Smart Swaps: A Guide to Ulcerative Colitis–Friendly Food Textures

When you have ulcerative colitis (UC), you probably know that it’s important to include adequate nutrients from whole foods in your diet to support your health. But during a flare, or if you have strictures (narrowing) in your colon, certain foods and textures may be more likely to exacerbate symptoms.

“We tell patients to choose softer, smooth textured foods to maintain a balanced diet,” says Courtney Schuchmann, RD, LDN, of the department of gastroenterology, hepatology, and nutrition at the University of Chicago Medicine. “This can include tender fruits, smooth nut and seed spreads, peeled and cooked vegetables, and blended beans like hummus and bean soups. Fruits, vegetables, nuts, and seeds can be blended into smoothies; and vegetables, herbs, and beans can be blended into soups, sauces, and dips.”

Here are food swaps to try when you’re having increased inflammatory bowel disease (IBD) symptoms and some practical tips from experts for introducing modifications into your diet.

Common Triggers and Smart Swaps

When your UC symptoms are more intense than usual and certain foods and textures are making things worse, try the following expert-recommended swaps.

1. Swap Raw Apples With Skin for Stewed, Skinless Apples

But eating raw apples whole can cause problems when UC is affecting digestion. “Skins of fruits and vegetables can irritate the walls of the colon, which can worsen symptoms by increasing bowel frequency or urgency,” says Kristen Nicolai, RD, of Mount Sinai in New York City.

Removing the skin and softening the flesh by stewing apples (cooking them in a small amount of water) can help you avoid symptom exacerbation while retaining most of the nutrients. “Apple skin is tough, insoluble [indigestible] fiber,” says Christina Fasulo, RD, who specializes in gastrointestinal disorders at UCLA Health in Los Angeles. “Stewing breaks down the flesh, and removing the skin eliminates the roughest part. You keep the pectin, vitamin C, and potassium.”

2. Swap Raw Almonds for Almond Flour

But almonds can be hard on the gastrointestinal (GI) tract when eaten whole, so consider swapping a handful of raw almonds as a snack for the use of almond flour at breakfast. “Nuts in their whole form can have large, hard pieces, which can be physically abrasive on the GI tract and brush up against the lining of the gut, causing more irritation,” says Nicolai. “Finely milled almond flour is much less abrasive and allows for a smoother, gentler texture.”

Schuchmann suggests using almond flour for baked goods like muffins, breads, waffles, and pancakes; or try adding almond butter to homemade salad dressings, dips, and smoothies, or putting it over a fruit puree for an alternative to peanut butter and jelly.

3. Swap Roasted Sweet Potatoes With Skin for Skinless Mashed Sweet Potatoes

The skin on roasted sweet potatoes is full of insoluble fiber that can speed up bowel movements and aggravate the colon as it moves through, so it may seem easier to avoid this nutrient-filled vegetable during a flare.

4. Swap Fresh Blueberries for a Smoothie With Pureed Blueberries

“Blueberries contain anthocyanins, a type of antioxidant that gives them their deep blue color and provides an anti-inflammatory effect,” Schuchmann says.

So why not include more whole blueberries in your diet during a flare? “The tough skins of blueberries may contribute to increased symptoms for some patients,” says Schuchmann. “But blending blueberries into smoothies or compote to top oatmeal, yogurt, or pancakes is a great way to soften the fiber to reduce symptoms.”

5. Swap Roasted Broccoli for Pureed Broccoli Soup

Diets that include cruciferous vegetables like broccoli have been connected to reduced inflammation and cancer risk, according to research. Broccoli also contains a plant compound that helps activate sulforaphane, a chemical compound that reduced inflammation-related chemicals in studies on IBD.

Luckily, there’s a work-around. “Cooking until soft and pureeing into soup makes it easy to digest while keeping the vitamin C, vitamin K, and sulforaphane,” says Fasulo.

Schuchmann agrees: “Finely chopping or blending into soups is an additional step you can take to help mechanically break down the fiber to improve tolerance,” she says.

Smart Swaps in Action: Practical Tips

Now that you have ideas about how you can make food textures easier to tolerate, how do you incorporate them into your diet when you need to?

Start Simple

Begin adding modified fiber-rich foods into your diet carefully. “Start with small portions and slowly increase the amount of fibrous foods (fruits, vegetables, legumes) you consume daily,” Schuchmann says. “Increasing fiber intake from any food too quickly can increase symptoms if you do not typically eat a higher fiber diet. Make sure to slow down and chew well.”

If you eliminated most fiber sources from your diet as your symptoms increased, take special care as you ease back into eating them. “If a diet is extremely limited while flaring, an individual can try to add in one modified texture at a time to slowly build a list of tolerated foods,” says Fasulo.

“The most important thing: Don't restrict your diet unnecessarily,” she says. “Many people with UC cut out entire food groups out of fear, which leads to nutritional deficiencies and doesn't always help symptoms. Texture modification, not fiber elimination, is the preferred strategy for patients with UC who are flaring or have difficulty tolerating certain foods.”

It can also help to remember that things won’t always be like this. “Once you are feeling better and the inflammation has healed, you may slowly bring back some of these larger or rougher textures,” Nicolai says. “As your symptoms improve and you transition out of a flare, it is recommended to increase rougher textures as tolerated.”

Dining Out Strategies

While eating out is often the last thing on your mind when you're symptomatic, there may be times when you opt to join friends or family at a restaurant, particularly if it’s a special occasion.

In this case, it can help to seek out restaurants that serve dishes with UC-friendly textures. “Mediterranean, Japanese, and Thai cuisines often feature soups, stews, and well-cooked vegetables,” Fasulo says. “Eat smaller portions slowly, chew well, and avoid carbonated drinks if they make you gassy.”

It’s advisable to prepare in advance of eating out by checking the restaurant’s menu online or calling to ask if it can make substitutions or modifications for you, Nicolai says. She and Fasulo also recommend avoiding preparations that are unrelated to fiber content but can exacerbate symptoms, like frying, which is sometimes disguised using terms like “crispy” and “crunchy.” Grilled, baked, and poached proteins may be easier to tolerate, they say.

“Letting the waiter know that you have a medical condition and can't have certain foods is perfectly acceptable, and most restaurants should be willing to accommodate,” Nicolai says. “Don't be afraid to advocate for yourself and ask for what you need.”

A Day of Smart Swaps: Your Blueprint

Breakfast: Swap a Bowl of Mixed Berries and Greek Yogurt for a Mixed Berry and Greek Yogurt Smoothie

“Fresh berries with intact skins and seeds are high in insoluble fiber,” says Nicolai. “Insoluble fiber remains intact throughout the digestive tract and acts like a street sweeper by mechanically agitating the walls of the colon. This stimulation also increases the rate at which stool moves through the colon, causing more frequency and urgency.”

But you can keep nutrient-dense berries in your diet if you change how you prepare them. “The smaller particle size of fiber found in pureed or blended foods requires less work for our digestive system to break down,” she says. “The fiber is still there, but no longer has the same mechanical effect in the gut and may be tolerated better since it will be able to smoothly glide through the intestines, unlike the coarse roughage” of whole berries.

Lunch: Swap a Kale Salad With Nuts, Seeds, White Beans, and Salami for a Butter Lettuce Salad With Poached Salmon and Pureed White Bean Soup

“Raw kale is one of the toughest greens to digest, and an entire lunch salad can trigger symptoms,” says Fasulo. “Butter lettuce is easy to break down and digest. Pureeing beans into soup keeps the iron, folate, protein, and fiber while requiring minimal digestive effort. Soup also helps with hydration during a flare.”

Dinner: Swap Fried Chicken With Sweet Potato Wedges for Baked Chicken and Mashed Sweet Potatoes

“Fried chicken's high fat content can speed gut motility and trigger diarrhea,” says Fasulo. “Baking gives you tender protein without the excess fat. Mashing sweet potatoes without skin replaces the chewy, fibrous wedges with a smooth, nutrient-rich side.”

Snack: Swap Raw Celery With Peanut Butter for Peanut Butter–Topped Sourdough Bread

“Raw fibrous vegetables such as celery, may aggravate GI symptoms for some people with ulcerative colitis, particularly during a flare,” Fasulo says. “Insoluble fiber can increase stool bulk and quicken intestinal transit, which may not be well tolerated with active inflammation.”