Ulcerative colitis (UC) is a form of irritable bowel disease. It can lead to painful inflammation, sores, and ulcers throughout the lining of the large intestine or colon.

People living with UC experience episodes of both flares and remission of the condition.

Symptoms of a flare include pain, bloody stools, diarrhea (with mucus), weight loss, and fatigue. And during remission, those symptoms reside (1).

Diet recommendations differ depending on whether you’re in a flare or remission. And a prominent difference is in the types of grains and carbs you eat.

This article dives into whether you can eat couscous if you have ulcerative colitis, recommends carbs to eat and avoid, and explores if you should use a low-FODMAP diet to manage your symptoms.

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Can you eat couscous with ulcerative colitis? 

No grains are inherently off-limits for people with ulcerative colitis (UC), including couscous.

While couscous may resemble rice, it is a type of pasta. It is a small, round processed grain made from semolina flour from durum wheat (2).

Couscous is high in gluten and therefore not considered safe to consume for people with Celiac disease or non-celiac gluten sensitivity.

However, it may be a particularly good carbohydrate choice during a UC flare because of its low fiber content.

One cup of cooked couscous provides (3):

• Calories: 176
• Carbohydrates: 36 grams
• Fiber: 2 grams

Fiber does not get broken down or absorbed in the digestive tract. Insoluble fiber, which is found primarily in whole grains like wheat, composes the bulk of the stool and can have a laxative effect (4).

These are undesirable qualities if you’re already experiencing abdominal pain and diarrhea.

In addition, the colon may be especially inflamed during a flare-up, restricting the diameter of the tract. An increase in stool volume could potentially lead to a blockage in the large intestine (5).

Therefore, the Crohn’s and Colitis Foundation recommends avoiding insoluble fibers and choosing refined, processed grains instead. And that can include couscous (5).

Once the flare passes, you may begin slowly adding some forms of insoluble fiber back to the diet. And couscous can continue to be consumed, if desired, during remission.

Summary

Couscous may be a good low fiber grain choice to consume during a UC flare. Once a flare passes, you may begin slowly adding some forms of fiber back to your diet.

What carbs can you eat with ulcerative colitis? 

While health professionals generally advise eating primarily whole grains, that doesn’t apply if you’re going through ulcerative colitis (UC) flare (6)

Choosing refined grains over whole grains can help manage symptoms and soothe intestinal distress during a UC flare because they contain less fiber.

There are three components to a grain kernel: germ, bran, and endosperm.

Whole grain products contain intact kernels with all three components. Most of a grain’s insoluble fiber is in the fibrous bran, and the germ is rich in vitamins and minerals.

Refined grains are processed and milled to remove the bran and germ, leaving only the starchy or carb-rich endosperm. At that point, they’re fortified with some nutrients lost during the milling process, like B vitamins, magnesium, and iron.

In addition to couscous, other good carbohydrate sources during a UC flare include: (5, 7)

• White pasta
• White bread (no seeds)
• Crackers (made with white flour)
• Sourdough
• French bread
• Cornmeal
• Oatmeal

While oatmeal is considered a fiber-rich food, it has mainly soluble fiber. Soluble fiber forms a gel-like consistency in the gut and slows the passage of food through the digestive tract rather than speeding it along (4).

Summary

Refined carbohydrate foods low in fiber like white rice, white pasta, and crackers are recommended over whole grains during a UC flare.

What carbs should you avoid with ulcerative colitis?

To avoid aggravating your symptoms, you should avoid carbs high in insoluble fiber during active ulcerative colitis (UC)-related flares.

Even during some remission periods, your doctor may recommend you keep concentrated sources of insoluble fiber, like whole grains, off your plate in favor of more digestible fiber choices.

More digestible choices include foods high in soluble fiber or fruits and vegetables (possibly cooked and with the skin removed) (7).

Avoid these sources of carbohydrates during UC flares.

• Whole grain bread
• Whole grain pasta
• Brown rice
• Millet
• Bulgur
• Quinoa
• Wheat bran
• Wheat berries
• Spelt flour

Summary

Whole grains and carbs high in insoluble fiber may exacerbate UC symptoms. A low fiber diet isn’t recommended for periods of remission, but some doctors may recommend a low-insoluble fiber diet for longer.

Does low FODMAP diet help with ulcerative colitis?

Carbs can be high or low in FODMAPs (fermentable, oligo-, di-, monosaccharides, and polyols). Foods high in FODMAPs may increase watery stools and the production of gas (8).

FODMAPs may be challenging to absorb for some people — particularly those with compromised digestive tracts. So a low FODMAP diet cuts back on these potentially poorly absorbed sugars.

A low FODMAP diet eliminates: (9)

• Fructans: Garlic, barley, broccoli, cabbage, wheat products
• Lactose: Dairy products
• Fructose: Honey, peaches, apricots, high-fructose corn syrup
• Oligosaccharides: Nuts, seeds, beans, asparagus, kale
• Polyols: Sugar-alcohols (sorbitol, mannitol, xylitol, maltitol)

Since couscous is a wheat product, you cannot consume it while on a low-FODMAP diet.

Some research indicates that a low FODMAP diet may be beneficial in managing symptoms during a flare in people with irritable bowel disease — including ulcerative colitis (UC), although it may not decrease inflammation in the colon (7, 8, 10)

However, it is not a long-term solution. Low-FODMAP diets usually only last 4–8 weeks before slowly adding the once removed foods back into your diet one at a time to see how you tolerate them.

If you want to try a low FODMAP diet, you should seek advice and guidance from a dietitian or medical professional to provide support and guidance.

UC treatment plans typically involve medications and diet alterations, and your care team may want to track your symptoms when you make a change (7).

Summary

A low-FODMAP diet may be an appropriate short-term approach to help manage ulcerative colitis symptoms during a flare with support from a dietitian or medical care team. Couscous does not fit into a low-FODMAP diet.

The bottom line

There’s no one-size-fits-all approach to managing ulcerative colitis (UC) symptoms. Foods that work for you may aggravate someone else’s inflamed digestive tract.

You can eat couscous if you have UC, but you should avoid it if you can’t consume gluten or actively follow a low-FODMAP diet.

You should avoid foods high in insoluble fiber during a UC flare, like whole grains. Couscous contains very little fiber per serving, making it a good choice to eat during a flare, although you can also consume it in remission.

Just one thing

Try this today: Navigating safe foods during a flare can be daunting. Check out this piece for recommended foods to eat during a flare and this article for what foods to avoid.