Dietitian and Nutritionist for Ulcerative Colitis Support

Name: JM Nutrition
Price range: $$

JM Nutrition’s dietitian and nutritionist for ulcerative colitis provides personalized strategies and tailored meal plans to help with management and help reduce associated symptoms. Schedule an appointment today!

JM Nutrition Dietitians on Ulcerative Colitis Support

Important information on Ulcerative Colitis management by our registered dietitians:

What is ulcerative colitis?

Ulcerative Colitis (UC) is the other main subtype of Inflammatory Bowel Disease (IBD). It also involves inflammation of the gastrointestinal (GI) tract, but specifically targets the large intestine (colon)–including the rectum and anus.

Like with Crohn’s Disease (CD), the other subtype of IBD, Ulcerative Colitis is an autoimmune disorder that involves therapeutic management, including medicinal management (i.e. steroids, biologics, anti-inflammatory medications, etc.), surgical management (in severe cases) and dietary management with the help of a dietitian.

Colitis interventions vary

Ulcerative Colitis can vary in severity between individuals.

Some may go their whole diagnosis without needing significant medical intervention, while some may be on medication(s) long-term, and potentially even require surgical procedures to remove severely affected and damaged areas of their colon.

Because Ulcerative Colitis targets the colon in particular, where most electrolyte and water reabsorption occurs, dehydration is very common in a flare-up state.

There are three main states that someone with colitis can be in, which dictates the intensity of intervention.

1. Remission state: when there is no active (or very little) inflammation present in the colon, rectum or anus. Someone with colitis in a remission state would be asymptomatic (or have minor symptoms), their inflammatory markers as per bloodwork would be within normal range, and colonoscopies (or other imaging) would not find any active sites of inflammation. There are typically no major dietary restrictions involved, or impact to quality of life/day-to-day function in this state.

2. Flare-up state: when there is active inflammation present in part(s) of the colon. Inflammatory markers in bloodwork would be high, and colonoscopies would find variable levels of active inflammation. Those in a flare-up state would be symptomatic, and their diet and quality of life would be impacted to some degree. In the peak of a colitis flare-up, symptoms often consist of unintentional weight loss, cramping (specifically in the lower left abdomen), and frequent, urgent loose stools, which may or may not contain blood (hematochezia) and/or mucus. Tenesmus, the urge to pass a bowel movement, despite the bowels being empty is a common UC symptom as well.

Our dietitians note that, for some, symptoms of colitis are less obvious and can affect people more indirectly.

For example, they may develop fatigue or anemia related to blood loss in stool. They might experience other symptoms of immune distress, such as joint pain or skin reactions2.

3. In-between state: when you are coming out of a flare-up of Ulcerative Colitis and working towards remission. Severe symptoms and inflammation have typically improved in this state, but not fully resolved. As a result, there are usually lingering symptoms and dietary adjustments that need to be made. Inflammation is typically still present, whether it be seen in bloodwork and/or imaging. This is typically the state where we start to work towards weight restoration, if relevant.

As a result, it may be important to seek the services of a dietitian who can provide guidance around ulcerative colitis management via dietary interventions.

How can a dietitian and nutritionist help manage Ulcerative Colitis?

As a result of these factors, the dietary management of colitis is individualized. It is also important to note that dietary adjustments on their own, are generally not enough to treat Ulcerative Colitis.

That said, our dietitians and nutritionists can help manage colitis in a number of ways:

Flare-up state management:

When the most dietary adjustments are made. For many, especially those experiencing persistent diarrhea, hematochezia, cramping, etc., a low-residue (low-fibre) diet is implemented by the dietitian.

If a flare-up is severe enough to warrant hospitalization, then a liquid diet would be started before a low-residue diet. For some, however, flare ups can even warrant the need for enteral nutrition (tube feeding) or parenteral nutrition (IV feeding), although this is more common with Crohn’s Disease.

Once a low-residue diet is tolerated, typically assisted by medical intervention, then the dietitian and nutritionist ofr ulcerative colitis would gradually work towards a ‘remission’ diet. Evidence suggests that some people with UC can better manage their symptoms by avoiding inflammatory foods, such as sugar, alcohol and red meat.

Some find their symptoms improve with the support of a low-FODMAP diet as well.

Gluten-free and/or dairy/lactose-free diets can be helpful in some cases as well.

Remission state management:

When the least dietary adjustments are made. Because Ulcerative Colitis is an autoimmune disorder, we often try to work towards some version of an anti-inflammatory diet, such as the Mediterranean Diet to help retain remission.

Foods that increase inflammation (i.e. sugar, ultra-processed foods, fried foods, sugar, red meat, etc.) have been shown to increase the frequency of flare-ups.

Some may require modifications to their anti-inflammatory diet, if perhaps they have gluten, dairy/lactose and/or FODMAP sensitivities.

Fibre modifications may have to be made by the dietitian if a colitis flare-up or surgery has resulted in scarring and narrowing of certain sections of the colon or a colostomy bag.

In-between state management:

Often involves a hybrid of a flare-up and remission diet. Dietary restrictions are often not as strict, but because there are some ongoing symptoms experienced in this state, restrictions are typically gradually phased out while we work towards an anti-inflammatory diet.

When tolerated, foods rich in soluble fibre are introduced first, before graduating to foods with a higher insoluble fibre content. Our dietitians note that research suggests that high-fibre intake can prevent the recurrence/frequency of Ulcerative Colitis flare-ups.

Our dietitians for Ulcerative Colitis can also help as follows:

There are some probiotics that have been researched to support the management of UC as well as remission. A registered dietitian (RD) can walk you through whether a probiotic is a supplement that might be beneficial to you.
Because there are many elements that contribute to the management of colitis in each person, working with a dietitian to develop a strategy and plan tailored to your personal needs and situation can be extremely valuable.
A colitis dietitian and nutritionist can also carefully assess your current diet and suggest areas for improvement.
Develop a personalized meal plan to help manage colitis.
Make recommendations for food product substitutions or similar products, if available.
Provide follow-up sessions to modify the meal plan, if or when needed.
Work in conjunction with your doctor.
Address related or co-existing conditions.
And more.