ULCERATIVE COLITIS EXCLUSION DIET (UCED) – AN EMERGING NEW DIETARY APPROACH FOR ULCERATIVE COLITIS
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6376Keywords:
Colitis, Ulcerative, Diet, Inflammatory Bowel Diseases, Crohn DiseaseAbstract
Background: Ulcerative colitis (UC) is a chronic condition marked by widespread inflammation of the mucosa of the colon and rectum. In view of the growing prevalence and hardships during the disease process, it is necessary to search for new therapeutical approaches.
Research objectives: The aim of this review is to investigate the new diet named Ulcerative Colitis Exclusion Diet (UCED), which may help in maintaining a stable course of UC.
Methods: The review was conducted using the PubMed database mainly from 2018 to 2024 with the use of keywords: “ulcerative colitis”, “ulcerative colitis treatment”, “ulcerative colitis diet”, “gastrointestinal microbiome”. Some of the data comes from the clinical trials website ”https://clinicaltrials.gov”.
Key findings: UC is a chronic, immune-mediated inflammatory condition of the colon, belonging to inflammatory bowel diseases (IBD). The exact pathogenesis is unknown, yet many factors contribute to the onset and exacerbation of the disease. Currently, the prevalence is increasing worldwide. The most common symptoms are diarrhea and lower gastrointestinal bleeding combined with other, less specific manifestations. Making a diagnosis requires endoscopic evaluation of the colon. Pharmacological treatment is insufficient in some cases, and therefore, new therapeutic approaches are being explored. Intake of strictly defined products and avoidance of certain substances according to UCED guidelines may result in beneficial gut microbiota changes and reduction of inflammation, leading to a better disease control.
Conclusions: Considering the challenges of UC and the importance of proper nutrition in IBD, the introduction of a proper diet is desirable. Although UCED is a relatively innovative dietary approach, it appears promising and requires further research.
References
Sarbagili-Shabat C, Albenberg L, Van Limbergen J, et al. (2021). A novel UC exclusion diet and antibiotics for treatment of mild to moderate pediatric ulcerative colitis: A prospective open-label pilot study. Nutrients, 13(11), 1-13. https://doi.org/10.3390/nu13113736
Feuerstein JD, Moss AC, Farraye FA. (2019). Ulcerative Colitis. Mayo Clin Proc, 94(7), 1357-1373. https://doi.org/10.1016/j.mayocp.2019.01.018
Kobayashi T, Siegmund B, Le Berre C, et al. (2020). Ulcerative colitis. Nat Rev Dis Prim, 6(1). https://doi.org/10.1038/s41572-020-0205-x
Pravda J. Can ulcerative colitis be cured? Discov Med. 2019;27(149):197-200. http://www.ncbi.nlm.nih.gov/pubmed/31361982.
Hirten RP, Sands BE. (2021). New Therapeutics for Ulcerative Colitis. Annu Rev Med, 72, 199-213. https://doi.org/10.1146/annurev-med-052919-120048
Chicco F, Magrì S, Cingolani A, et al. (2021). Multidimensional Impact of Mediterranean Diet on IBD Patients. Inflamm Bowel Dis, 27(1), 1-9. https://doi.org/10.1093/ibd/izaa097
Mak WY, Zhao M, Ng SC, et al. (2020). The epidemiology of inflammatory bowel disease: East meets west. J Gastroenterol Hepatol, 35(3), 380-389. https://doi.org/10.1111/jgh.14872
Shivashankar R, Tremaine WJ, Harmsen WS, et al. (2017). Incidence and Prevalence of Crohn’s Disease and Ulcerative Colitis in Olmsted County, Minnesota From 1970 Through 2010. Clin Gastroenterol Hepatol, 15(6), 857-863. https://doi.org/10.1016/j.cgh.2016.10.039
Sharara AI, Al Awadhi S, Alharbi O, et al. (2018). Epidemiology, disease burden, and treatment challenges of ulcerative colitis in Africa and the Middle East. Expert Rev Gastroenterol Hepatol, 12(9), 883-897. https://doi.org/10.1080/17474124.2018.1503052
Lophaven SN, Lynge E, Burisch J. (2017). The incidence of inflammatory bowel disease in Denmark 1980–2013: a nationwide cohort study. Aliment Pharmacol Ther, 45(7), 961-972. https://doi.org/10.1111/apt.13971
Du L, Ha C. (2020). Epidemiology and Pathogenesis of Ulcerative Colitis. Gastroenterol Clin North Am, 49(4), 643-654. https://doi.org/10.1016/j.gtc.2020.07.005
Zheng D, Liwinski T, Elinav E. (2020). Interaction between microbiota and immunity in health and disease. Cell Res, 30(6), 492-506. https://doi.org/10.1038/s41422-020-0332-7
Sun Y, Zhang Z, Zheng CQ, Sang LX. (2021). Mucosal lesions of the upper gastrointestinal tract in patients with ulcerative colitis: A review. World J Gastroenterol, 27(22), 2963-2978. https://doi.org/10.3748/wjg.v27.i22.2963
Levine A, Rhodes JM, Lindsay JO, et al. (2020). Dietary Guidance From the International Organization for the Study of Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol, 18(6), 1381-1392. https://doi.org/10.1016/j.cgh.2020.01.046
Guo M, Wang X. (2023). Pathological mechanism and targeted drugs of ulcerative colitis: A review. Med (United States), 102(37), E35020. https://doi.org/10.1097/md.0000000000035020
Ananthakrishnan AN, Gerasimidis K, Ho SM, et al. (2024). Challenges in IBD Research 2024: Environmental Triggers. Inflamm Bowel Dis, 30(Supplement_2), S19-S29. https://doi.org/10.1093/ibd/izae085
Eder P, Łodyga M, Gawron-Kiszka M, et al. (2023). Guidelines for the management of ulcerative colitis. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology. Prz Gastroenterol, 18(1), 1-42. https://doi.org/10.5114/pg.2023.125882
Lamb CA, Kennedy NA, Raine T, et al. (2019). British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut, 68, s1-s106. https://doi.org/10.1136/gutjnl-2019-318484
Maaser C, Sturm A, Vavricka SR, et al. (2019). ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohn’s Colitis, 13(2), 144-164. https://doi.org/10.1093/ecco-jcc/jjy113
Spinelli A, Bonovas S, Burisch J, et al. (2022). ECCO Guidelines on Therapeutics in Ulcerative Colitis: Surgical Treatment. J Crohn’s Colitis, 16(2), 179-189. https://doi.org/10.1093/ecco-jcc/jjab177
Radziszewska M, Smarkusz‐Zarzecka J, Ostrowska L, et al. (2022). Nutrition and Supplementation in Ulcerative Colitis. Nutrients, 14(12). https://doi.org/10.3390/nu14122469
Burri E, Maillard MH, Schoepfer AM, et al. (2020). Treatment Algorithm for Mild and Moderate-to-Severe Ulcerative Colitis: An Update. Digestion, 101(Suppl1), 2-15. https://doi.org/10.1159/000504092
Cusimano FA, Damas OM. Diet as a treatment for inflammatory bowel disease: is it ready for prime time? Curr Opin Gastroenterol. 2022;38(4):358-372. https://doi.org/10.1097/mog.0000000000000850.
Herrador-López M, Martín-Masot R, Navas-López VM. (2023). Dietary Interventions in Ulcerative Colitis: A Systematic Review of the Evidence with Meta-Analysis. Nutrients, 15(19), 1-20. https://doi.org/10.3390/nu15194194
Shabat CS, Scaldaferri F, Zittan E, et al. (2022). Use of Faecal Transplantation with a Novel Diet for Mild to Moderate Active Ulcerative Colitis: The CRAFT UC Randomised Controlled Trial. J Crohn’s Colitis, 16(3), 369-378. https://doi.org/10.1093/ecco-jcc/jjab165
Melton SL, Day AS, Bryant RV, et al. (2024). Revolution in diet therapy for inflammatory bowel disease. JGH Open, 8(7), 1-10. https://doi.org/10.1002/jgh3.13097
Roediger WEW. (1998). Decreased sulphur aminoacid intake in ulcerative colitis. Lancet, 351(9115), 1555. https://doi.org/10.1016/s0140-6736(05)61120-8
El Amrousy D, Elashry H, Salamah A, et al. (2022). Adherence to the Mediterranean Diet Improved Clinical Scores and Inflammatory Markers in Children with Active Inflammatory Bowel Disease: A Randomized Trial. J Inflamm Res, 15(February), 2075-2086. https://doi.org/10.2147/jir.s349502
Jian L, Anqi H, Gang L, et al. (2018). Food Exclusion Based on IgG Antibodies Alleviates Symptoms in Ulcerative Colitis: A Prospective Study. Inflamm Bowel Dis, 24(9), 1918-1925. https://doi.org/10.1093/ibd/izy110
Strisciuglio C, Giannetti E, Martinelli M, et al. Does cow’s milk protein elimination diet have a role on induction and maintenance of remission in children with ulcerative colitis? Acta Paediatr Int J Paediatr. 2013;102(6):273-278. https://doi.org/10.1111/apa.12215.
Bodini G, Zanella C, Crespi M, et al. (2019). A randomized, 6-wk trial of a low FODMAP diet in patients with inflammatory bowel disease. Nutrition, 67-68, 110542. https://doi.org/10.1016/j.nut.2019.06.023
Leibovitzh H, Sarbagili Shabat C, Hirsch A, et al. (2024). Faecal Transplantation for Ulcerative Colitis From Diet Conditioned Donors Followed by Dietary Intervention Results in Favourable Gut Microbial Profile Compared to Faecal Transplantation Alone. J Crohn’s Colitis, (May), 1606-1614. https://doi.org/10.1093/ecco-jcc/jjae062
Wolfson Medical Center. Combination of Diet and Oral Budesonide for Ulcerative Colitis (ReDUCE). https://clinicaltrials.gov/study/NCT05791487?term=NCT05791487&rank=1&tab=results (access: 2024.12.29).
Bischoff SC, Bager P, Escher J, et al. (2023). ESPEN guideline on Clinical Nutrition in inflammatory bowel disease. Clin Nutr, 42(3), 352-379. https://doi.org/10.1016/j.clnu.2022.12.004
Comeche JM, Gutierrez-Hervás A, Tuells J, et al. (2021). Predefined diets in patients with inflammatory bowel disease: Systematic review and meta-analysis. Nutrients, 13(1), 1-22. https://doi.org/10.3390/nu13010052
Hashash JG, Elkins J, Lewis JD, et al. (2024). AGA Clinical Practice Update on Diet and Nutritional Therapies in Patients With Inflammatory Bowel Disease: Expert Review. Gastroenterology, 166(3), 521-532. https://doi.org/10.1053/j.gastro.2023.11.303
Turner D, Ruemmele FM, Orlanski-Meyer E, et al. (2018). Management of Paediatric Ulcerative Colitis, Part 1: Ambulatory Care-An Evidence-Based Guideline From European Crohn’s and Colitis Organization and European Society of Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr, 67(2), 257-291. https://doi.org/10.1097/mpg.0000000000002035
Turner D, Ruemmele FM, Orlanski-Meyer E, et al. (2018). Management of Paediatric Ulcerative Colitis, Part 2: Acute Severe Colitis-An Evidence-Based Consensus Guideline From the European Crohn's and Colitis Organization and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr, 67(2), 292-310. https://doi.org/10.1097/mpg.0000000000002036
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Karolina Barzyk, Magdalena Pietrzak, Jolanta Wiśniewska, Weronika Buczek, Mikołaj Wiśniewski, Piotr Bartnik, Emil Pencuła
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
