I have ulcerative colitis. What diet changes can help me?

Hello,

Welcome to icliniq.com.

Thank you for reaching out on iCliniq. I completely understand your concern, and I appreciate you for explaining your situation so clearly.

From what you have described, this condition has understandably affected your comfort and peace of mind.

Please know you have done the right thing by seeking professional guidance, and I will do my best to guide you clearly, safely, and based on the most up-to-date medical evidence.

From your message, you are a 35-year-old woman diagnosed with ulcerative colitis involving the rectum and sigmoid colon.

You have been on Mesalazine but continue to experience five to six bloody stools daily, with CRP (C-reactive protein) elevated at 19, and hemoglobin reduced to 10.2 g/dL.

These findings suggest that your inflammation is still active despite current treatment, and your anemia is likely secondary to ongoing blood loss from the bowel.

Based on this description, your case fits what we classify as moderate to moderately severe ulcerative colitis.

When symptoms such as frequent bloody stools, anemia, and elevated inflammatory markers persist despite optimized oral and rectal Mesalazine, physicians generally consider adding short-term corticosteroids to induce remission.

If steroids are ineffective, or if the disease flares again once they are reduced, biologic or advanced therapies like anti-TNF (anti-tumor necrosis factor) agents or newer biologic injections are the next step.

These decisions are individualized and guided by disease severity, colonoscopy findings, and your overall health profile.

Regarding diet, while food alone does not cause ulcerative colitis, it can influence symptom control. Many patients notice improvement when they reduce or temporarily avoid dairy products (especially if lactose intolerance is suspected), fried or spicy foods, alcohol, and caffeine.

Keeping a simple food-symptom diary can help identify personal triggers.

During a flare, a low-residue diet, soft foods that reduce bowel irritation, may also be advised. Adequate hydration and iron-rich foods are important, especially given your low hemoglobin.

As for colonoscopy, once the diagnosis is established, repeat colonoscopy is not required frequently unless symptoms worsen or there’s concern for complications.

However, after eight to 10 years of continuous disease, colonoscopic surveillance is recommended every one to two years to monitor for precancerous changes.

In your case, since the diagnosis is recent, the next colonoscopy will usually be scheduled once remission is achieved or if there is a major change in symptoms.

It would be helpful if you could upload your colonoscopy report, biopsy summary, and recent blood test results (including ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), and fecal calprotectin if available). This will allow a more accurate understanding of your current disease activity and treatment response.

For now, continue your prescribed medications, maintain a simple, non-irritating diet, stay hydrated, rest adequately, and track your symptoms.

Avoid stopping or changing any treatment on your own. With appropriate medical management and lifestyle care, most patients with ulcerative colitis achieve long-term remission and lead full, active lives.

Please keep me updated if your symptoms change or if you receive any new test results. I will be glad to review them.

Most patients improve steadily with consistent care, so stay positive and patient with the process.

I hope you find this helpful.

Take care and stay well.