IBD: Eating for Bowel Urgency Control

Eating to Control Ulcerative Colitis Bowel Urgency: Foods, Timing, and Habits That Can Help

Eating to Control Ulcerative Colitis Bowel Urgency: Foods, Timing, and Habits That Can Help
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If you live with ulcerative colitis (UC), you probably know what it’s like to suddenly need to run to the bathroom ASAP. Sometimes, adjusting what and how you eat can help you avoid such situations.

Bowel urgency is among the most prevalent and disruptive symptoms experienced by people with UC.

 While urgency may be a sign that your UC isn’t well-controlled, many people who are in remission also struggle with feeling like they need to go right away.

 It’s important to talk with your gastroenterologist to figure out which camp you fall into, so you can make adjustments to your treatment plan as needed.

If you and your care team decide that dietary shifts are worth exploring, these expert-recommended changes could make a difference.

Top Foods for Bowel Urgency Control

It might sound counterintuitive, but foods that are high in certain types of fiber can actually be helpful for urgency. “Soluble fiber can reduce urgency in UC by absorbing excess fluids [in the GI tract], thus firming up loose stools,” says Deepinder Goyal, MD, a gastroenterologist with Gastro Health in Kissimmee, Florida.

According to Stacey Collins, RDN, a clinical dietitian at the University of Colorado Health Crohn's and Colitis Center in Aurora, Colorado, UC-friendly sources of soluble fiber include:

  • Avocado
  • Bananas
  • Beans and other legumes
  • Berries
  • Carrots, cooked until soft
  • Chia seeds
  • Oatmeal
  • Psyllium
  • Winter squash, peeled and cooked until soft
  • Zucchini, peeled and cooked until soft
If you haven’t been eating much fiber lately, increase your intake slowly over a few weeks and drink plenty of water. Adding a lot of fiber to your diet at once can cause symptoms like gas, bloating, and constipation.

Foods that are high in resistant starch, a type of fiber that feeds the good bacteria in your gut, may also help rein in urgency and loose stools, says Ashley Hurst, RD, the owner of the Crohn’s & Colitis Dietitians in Sugar Land, Texas.

You can find resistant starches in foods like:

  • Green bananas
  • Beans and legumes, especially lima beans, kidney beans, black beans, and lentils
  • Cooked and cooled potatoes (without skin)
  • Cooked and cooled white pasta and white rice
  • Sourdough bread
Most people whose UC is well-controlled don’t need to limit any of the above foods. But you may need to make adjustments if you’re dealing with an active flare or if you have a stricture. Your gastroenterologist and a registered dietitian specializing in IBD can help you make the right food choices for you.

How to Time Eating for Bowel Urgency Control

Being strategic about the timing and size of your meals is another tool that can help keep sudden bathroom urges in check. You can:

  • Have bowel urgency-controlling foods at breakfast. “Front-loading your day with foods that can reduce urgency is helpful,” Hurst says. Try having oatmeal, a smoothie with banana and berries, or mashed avocado on sourdough toast in the morning, for instance.
  • Eat smaller, more frequent meals. Think five or six mini meals rather than three large ones. Smaller amounts of food are less likely to trigger your gastrocolic reflex, the reflex that signals the nerve endings in your GI tract to have a bowel movement, Dr. Goyal says.

  • Be mindful of when you have caffeine. Caffeine can make you have to go to the bathroom — sometimes suddenly — especially when it’s paired with food. (Even decaffeinated coffee can have an effect on bowels, so stick with beverages that are naturally caffeine-free.)

  • Try taking psyllium at night. Psyllium husk is a natural soluble fiber supplement that may help control your bowel movements. If your urgency is the most intense in the morning, taking psyllium husk fiber at night, especially if you’re also well-hydrated, may help reduce morning urgency by resulting in a more complete bowel movement, Collins says.

Other Helpful Habits for Bowel Urgency Control

Consider limiting foods that seem to quickly trigger a bathroom trip. While triggers may be different for everyone, common culprits often include:

  • Alcohol
  • Caffeine
  • Dairy foods like milk, cheese, or ice cream
  • Rich or spicy meals
  • Sugar alcohols like xylitol, sorbitol, or mannitol, which are commonly found in sugarless gum, candy, and drinks
  • Soda, fruit juice, or other sugary drinks
You should also talk with your gastroenterologist if you feel like you’re having trouble managing your bowel urgency on your own. Often, uncontrollable urgency is a sign of underlying inflammation in your colon or rectum.

In that case, your doctor may recommend adjusting your UC treatment plan to improve your symptoms and reduce your risk for long-term complications. If your bowel urgency is accompanied by blood in the stool, fever, significant weight loss, dehydration, or symptoms that are prominent at night, seek immediate medical attention.

EDITORIAL SOURCES
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Resources
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Amber Charoen

Amber Charoen, MD

Medical Reviewer

Amber Charoen, MD, is a triple board-certified gastroenterologist at Prosser Memorial Health in Prosser, Washington, where she provides comprehensive gastrointestinal (GI) care in ...

Marygrace Taylor

Marygrace Taylor

Author

Marygrace Taylor is an award-winning freelance health and wellness writer with more than 15 years of experience covering topics including women’s health, nutrition, chronic conditi...