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Researchers don’t know for sure what causes UC, but they think it may be caused by a misdirected immune reaction. Numerous things may trigger a flare, including certain foods. 


Much is being learned about the role of diet and gut bacteria in inflammatory bowel diseases, but some research is still in its infancy. However, the Academy of Nutrition and Dietetics, the World Gastroenterology Organization, and the Crohn's and Colitis Foundation of America all agree that fiber is a protective nutrient for the colon. Fiber should only be reduced when you are experiencing acute symptoms like a flare-up or strictures. 
During a flare-up of symptoms, a low-fiber diet may be helpful in reducing material in the colon, and thereby reducing symptoms and helping you recover more quickly. If your doctor has prescribed a low-fiber diet for your symptoms, follow the recommendations below. Otherwise, follow a high fiber diet.
Foods that contain a lot of fiber tend to be difficult for people with UC to digest. Whole grain flour is high in fiber because it hasn’t had the germ or bran removed. 
You should avoid eating food made from any whole grain flour, such as:
  • breads
  • cereals
  • pastas
  • noodles
  • macaroni
During flare-ups, choose white breads and pastas made from enriched white flour, unless you have a gluten intolerance. Flour is “enriched” when nutrients lost during the germ and bran removal process are replaced. Cereals like puffed rice, corn flakes, oats, and cream of wheat are also lower in fiber.
Avoid the following whole grain foods:
  • brown rice
  • quinoa
  • buckwheat
  • oats
  • wild rice
These grains still have the fibrous endosperm, germ, and bran that can irritate UC and may trigger a flare-up. 
Avoid these other whole grains:
  • plain barley
  • millet
  • wheat-berries
  • bulgur wheat
  • spelt
A better option for those with UC is well-cooked white rice.
Nuts, including those cooked into other foods or made into flours, should be on your do-not-eat list if you have been prescribed a low fiber diet for UC. The fiber in nuts can be very hard to digest. 
It’s best to avoid the following nuts:
  • walnuts
  • hazelnuts
  • pecans
  • cashews
  • almonds
  • macadamia nuts
  • peanuts
  • pistachios
Like nuts, seeds can also aggravate symptoms. Seeds are a type of insoluble fiber, which can cause bloating, diarrhea, gas, and other irritating side effects. 
Some seeds to avoid include: 
  • sesame seeds
  • flax seeds
  • millet
  • pine nuts
  • sunflower seeds
  • pumpkin seeds
  • wild rice
Legumes, including beans, lentils, and peas, are high-fiber, high-protein foods. Because of the indigestible sugars in beans, they’re also notorious for causing gas. If you are experiencing a UC flare-up, you’ll want to pass on the following:
  • all beans, including chickpeas 
  • adzuki beans 
  • soy nuts, including soybeans and edamame
While they are healthy for you, most fruits contain a lot of fiber. Fruits belong on the list of foods to avoid if they are:
  • raw
  • dried
  • have seeds that can’t be removed (like most berries)
You can eat fruit that’s been peeled and if the flesh has been cooked until very soft, such as applesauce. You can also eat canned fruits, but choose the type packed in water or in their own juice to avoid excess sugar. Most fruit juices are fine to drink, but only with the pulp removed. Skip prune juice since it’s very high in fiber.
Like fruits, vegetables are also full of fiber. Include them in your diet only if they are:
  • skinned or peeled
  • have no seeds
  • are cooked until soft
Avoid all raw or undercooked vegetables, including corn. It’s fine to consume canned vegetables and potatoes, as long as the skin has been discarded. Try pureed vegetable soups for an easy way to digest vegetables. Vegetables provide many important nutrients and it’s important to incorporate them in your diet.
Sulfate is a required nutrient in the human diet that assists in many body processes, however, it can also feed certain bacteria that create H2S toxic gas in the UC patient. In fact, over 90percent of UC patients make H2S gas rather than the normal methane gas. If you find yourself experiencing bloating and malodorous gas, you may have an overabundance of these types of bacteria in your colon, excess sulfate and sulfides in your diet, or both. Sulfate and sulfide rich foods to reduce include red meat, dairy milk, beer and wine, apple and grape juice, cruciferous vegetables, eggs, cheese, dried fruit and some well water.
A common food intolerance among those with UC is dairy. If you suspect dairy may be a symptom trigger for you, remove all types of dairy including butter, milk, yogurt, and cheese for at least four weeks. Many resources are available to help you learn how to follow an elimination diet, especially when you work closely with your doctor and dietitian.
A food intolerance that is becoming more common among those who suffer from digestive symptoms is gluten. Gluten is one protein found in wheat, rye, and barley. Gluten is not only found in common foods like bread and pasta, but is also added to prepared products like condiments, sauces, soups, and proteins. If you suspect gluten may be a symptom trigger for you, remove all types of gluten-containing grains, cereals, baked goods, and other products for at least four weeks. Many resources are available to help you learn how to follow an elimination diet, especially when you work closely with your doctor and dietitian.
While your diet may be restricted if you are experiencing a UC flare up, it doesn’t have to be boring. Focus on the foods that you can eat rather than the foods you should avoid. The foods you can eat (unless you have an identified allergy or intolerance to any of the foods below) include:
  • white bread without seeds
  • white pasta, noodles, and macaroni
  • white rice
  • crackers and cereals made with refined white flour
  • canned, cooked fruits
  • cooked vegetables without skins or seeds
  • pureed vegetable soups
  • tender, soft meats (no gristle or skin), fish, and eggs
  • peanut and other nut butters
  • oils like olive oil and coconut oil
It’s important to remember that your diet plays a vital role in your overall health. Use this information as a guide to help you recover from acute symptoms like diarrhea, strictures, or after surgery. To increase your chances of remission, gradually reintroduce high fiber foods, since fiber protects the health of your colon tissue as well as your gut bacteria.

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A gastrointestinal fistula occurs when an abnormal connection forms between part of the gastrointestinal tract and the skin or another organ, resulting in stomach acid leaking out. Doctors may also call a gastrointestinal fistula an enterocutaneous fistula or an intestinal fistula.
A gastrointestinal fistula is a severe medical condition that may require long-term care. This article will describe the most common causes, treatments, and complications of gastrointestinal fistulae.

Causes
An infection may cause an intestinal fistula.
Around 85–90 percent of all gastrointestinal fistulae occur as a complication of surgical procedures.
In a study of 1,148 people undergoing abdominal surgery, researchers noted that 5.5 percent of participants developed fistulae after their operation. Most fistulae appeared during the first week after surgery.
A doctor should always discuss the risks of fistulae with a person before they have abdominal surgery. They should also check in with the individual after the surgery in case they have any symptoms of a fistula, as a prompt diagnosis is likely to improve the outcome.
Other possible causes of gastrointestinal fistulae include:
  • a history of radiation to the abdomen
  • infection, such as diverticulitis
  • inflammatory bowel diseases, including Crohn's disease
  • an ulcer in the gut
  • physical injury to the abdomen
  • cancer Symptoms
    When a person has a gastrointestinal fistula, digested food material cannot move properly through the body. The fistula also causes fluid to leak out, reducing levels throughout the body. Symptoms can include:
  • abdominal pain
  • dehydration
  • diarrhea
  • fever
  • malnutrition
  • raised heart rate
  • vomiting
A person with a gastrointestinal fistula can become very ill and may develop a condition known as sepsis. This is where a person's body attacks itself as a reaction to a severe infection.
Sepsis causes a range of symptoms, such as low blood pressure, high fever, high heart rate, and organ failure. In some cases, it can even be fatal.
Doctors classify fistulae into four main categories, which may cause different symptoms:
  • Complex: This type of fistula has multiple channels that affect more than one organ.
  • External: An external fistula is one that connects a portion of the gastrointestinal tract to the skin.
  • Extraintestinal: This fistula connects part of the intestine to another organ in the body, such as the bladder.
  • Intestinal: This fistula involves the connection of one area of the intestine to another.
A person with an external gastrointestinal fistula will have an area of skin that is open. This means that acid and other contents from the stomach will leak onto the skin through the wound opening. This can be very harmful to the skin.
Diagnosis
Barium imagining techniques can highlight the presence of a fistula.
A doctor will consider a person's medical history when diagnosing a gastrointestinal fistula. If a person has had specific surgical procedures, including gynecologic surgery, they have a higher risk of getting a fistula.
The doctor will also ask about the person's symptoms, including when they presented and whether anything relieves or worsens them.
If the doctor suspects a gastrointestinal fistula, they will order medical tests to confirm the diagnosis. These tests may include:
  • Imaging scans, such as a CT scan, to identify the fistula and determine its size. This is essential so that surgeons can decide where to place drains and operate.
  • Barium studies, in which the doctor will administer barium to the individual orally or by enema before taking an X-ray. If the barium reveals signs of leaking in the intestines, this will confirm the fistula's presence.
  • Fistulogram, a diagnostic test that involves injecting dye into the area of the gastrointestinal fistula where the skin is open and leaking. This should reveal any blockages in the fistula.

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If you’ve ever experienced a weight-loss plateau, you know the disappointment of stepping on the scale after another week of eating well and exercising only to see the same exact number as the week before. For days, or sometimes even weeks at a time, your weight may not budge, which can make your efforts to eat well and move more seem, well, like a waste of time.

The truth is, weight-loss plateaus happen to almost everyone trying to lose weight — even those go-getters with plateau prevention plans. In order to overcome one, it’s important first to understand why they occur. Here are three contributing factors that can lead to a stalemate with the scale:

1. WATER WEIGHT LOSS RETURNS
A rapid drop in weight is normal during the first few weeks of weight loss, but what you may not realize is that a fair amount of this initial weight decrease comes from water lost as the body uses up carbohydrate stores in the form of glycogen (sugar). As carbohydrate intake fluctuates day-to-day, it’s not uncommon for some, if not all, of that water weight to return, which can offset fat loss and cause a plateau.
2. YOUR BODY DOESN’T JUST BURN FAT
The downside to losing weight is that your body doesn’t just burn fat for energy — it breaks down muscle, too. Unlike fat, muscles burn calories, so losing muscle will slow the rate at which you use up energy from food. This, of course, impacts weight loss, and is part of the reason why cutting too many calories can work against you because your body will break down muscle at a faster rate. For tips to offset this, learn why protein is good for weight loss and how to optimize your carb, fat and protein goals.

3. WHEN YOU WEIGH LESS, YOU BURN LESS
As a smaller person, you expend less energy moving around than you did at your heavier weight. Thus, the same number of calories that produced an initial loss may now just maintain your current weight. To continue losing, you’ll have to increase the calories you burn through physical activity and/or reduce the number of calories you eat. For up-to-date calorie need estimates, be sure to update your nutrition goals in MyFitnessPal every 5–10 pounds or so.

Remember, it’s completely normal for weight loss to slow or even stall on occasion, so don’t get discouraged. Now that you understand the main causes of weight-loss plateaus, you’ll be able to devise a plan of attack if and when the number on the scale stops dropping.
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