Dante Carrillo
Proctitis is an inflammatory bowel disease (IBD) that affects the digestive tract. While there is no specific diet to prevent or treat proctitis, certain foods can help manage symptoms and minimise flare-ups. It is important to note that trigger foods vary from person to person, and a registered dietitian should be consulted for personalised dietary advice. Generally, a diet rich in omega-3 fatty acids, lean proteins, probiotics, soluble fibre, and low-lactose or lactose-free dairy alternatives is recommended. Spicy, high-fibre, and insoluble fibre-rich foods, as well as solid fats, are often restricted to reduce inflammation and manage symptoms. Keeping a food journal can help identify individual trigger foods and fine-tune a diet plan that works best for managing proctitis.
Diet for Ulcerative Colitis
| Characteristics | Values |
|---|---|
| Fibre | Soluble fibre is good, insoluble fibre may irritate the colon. |
| Dairy | Some people are unable to tolerate lactose, especially during flare-ups. |
| Fatty acids | Omega-3 fatty acids have an anti-inflammatory effect. |
| Whole grains | May be restricted during flare-ups. |
| Lean protein | May help reduce symptoms. |
| Fruits and vegetables | May help to eat peeled fruits and cooked vegetables. |
| Spicy foods | May trigger symptoms. |
| Solid fats | Should be avoided. |
| Alcohol | Consumption should be decreased. |
| Caffeine | May increase stool output. |
| Water | Should be consumed throughout the day. |
| Meal frequency | Smaller, more frequent meals are better tolerated. |
| Meal preparation | Avoid frying food, consider grilling, steaming, baking, or poaching. |
| Food journal | Keeping a food journal can help identify trigger foods. |
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What You'll Learn
- A low-residue diet can help relieve abdominal pain and diarrhoea
- Avoid insoluble fibre, which speeds up bowel movements and irritates the colon
- Consume adequate calcium, vitamin D, probiotics and prebiotics
- Limit added fats and oils, and focus on consuming wholesome foods
- Keep a food diary to help identify food triggers
A low-residue diet can help relieve abdominal pain and diarrhoea
A low-residue diet is often recommended for people with inflammatory bowel diseases (IBD) like Crohn's disease or ulcerative colitis, as well as other gastrointestinal conditions such as diverticulitis. The diet aims to reduce painful symptoms by decreasing the size and frequency of bowel movements. This is achieved by limiting indigestible materials in the food you eat, specifically dietary fibre, which ends up in the large intestine as residue after digestion.
The low-residue diet is not a long-term solution and should only be followed under the supervision of a healthcare professional. It is typically used as a short-term option to manage symptoms like abdominal pain and diarrhoea. The diet is particularly helpful during heightened or acute episodes of abdominal pain, infection, or inflammation.
To follow a low-residue diet, you will need to avoid high-fibre foods and other indigestible materials, such as raw fruits and vegetables, nuts, seeds, and whole grains. Instead, opt for softer, cooked fruits and vegetables, lean meats, and dairy products. Examples of low-residue foods include:
- White bread, white rice, and grits
- Canned or well-cooked fruits and vegetables without peels or seeds, such as peeled apples, seedless grapes, bananas, and cantaloupe
- Certain cooked vegetables, including beets, beans, carrots, cucumbers, eggplant, mushrooms, spinach, and squash
- Lean meats, such as ground or tender beef, chicken, and turkey
- Seafood
- Dairy products like milk, yoghurt, and cheese (hard cheese may be better tolerated than soft cheese)
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Avoid insoluble fibre, which speeds up bowel movements and irritates the colon
Dietary fibre is divided into two types: soluble and insoluble. While soluble fibre is easily digested and helps produce soft stools, insoluble fibre is hard to digest and speeds up bowel movements, irritating the colon. Insoluble fibre is found in foods such as high-fibre cereals (e.g. bran flakes, shredded wheat), sweetcorn, mushrooms, onions (especially raw), broccoli, cabbage, and the skins of fruits and vegetables.
If you are living with inflammatory bowel diseases (IBD) like ulcerative colitis, insoluble fibre may be a trigger food and could worsen symptoms during flare-ups. Trigger foods are those that cause unpleasant symptoms, but they do not necessarily cause harm or inflammation in the body. People with IBD may have different experiences with food, and it is important to remember that not all trigger foods affect everyone in the same way.
To identify your trigger foods, it is recommended to keep a food diary or journal. Write down what you ate and drank, and any symptoms you experience throughout the day. This can help you detect patterns and identify problem foods. For instance, if you notice that you feel unwell every time you consume spicy food, it is likely that spicy foods are a trigger for you, and you may want to avoid them.
During a flare-up, it is advisable to reduce your consumption of trigger foods. However, it is important to ensure adequate nutrition and not overly restrict your diet. Consult with your doctor or a registered dietitian to help develop a personalised diet plan that works for you.
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Consume adequate calcium, vitamin D, probiotics and prebiotics
Calcium is important for strong bones, as well as muscle and nerve function. Vitamin D helps your body absorb calcium and promotes bone health. Low stores of calcium and vitamin D are the main vitamin and mineral deficiencies in people with UC, according to Kristi L. King, MPH, RD, a senior pediatric dietitian at Texas Children's Hospital and a clinical instructor at the Baylor College of Medicine in Houston. Many drugs commonly prescribed to treat colitis, such as prednisone, can interfere with calcium and vitamin D absorption when used for extended periods. Losing calcium and vitamin D will lower your bone density and put you at risk of osteoporosis and osteopenia. Dairy products are rich in both calcium and vitamin D, but some people with UC restrict dairy from their diets, thinking it will trigger symptoms. If you’re sensitive to dairy, consider soy or rice milk that’s fortified with calcium and vitamin D instead. You can also eat more leafy green vegetables (cooked to minimize bowel irritation), which are rich in calcium.
Probiotics, or "friendly" bacteria, can help restore the right balance of bacteria in your intestines. Taking antibiotics can kill both friendly and unfriendly bacteria, upsetting the balance your body needs for healthy digestion. People who have IBD should ask their doctors about probiotics, as some studies have found that they help reduce symptoms, but other studies have not found any effect. Some people with weakened immune systems might need to avoid probiotics, so it's important to consult a doctor.
Prebiotics are a type of fibre that acts as food for the healthy bacteria in your gut. They help to promote the growth of these bacteria, which are essential for maintaining a healthy digestive system. Prebiotics can be found in many plant-based foods, such as whole grains, legumes, and certain fruits and vegetables.
Vitamin C and E supplements have been found to reduce symptoms of proctitis caused by radiation therapy. However, taking large doses of vitamin E can increase the risk of bleeding, especially if you take blood thinners. It is important to talk to your doctor before taking vitamin E for proctitis.
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Limit added fats and oils, and focus on consuming wholesome foods
A healthy diet and nutrition play a significant role in managing proctitis, an inflammation of the gastrointestinal tract, which includes conditions like ulcerative colitis. While there is no proven plan to prevent or control proctitis, certain dietary changes can help manage the disease during flares and periods of remission.
Limit Added Fats and Oils
It is recommended to limit added fats and oils in your diet and opt for oils instead of solid fats. For example, olive oil or canola oil are considered healthier alternatives. It is also advised to limit intake to less than eight teaspoons of oil per day. Additionally, reducing or eliminating trans fats found in commercially baked goods, processed foods, and margarine can be beneficial.
Focus on Consuming Wholesome Foods
Wholesome foods refer to those that are minimally processed and have minimal ingredients. Eating foods in their natural state ensures that you get the maximum nutritional value and can help reduce symptoms of proctitis.
- Antioxidant-rich foods: Blueberries, cherries, tomatoes, squash, and bell peppers are excellent sources of antioxidants and can help fight inflammation.
- High B-vitamin foods: Almonds, beans, whole grains, and dark leafy greens like spinach and kale are rich in B-vitamins, calcium, and magnesium. These nutrients are essential for overall health and can help reduce symptoms of proctitis.
- Omega-3 fatty acids: Fatty fish like salmon, tuna, and mackerel, as well as walnut butter, chia seeds, and flaxseed products, are rich in omega-3 fatty acids, which have been shown to have anti-inflammatory effects and reduce symptoms of proctocolitis.
- Lean proteins: Chicken, turkey, tofu, eggs, and beans are great sources of lean protein. Including these in your diet can help reduce inflammation and provide essential nutrients.
- Calcium and vitamin D: Ensure you are consuming adequate amounts of calcium and vitamin D. Low-lactose or lactose-free dairy products can be a good source of calcium. Fortified non-dairy milk alternatives like almond, cashew, or rice milk can also provide these nutrients.
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Keep a food diary to help identify food triggers
Keeping a food diary is a great way to help identify food triggers for proctitis. It can be a useful tool to help you understand your body's responses to different foods and drinks. Here are some tips on how to keep a food diary effectively:
Be Consistent and Detailed:
Consistency and detail are key to an effective food diary. Record your meals and snacks as soon as possible after consumption. Include as much detail as possible, such as portion sizes, sauces used, and cooking methods. For example, if you have pasta with marinara sauce, note the type of pasta, the amount of sauce, and any spices or toppings added.
Track Symptoms:
In addition to tracking your food and beverage intake, jot down any symptoms you experience throughout the day. Make note of how you feel after each meal, and any gastrointestinal issues that arise. For instance, you might feel unwell after consuming spicy food. This can help you identify patterns and potential triggers.
Use Templates or Apps:
There are various food diary templates available, such as the "My Food and Beverage Diary" from the Centers for Disease Control and Prevention. These templates often include columns for the time of day, meals, and snacks. You can also find food-tracking apps that can make the process more convenient. However, be cautious when using apps, as some research suggests they may be linked to intensified symptoms of eating disorders.
Consult with Healthcare Professionals:
Discuss your food diary with your doctor or a registered dietitian. They can provide valuable insights and help you interpret your findings. They can also advise you on any necessary dietary restrictions or adjustments to improve your overall health.
Be Patient and Adaptable:
Keeping a food diary takes time and patience. It is a process of trial and error to identify your specific triggers. Remember that everyone's triggers are unique, and yours may differ from those of another person with proctitis. Be open to adapting your diet and trying new, tolerable alternatives.
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Frequently asked questions
Proctitis is a type of inflammatory bowel disease (IBD) that affects the digestive tract. While there is no specific diet for proctitis, certain foods may help reduce symptoms. A Mediterranean-style meal plan is recommended by the American Gastroenterological Association (AGA) for people with IBD. This includes eating lots of fruits and vegetables, whole grains, healthy fats such as olive oil, and lean protein, such as fish and skinless chicken breasts.
It is recommended to eat anti-inflammatory foods such as bananas, applesauce, berries, squashes, carrots, green beans, fatty fish, walnuts, chia seeds, and flaxseed. It is also suggested to eat soluble fibre, which can be found in foods such as porridge oats, peeled apples and pears, and root vegetables.
It is recommended to avoid foods that are high in insoluble fibre, such as raw kale, apple skin, and sunflower seeds, as these can be hard to digest. It is also suggested to limit added fats and oils, and to focus on consuming oils such as olive oil and canola oil instead of solid fats. Additionally, some people find they are unable to tolerate lactose, especially during a flare-up, so it may be beneficial to choose lactose-free alternatives.
It may be helpful to keep a food diary to identify patterns and detect which foods trigger your symptoms. You can record what you eat and drink throughout the day, and any digestive symptoms you experience. This will help you to determine which foods to avoid and which foods make you feel good.
