Ulcerative Colitis

Ulcerative colitis (UC) is a chronic inflammatory disease in the family of inflammatory bowel diseases (IBD) that causes inflammation and damage to the large intestine and/or rectum.

  • Overview
  • Action Plan
  • Ask The Doctor
  • Related Info
  • Success Stories


Ulcerative colitis (UC) is more common in Western and Industrialized countries and seems to be increasing in developing countries as they adopt Western habits, such as poor diet. Approximately 0.2% of the U.S. population suffers from UC.1

Some of the potential explanations of this geographical trend include Westernized factors, such as antibiotic use, hygiene, exposures to certain infections, pollution, and diet. A higher risk follows those with a family history of the disease as well. Intestinal permeability (leaky gut) and altered intestinal bacteria seem to play an important role, but it is still not known exactly what causes UC.

Those with UC may experience some or all of the following symptoms:

  • Abdominal pain
  • Diarrhea
  • Dehydration
  • Weight loss
  • Nausea
  • Rectal bleeding
  • Fever
  • Possible joint pain

Nutrition plays a key role to help those with UC. Improvements in lower inflammation and intestinal bacterial balance precede improvements in symptoms, and even remission is possible.

  1. Kappelman MD, Moore KR, Allen JK, Cook SF. Recent trends in the prevalence of Crohn's disease and ulcerative colitis in a commercially insured US population. Dig Dis Sci 2013, 58:519-525.

Action Plan


  • A modified Nutritarian diet may be used to help manage ulcerative colitis (UC). Of specific importance is the avoidance of processed grains, oils, commercial baked goods, fried foods, and most animal products.
  • The foods that are part of a Nutritarian eating style favorably support beneficial bacteria and improve immune function and digestive health.
  • Some temporary modifications that may be helpful during a flare-up are to eat less raw food and more cooked, blend more food (smoothies, pureed soups), and add vegetable juices.
  • When experiencing symptoms of a flare-up, raw foods such as salads, fresh fruits, and also beans may exacerbate symptoms. The use of cooked, natural foods, such as butternut and acorn squash, cooked turnips, parsnips, peas, and carrots, as well as steel cut oats, are recommended and generally tolerated better.
  • If one is having a flare-up, it may be required to use medication and/or medically supervised fasting to control inflammation and/or bleeding.
  • Many with UC will find they are sensitive to gluten, processed foods such as sugar, and animal products, and removing or reducing these may help. Other foods may be triggers, and may be unique to each person. Fruit intake may need to be reduced to low or moderate amounts in some.
  • Maximize the intake of immune-system-supporting, anti-inflammatory foods, such as cooked mushrooms and yellow and green vegetables. Cruciferous vegetables, in particular, are recommended to be eaten every day. All these foods seem to have a protective effect against developing UC.1


Research has suggested that healthy bacteria in our intestines are protective, especially in inflammatory bowel diseases such as UC, and can help to reduce inflammation, as well as help to keep a normal functioning immune system.2 Although eating a fiber-rich diet helps to build up healthy bacteria over time, many with UC find it very helpful to take supplemental probiotics in higher doses.3 Ask your doctor to discuss if taking high dose probiotics is right for you.


Some with UC may benefit from taking supplemental omega-3 oils for their anti-inflammatory action as part of their treatment plan. High doses and special formulations may be necessary, so if considering this, please talk to your doctor to see if this is appropriate for you.

  1. Gentschew L, Ferguson LR. Role of nutrition and microbiota in susceptibility to inflammatory bowel diseases. Mol Nutr Food Res 2012, 56:524-535.
  2. Fava F, Danese S. Intestinal microbiota in inflammatory bowel disease: friend of foe? World J Gastroenterol 2011, 17:557-566.
  3. Shen J, Zuo ZX, Mao AP. Effect of probiotics on inducing remission and maintaining therapy in ulcerative colitis, Crohn's disease, and pouchitis: meta-analysis of randomized controlled trials. Inflamm Bowel Dis 2014, 20:21-35.

Ask The Doctor

The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)


I’ve been diagnosed with a mild form of ulcerative colitis. Hoping for a long-term solution to control this problem, I started your IBD protocol four days ago (I am only eating the foods listed in Phase 1, as noted in the March 2008 newsletter No 36 and taking all the recommended supplements) and was wondering about what to expect in terms of symptom reduction.

My current symptoms are blood and mucus with stool. How long should I expect to be on Phase 1 before the bleeding stops? Do I also need to wait for the mucus to stop completely before moving to Phase 2? In Phase 2, it says tofu can be added. Can beans be added then as well? When can whole grains (brown rice, quinoa, millet) be added back in?


It usually takes about 3 months to bring micronutrients in the body’s tissues to a high enough level to reduce the inflammatory response. Juicing speeds up this process. It sounds like your condition is not so severe, so the likelihood of a recovery via nutrition is high.

After a few weeks of phase one, beans can be added, but only start with a small amount for the first week and then increase very gradually. I would stick with brown rice, wild rice, quinoa, and millet and not add back wheat for a few months, until you are considerably better. Make sure you are taking the supplements with probiotics, Vitamin D, and fish oil too.


I suffer from ulcerative colitis. The diet I am trying to heal with is:
Green smoothies without fruit; Dr. Fuhrman’s soup recipes, fully blended; homemade soft white bread; oatmeal; maybe a banana; some melon or a peach
What do you think? Will this diet help me heal?


First you have to review my protocol for ulcerative colitis that I describe in more depth in my newsletter on inflammatory bowel disease. The supplemental protocol is important too. You have to avoid the white bread, and in fact, it would be best to avoid all gluten grains. Make sure you’re having steamed kale, collards, and bok choy, along with steamed asparagus, squash, avocado, carrots, peas, artichokes, and mushrooms. Include some tofu or tempeh a few times a week. Doing this will reduce inflammation and provide the protective phytonutrients that are critical to heal your gut. Continue to have blended salads without fruit. Steam all the greens, including leafy greens, before blending in your smoothie, and add steamed zucchini to the smoothie. Raw fruits and vegetables can be irritating for a person with bloody ulcerations, and I like to keep the diet mostly cooked until the bleeding stops, and then, slowly introduce small amounts of soft lettuce and other raw food gradually.