If you have an inflammatory bowel disease (IBD), you have probably noticed the effect of some foods and beverages on your digestive symptoms. However, if during flare-ups bowel movements are, shall we say, a bit more frequent, it can be hard to tell what might be helping or making things worse. Dehydration from frequent trips to the bathroom can also be much more common in ulcerative colitis (UC). In this article, we’ll look at the liquids that heal and those that might hurt the sensitive balance of your gut. These recipes and additional tips on managing inflammatory bowel disease symptoms can help you get back on track. 

What Is Ulcerative Colitis? 

Ulcerative colitis is a type of IBD that is characterized by signs and symptoms of inflammation, including the loss of protective mucus barriers and the development of open sores, or ulcers, in the intestinal tract. Ulcerative colitis also causes changes in the gut microbiome function, with overpopulation of harmful gut bacteria and intestinal permeability (also known as “leaky gut”). Although it has many of the same symptoms and characteristics of Crohn’s disease, the other main inflammatory bowel disease, UC is set apart by its primary location of imbalance: the colon. 

Diarrhea and Dehydration in Ulcerative Colitis

Electrolytes are substances in body fluids that carry a chemical charge (for example, minerals such as sodium, magnesium, potassium, chloride, and calcium). They facilitate critical functions such as muscle contraction, acid-base balance, and maintaining fluid balance inside and outside of cells. Essential electrolytes not filtered and reabsorbed by the kidneys are usually reabsorbed by the colon, or large intestine, as food waste is solidified and turned into stool. 

When a UC flare causes diarrhea, waste moves through the colon too quickly for water and electrolytes to be reabsorbed. The resulting dehydration and loss of electrolytes can worsen inflammation and overall stress in the body. While drinks like soda and other carbonated beverages (even bubbly water) may seem soothing, they can end up adding to uncomfortable symptoms such as gas, bloating, and pain. (Source, Source, Source)

Healing Liquids to Drink With Ulcerative Colitis 

Because dehydration is not uncommon in inflammatory bowel diseases, it is especially beneficial to double down on fluids. However, restoring hydration, especially in UC, requires a little more than plain water. This collection of elixirs offers powerful rebalancing support, with some beverages containing nutrients for intestinal permeability healing and others providing boosts for beneficial bacteria. Some recipes are best as soothing sippers, while others are electrolyte-enhanced water replacements for rehydration needs. No matter the type of beverage or occasion, we have cross-checked and verified the benefits and tastiness, so you can’t go wrong. 

Homemade Oral Rehydration Solutions

Source: The University of Virginia Health System

Resolving acute or chronic dehydration from symptoms of UC can help manage a flare and bring you back to baseline. These 6 rehydration recipes match the ratio of sodium (i.e., salt)  and glucose (i.e., sugar) that maintains your body’s fluid balance. They are intended to help you rehydrate after excessive fluid loss as you might have with diarrhea, but because of their higher salt and sugar content they are not intended as regular drinks during remission. These recipes can easily be made at home using pantry items you likely already have on hand.

Ingredients for all recipes: water, salt, sugar, Gatorade, chicken broth bouillon cube, fruit juice.

Bone Broth 

Source: The Minimalist Baker 

Bone broth is essentially a soup stock that is made from simmering chicken bones for an extended time. As a result, cartilage and joints get broken down into their essential nutrients, which happen to be very nourishing for the intestinal lining that is often damaged in UC. So instead of tossing (or composting) the bones after your next poultry meal, consider simmering them with vegetable scraps and herbs first, and then adding this bone broth to your regenerative routine as a sippable libation. (Source)

Ingredients: bones from whole roasted chicken, water, lemon, apple cider vinegar, herbs, salt, pepper.

Ginger, Turmeric, Licorice, Slippery Elm, and Green Teas

Source: Mountain Rose Herbs

Although there are limited studies on the therapeutic benefits of herbs (and they are generally not recommended as stand-alone medical treatments), many botanicals have been used traditionally for thousands of years and some may offer benefits for UC. Herbs such as ginger and turmeric have been shown to have anti-inflammatory properties, and mucilaginous herbs such as slippery elm and licorice are suggested to provide a protective coating for an inflamed gastrointestinal tract. This may be especially beneficial in IBD when there is damage to the intestinal mucus barrier, which has an important antimicrobial role. (Source, Source, Source, Source)

The benefits of green tea have been the subject of animal and human studies showing that its polyphenols can have anti-inflammatory effects and restore antioxidant status in the body in cases of IBD. Although more research is needed, there is more benefit than risk in starting up a regular tea time. (Source, Source)

Ingredients: ginger, slippery elm, turmeric, licorice, green tea, hot water.

Aloe Vera Juice

Source: Yummy Mummy Kitchen

An aloe plant is helpful to have on hand in the case of a sunburn, but it's less known that the inner pulp can also be consumed. Aloe vera juice is easy to prepare. Dilute it with water and blend with a dash of pineapple or lime juice for extra flavor. Aside from its high nutrient content, compounds in aloe are antioxidant and immune supportive. In fact, in a small study aloe was shown to increase reaching clinical remission of UC. (Source)

While a potentially therapeutic beverage, it is important to consume aloe vera in moderation and consult your health care provider if you are considering aloe or any herbal supplements, as even natural compounds can sometimes have medication interactions and contraindications. 

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Spinach Mint Smoothie

Source: The Healthier Bite

This recipe follows the specific carbohydrate diet (SCD), which is the low FODMAP diet’s lesser known sibling. Low FODMAP and SCD are top choices for digestive distress because they limit the (mainly carbohydrate) foods that can rapidly ferment in the intestines, leading to symptoms of gas and bloating. While the low FODMAP diet has been recommended for irritable bowel syndrome (IBS), recent research supports SCD for minimizing IBD symptoms when experiencing a flare (and as a bonus, it doesn’t restrict fruits as much as the low FODMAP diet). 

Another benefit of SCD is that it is more possible to meet nutritional needs and foster a healthy microbiome for long-term IBD maintenance compared to the low FODMAP diet, which is more restrictive, nutritionally incomplete, and intended for short-term use while identifying triggers for IBS symptoms. (Source, Source)

If you have an aversion to green beverages, we promise this one is special. Sweetened with dates and uplifted by mint, this smoothie is cooling and nutrient packed. Make the night before for a grab and go breakfast, or savor this smoothie as a sweet treat.

Ingredients: canned coconut milk, baby spinach, mint or peppermint extract, dates, banana, ice.

Pineapple Coconut Smoothie

Source: The Healthier Bite 

Thankfully with smoothies, you can have a different one each day and never get bored. We like this one in particular because not only does it have a (sans alcohol) pina colada vibe, pineapple offers a unique digestif prowess via bromelain, a protein-digesting enzyme found in its stem and fruit. 

Superstar bromelain shows promise by potentially interrupting many inflammatory processes in the body, from high cholesterol to cancer. While the exact mechanisms aren’t fully understood, both human and animal studies have found immune system benefits in either adding a cup of fresh pineapple or juice to your daily fruit intake or with bromelain supplementation. But if it tastes good, why not eat (or drink) it? (Source, Source, Source, Source, Source)

Ingredients: banana, pineapple, coconut milk.

5 Minute Breakfast Kefir Smoothie

Source: The Miller’s Kitchen

Kefir is a tangy fermented liquid that contains beneficial bacteria and yeasts that support enhanced immune function and reduced inflammation. It is usually made from cow’s milk, but other varieties such as water or coconut kefir can be used instead. In addition to the health benefits, you can add kefir to any smoothie you like, or simply drink it without any added fuss. This recipe adds kefir to yogurt to create a more potent probiotic combination for gut health. It’s simple, nutritious, and banana sweetened. 

You can purchase milk (or water) kefir from some grocery stores. You can also make it yourself using kefir “grains” (a term that describes the appearance of the bacteria and yeast it’s made with, which don’t actually include any grains). We recommend trying store-bought first, because making kefir can take several days due to time and safety precautions needed for healthy cultures to grow. (Source)

Ingredients: plain unsweetened kefir, plain whole milk yogurt, banana, ice cubes.

The Question About Dairy

Lactose intolerance, or the inability to digest lactose, a sugar found in milk, is common in two thirds of the world’s population. Even so, it is not specifically higher in those with UC, but can still be co-occurring. Many people with lactose intolerance (who may or may not have UC) have been reported to tolerate fermented milk products, such as yogurt and kefir, likely because the fermentation process reduces lactose content. This is good news, since calcium needs can be higher for those with UC due to digestive absorption issues. (Source, Source, Source)

Okroshka: Russian Cold Kefir Soup 

Source: Cultures for Health

Who says you can’t drink your food? When you are looking for more than one way to stay hydrated, adding fluid-based meals to the mix can provide extra support, especially when they offer health promoting benefits. This version of okroshka (a traditional Russian chilled soup) substitutes milk kefir for kvass, a grain-based fermented beverage. It is a perfect light meal for a warm day.

Ingredients: milk kefir, scallions, dill, radish, cucumber, hard boiled eggs, red or golden potatoes, salt, pepper, water. 

Liquids to Limit

Dietary triggers for gastrointestinal symptoms are highly individualized, so drinks that don’t work for you may not be a noticeable problem for someone else. Even so, certain beverages such as soda (including diet soda) have been connected to higher risk of developing inflammatory bowel disease and should be avoided. (Source, Source)

While not necessarily a risk for developing IBD, beer and wine can be dietary triggers of gastrointestinal symptoms for some, and like caffeinated drinks, can contribute to dehydration and irritate your GI tract when consumed in excess. Research is inconsistent in this area as some studies show clinical relapse associated with intake of sulfite-containing beer and wine, and other studies show potential benefit in moderate red wine intake, likely due to the polyphenol content of red grapes. (Source, Source)

Additional Resources

In addition to resources listed in this article, we recommend learning more about diet options for IBD, as well as herbal uses and medication interactions, from these folks: 

Crohn’s and Colitis Foundation: Specific Carbohydrate Diet 

Sloan Kettering Cancer Center Herbal Database 

The Bottom Line

Hydration is an essential step in calming inflammation and rebalancing your gastrointestinal tract in UC, no matter where you are in your recovery process. While minding your individual dietary triggers, there are easy-to-digest options for rehydration, intestinal tract soothing, nourishment, and gut bacteria repopulation. Like food, beverages can be medicine, too! 

We know it’s a bummer to restrict, well, anything. Our team at WellTheory can help you through the process of optimizing your health by finding your symptom triggers and making sure your nutrition is supportive and enjoyable.