Intermittent fasting (IF) – cycling between periods of eating and voluntary fasting – has gained popularity for various health reasons. But what about people living with ulcerative colitis (UC), a chronic inflammatory bowel disease? The question isn’t simple. While some with UC report symptom relief through IF, experts stress it’s not a cure and carries risks.
Why People With UC Consider Intermittent Fasting
Many individuals with UC explore IF hoping to reduce digestive stress, pain, and frequent bowel movements. The idea is that giving the gut a break from constant digestion might lessen inflammation. However, this is largely based on anecdotal evidence, and the science is still developing.
What Experts Say: Not a One-Size-Fits-All Solution
Gastroenterologists like Dr. Priya Sehgal at Thomas Jefferson University emphasize that IF won’t cure UC and shouldn’t replace standard treatment. It may help a subset of patients, but it’s not universally effective.
Risks of Intermittent Fasting for UC Patients
Before trying IF, understand the potential downsides:
- Nutrient Deficiencies: Prolonged fasting can lead to malnutrition, especially problematic in UC where proper nutrition is crucial.
- Disordered Eating: People with IBD are already at higher risk for unhealthy eating patterns; IF’s restriction could trigger binge eating cycles.
- Medication Issues: Taking steroids on an empty stomach can cause irritation.
- Dehydration: UC flares often involve severe diarrhea, and fasting exacerbates dehydration risk.
Who Might (and Shouldn’t) Try Intermittent Fasting
Avoid IF if:
- You are in an active UC flare.
- You take steroids.
- You have existing nutrient deficiencies.
- Your BMI is under 20.
Consider IF only if:
- Your UC is stable.
- You also have metabolic syndrome (high blood pressure, blood sugar, etc.).
- Your gastroenterologist or an IBD-specialized dietitian has approved it.
IF and Metabolic Syndrome: A Potential Benefit
For UC patients also dealing with metabolic syndrome, IF may indirectly help. Weight loss, particularly abdominal fat reduction, can lower systemic inflammation. While this doesn’t directly fix UC, reducing overall inflammation might ease symptoms.
Research Findings: Mixed Results
A study during Ramadan found that fasting worsened UC symptoms in many participants. Those over 30 with higher baseline inflammation saw the biggest decline. However, inflammatory markers themselves didn’t necessarily increase after fasting. This suggests IF affects symptom perception more than underlying inflammation directly.
Alternatives to Intermittent Fasting
If IF isn’t right for you, consider:
- Mediterranean Diet: Provides essential nutrients in an easily digestible format.
- GLP-1 Medications: If you have metabolic syndrome, these may offer a faster anti-inflammatory effect than IF.
How to Try IF Safely (If Approved)
If your doctor approves, start slowly:
- Shorter Fasting Windows: Begin with 12–14 hours of fasting, not aggressive 16/8 schedules.
- Food Quality Matters: Focus on fresh, unprocessed foods.
- Stay Hydrated: Drink plenty of water.
The Bottom Line
Intermittent fasting isn’t a guaranteed solution for UC. It’s a tool that might benefit some patients with stable disease and metabolic syndrome, but it’s not without risks. Always consult a healthcare professional before making changes to your diet, especially if you have a chronic condition like ulcerative colitis.
