimmune-related condition in which the immune system mistakenly attacks the lining of the colon—might find that some of their favorite, festive fall foods trigger unwanted symptoms. And no one wants to associate diarrhea and rectal bleeding with the arrival of Thanksgiving! Here are some expert tips for deciding which fall foods to choose (and which ones to lose) to keep your UC under control.
What Causes UC?
According to research, about 1 million adults in the U.S. have this chronic condition—and there’s no cure. Eating a specific diet isn’t believed to cause UC. It’s likely the result of a complex interplay of genetics, environmental exposures, diet, and the intestinal bacterial environment, a.k.a., the microbiome. “We suspect rising rates of UC in developing countries are related to changes in diet and behavior, but we don’t yet know how to prevent it,” says Simon Hong, M.D., a gastroenterologist at NYU Langone’s Inflammatory Bowel Disease Center. Making dietary changes, however, may help control symptoms.
What Are The Symptoms of UC?
The main symptoms of UC are diarrhea, rectal bleeding, and abdominal pain. “You may also feel an increased urgency to defecate, have a sensation of incomplete defecation, or have weight loss,” says Dr. Hong. He points out that it’s important to not confuse UC with irritable bowel syndrome (IBS), in which you can have abdominal pain, diarrhea and bloating, but not active inflammation of the bowel—so there’s generally not the same rectal bleeding or urgency. Other symptoms of UC are fever, fatigue, and night sweats, per the CDC.
What Is the Diet-UC Connection?
Although there’s a lot of existing research on the relationship between food and UC, no one diet has been shown to consistently reduce the underlying inflammation that’s found in adults with this condition. (Also, foods that trigger symptoms in one person may be perfectly fine for someone else.) Some studies suggest that UC flares are associated with the consumption of red or processed meat, dairy products, coconut oil, palm oil, artificial sweeteners, and/or certain food additives. However, “avoiding these foods may help improve symptoms of the disease, but reducing actual inflammation is best achieved with medical therapies,” advises Dr. Hong.
Identify Your Own Food Triggers Before the Big Feast
As a general rule, every person with UC is different. “Patients may have very specific food triggers that cause their disease to flare, so keeping a food diary and doing an elimination diet can be helpful,” says Dr. Singh. You might also find it helpful to work with a dietitian to identify what foods seem to worsen your UC symptoms, and which ones can be reintroduced without exacerbating them. If you start tracking this info now, you might know what you can—and can’t—safely consume before the next fall event arrives.
Forget Fall Foods That Are High in FODMAPs
Restricting FODMAPS, a.k.a. foods that are high in fermentable oligo-, di-, mono-saccharides and polyols (which is just a fancy way of saying cutting out certain carbs and sugar alcohols that are often poorly absorbed by the GI tract), may help alleviate UC symptoms, says Dr. Hong. Examples of foods that are high in FODMAPS that you might encounter at a fall celebration include apples, honey, high-fructose corn syrup, custard, dairy, soft cheeses, asparagus, broccoli, beans, and mushrooms, says Dr. Hong.
Set an Autumnal Table With Low-FODMAP Fare
If you stick to Dr. Hong’s approach of avoiding FODMAPs, foods that should be well-tolerated include carrots, celery, squash, turkey, almond milk, oat milk, maple syrup, and hard cheeses—not a bad list of ingredients for Thanksgiving! Many folks with UC can tolerate small amounts of bananas, blueberries, pumpkins, and sweet potatoes, too, he adds. In other words, your favorite fall side dishes (like stuffing and roasted veggies) don’t have to be totally off the menu. P.S.: The Crohn’s & Colitis Foundation says a low-FODMAP diet may relieve gas and bloating, although it won’t prevent a flare.
Skip Hot Peppers but Spice Up Fall Meals With Other Garnishes
When thinking of Thanksgiving and you can almost smell the sage. When it comes to UC, most spices are okay, but Dr. Hong suggests avoiding particularly spicy foods, including anything with hot peppers. That means you can add flavor to traditional holiday dishes with a range of pantry staples: Add oregano to your chicken dish, garnish your fish with sprigs of thyme, jazz up your roasted carrots with grated ginger, and pop a cinnamon stick in your stew.
A Little UC Indulgence Goes a Long Way This Time of Year
Since fall kicks off the holiday season, it’s typically a time of over-indulgence, especially when it comes to extra portions or delicious desserts. To help keep UC symptoms under control, Hardeep Singh, M.D., a gastroenterologist with St. Joseph Hospital in Orange, CA, suggests avoiding—or at least seriously minimizing—sweets, fried fare, and foods high in saturated fats (like red meat and whole-fat dairy products). Stick to lean proteins like chicken (without the skin) and fish, served with rice or potatoes.
Drinking in Moderation Is Fine if You Have UC
If you like to have a glass of wine or beer with family and friends over a heated fall football match or a festive holiday dinner, you probably don’t need to worry about your UC symptoms flaring. There’s no evidence that alcohol increases UC flares, Dr. Hong says (although moderate drinking, meaning just one glass per day for women, and no more than two for men, is best for your health). If boozing is a trigger for you, stick to alcohol-free versions of your top tipples.
Cut Down on Caffeine (or Maybe Consider Decaf)
If caffeine triggers your UC symptoms—and you certainly wouldn’t be alone in that!—you might want to rethink that post-dinner coffee. “Caffeine is a natural irritant to the GI tract and can cause gas, bloating, and diarrhea,” Dr. Singh adds. But you don’t have to forgo your Thanksgiving cup of joe altogether—brew some decaf instead. If you’re a tea drinker, decaf black tea is your friend, and some herbal teas, like ginger and peppermint, can actually help settle your stomach if you’ve enjoyed one too many helpings.
Prevalence of IBD/UC: Centers for Disease Control and Prevention (CDC). (2020.) “Inflammatory Bowel Disease (IBD).” cdc.gov/dotw/ibd/index.html
UC Symptoms: Centers for Disease Control and Prevention (CDC). (2020.) “Inflammatory Bowel Disease (IBD).” cdc.gov/dotw/ibd/index.html
Low-FODMAP Diet: Crohn’s & Colitis Foundation. (n.d.) “Special IBD Diets.” crohnscolitisfoundation.org/diet-and-nutrition/special-ibd-diets