Microscopic colitis is an inflammatory bowel condition characterized by inflammation of the colon, visible only under a microscope. This condition often results in chronic watery diarrhea, along with other symptoms like abdominal pain, bloating, and weight loss. While the precise cause remains unclear, dietary choices frequently play a role in managing symptoms and improving comfort for individuals.
General Dietary Guidelines
Managing microscopic colitis through diet often begins with identifying individual trigger foods, as responses to specific foods can vary greatly among people. An elimination diet, where certain foods are temporarily removed and then reintroduced, can help pinpoint items that worsen symptoms. It is also important to maintain adequate hydration, particularly given the chronic watery diarrhea, by drinking water, broth, or fluids with added electrolytes.
Eating small, frequent meals throughout the day, rather than a few large ones, can be gentler on the digestive system and may help ease diarrhea. Thoroughly cooking foods also aids digestion, making them easier for the inflamed colon to process. While there is no single universal diet for microscopic colitis, these foundational strategies provide a framework for individuals to approach their dietary management.
Foods to Limit or Avoid
Several food categories are commonly reported to exacerbate microscopic colitis symptoms and are often recommended for limitation or avoidance. Dairy products, especially those high in lactose, can be problematic for many individuals, as lactose intolerance can worsen diarrhea and discomfort. Some people also find relief by eliminating gluten, a protein found in wheat, barley, and rye.
Foods commonly reported to worsen microscopic colitis symptoms include:
- Caffeine: In coffee, tea, and some sodas, it can stimulate the gut and worsen diarrhea.
- Alcohol: Irritates the digestive tract and contributes to dehydration.
- Artificial sweeteners: In diet drinks and processed foods, they can trigger digestive upset.
- Highly processed foods: High in unhealthy fats, sugar, and additives, they are difficult to digest and may promote inflammation.
- Fatty or fried foods: Can be hard on the digestive system and should be limited.
- Insoluble fiber: Raw vegetables, nuts, and seeds can be abrasive to an inflamed colon, worsening cramping and diarrhea.
Foods to Incorporate and Support Gut Health
Focusing on well-tolerated foods can help soothe the digestive tract and provide necessary nutrients. Soluble fiber, found in foods like oats, bananas, applesauce, and psyllium, can help absorb excess water in the colon, potentially firming stools and reducing diarrhea. These fibers form a gel-like substance that can be less irritating than insoluble fibers. Lean proteins, such as skinless chicken, turkey, fish, and eggs, are well-tolerated and provide essential amino acids for tissue repair without adding excessive fat.
Healthy fats, like those found in avocados and olive oil, offer caloric density and can be easier to digest than saturated or trans fats. Easily digestible cooked vegetables, such as peeled potatoes, carrots, and squash, are also beneficial as cooking breaks down tough fibers, making them gentler on the gut. Plain rice, noodles, and white bread are also tolerated well and can provide easily digestible carbohydrates. These foods not only provide energy but also help minimize irritation to the inflamed colon.
Nutritional Considerations and Supplements
Chronic watery diarrhea, a common symptom of microscopic colitis, can lead to various nutrient deficiencies. Individuals may experience lower levels of fat-soluble vitamins like Vitamin D, as well as B vitamins such as B12, due to malabsorption. Mineral deficiencies are also possible, including iron, magnesium, and calcium. Monitoring these levels with a healthcare professional is advised.
Probiotics, beneficial live microorganisms, and prebiotics, non-digestible food ingredients that feed these microorganisms, can support a healthy gut microbiome. However, responses to probiotics can vary, and some individuals may find them unhelpful or even worsening symptoms initially. Omega-3 fatty acids, found in fish oil, are also considered for their potential anti-inflammatory properties. Any supplementation, including vitamins, minerals, probiotics, or omega-3s, should always be discussed with a healthcare professional to ensure safety and appropriateness for their specific condition.