It can be embarrassing to talk about your bowel movements. And so many people suffer from loose stools now and then, that you may not see it as a great health issue. However, if you start to see blood or pus in your stool during bowel movements, then it could be something more serious. As of 2015, about 1 in 100 adults suffer from inflammatory bowel disease (IBD), which can be either Crohn’s disease or colitis. Colitis is an inflammatory disease of the large intestine that can worsen over time if left untreated. Therefore, let’s talk about what colitis is, how it can be treated, and if the low FODMAP diet could help.

What is colitis?

Colitis, also known as ulcerative colitis (UC), is a condition where the large intestine becomes chronically inflamed. The most common symptom of colitis is bloody diarrhea or loose stools with pus in it. Other signs and symptoms of colitis include:

  • Fatigue
  • Nausea
  • Loss of appetite
  • Urgent need to have bowel movements
  • Weight loss
  • Anemia, or a low level of red blood cells in the blood

Early stages of colitis may only have mild to moderate symptoms. Bu as the disease progresses, symptoms may become more severe such as frequent bloody stools, fever, and severe abdominal cramping.  These more severe symptoms are only seen in about 1 in 10 of people in the early stages of colitis.

Colitis can be diagnosed by a physical exam, lab tests, and/or endoscopy procedures.  A physical exam may help to identify swelling or tenderness in your abdomen. Labs such as blood and stool tests can help diagnose colitis by looking for inflammation markers, low iron levels, and maybe even low albumin levels, of which the latter is found in those with severe colitis.

Finally, endoscopies like a colonoscopy, can help locate irritated and swollen tissue, polyps, and ulcers in the large intestine. Colitis is an inherited disease, so if you have a parent or sibling with UC, then you have a 25-percent chance of developing the condition.

Colitis treatment

Once colitis is diagnosed, treatment can begin. Depending on the severity of the disease, a person may receive medications or surgery for treatment of colitis. There is no one medicine that can cure ulcerative colitis, but it can help reduce symptoms. This medication will need to be taken indefinitely to control symptoms of colitis. Examples of medications include corticosteroids, immunomodulators, or biologics, to name a few. Aminosalicylates may also be used to help reduce inflammation in the colon, although there may be some digestive-related side effects like abdominal pain, diarrhea, and nausea.

Some severe cases of colitis may require surgery. Those with colon cancer or those who have continued symptoms even with treatment, are just some of the cases where part or all the colon and/or rectum may need to be removed.

The low FODMAP diet and colitis

The low FODMAP diet may be an alternative treatment in those with less severe cases of inflammatory bowel diseases like colitis. A 2017 study shows that the low FODMAP diet can reduce IBS-like symptoms like abdominal pain, bloating, gas, or diarrhea in those with non-active IBD. Non-active IBD is a state of colitis remission in which there are no flare-ups of symptoms. A 2018 study found similar results and showed an improvement in quality of life of those with non-active IBD on the low FODMAP diet.

Take home message

Colitis is a serious inflammatory condition in which treatment should be supervised by a qualified healthcare provider. However, the low FODMAP may be an effective first line of treatment in mild cases of colitis or as a supplementary treatment in those with UC at any stage. Learn more about how to get started on the low FODMAP diet on the Casa de Sante website.

-written by Staci Gulbin, MS, MEd, RD at

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