P1182Patients’ perceptions of the effects of diet on disease activity and quality of life in Ulcerative Colitis: a Cross-sectional study

Abstract Background Dietary patterns are thought to have considerable influence on quality of life and disease activity in patients with Ulcerative Colitis (UC).1 Expert dietary guidance is becoming more accessible, most recently with ECCO guidelines 2025.2 However there is a dearth of robust trial data to support patient choices. Diet is a key concern raised by patients at clinical review and one of the main sources of confusion, with experimentation and online advice sometimes leading to poor dietary choices, worsening symptoms and exacerbating disease activity.3 Here we describe UC patients’ perceptions of the interaction between dietary choices, quality of life and symptoms, comparing those in remission to those in flare. Methods Participants in this cross-sectional study were recruited from members of Crohn’s and Colitis Society Ireland or local IBD clinics in the Republic of Ireland. Ethical approval for the study was obtained from Cork Research Ethics Committee. All participants completed the following: P-SCCAI (for disease activity), FR-QoL-29 (a questionnaire for food-related quality of life, validated in IBD cohorts), a dietary and disease management questionnaire. Remission was defined as P-SCCAI ≤ 5. Results 65 participants were recruited, 35 in remission (54%, average P-SCCAI 5.31) and 30 in flare (46%, average 7.69). Average FR-QoL-29 in remission was 63.6 and in flare was 52. (FR-QoL-29 maximum score is 145, a higher score indicates better perceived quality of life). Higher disease activity scores showed significant negative correlation with FR-QoL (r = -0.49). 91% of participants avoided at least one food group, especially spicy foods (52%), nuts/seeds (43%), raw vegetables (35%), dairy/lactose (29%) and gluten (26%). 34% avoided 4 or more food groups. Avoidance patterns did not differ significantly between remission and active groups (p 0.05). The number of food groups avoided was not meaningfully associated with FR-QoL. Conclusion This study demonstrates that UC patients feel that diet has a direct impact upon their symptoms and quality of life, whether in flare or remission. Indeed, symptom burden was the strongest predictor of reduced food-related quality of life. Dietary restrictions are extremely common in this group and are often made with UC activity in mind. Dietary choices in this Irish population do not adhere closely to existing dietary advice, raising the risk of adverse nutritional outcomes. These findings highlight the need, and appetite, for structured, evidence-based dietary support within UC care in Ireland based upon larger experimental clinical studies. References: 1. Levine A, Rhodes JM, Lindsay JO, et al. Dietary Guidance From the International Organization for the Study of Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol. May 2020;18(6):1381–1392. doi:10.1016/j.cgh.2020.01.046 2. Svolos V, Gordon H, Lomer MCE, et al. European Crohn’s and Colitis Organisation consensus on dietary management of inflammatory bowel disease. J Crohns Colitis. Sep 28 2025;19(9)doi:10.1093/ecco-jcc/jjaf122 3. Hashash JG, Elkins J, Lewis JD, Binion DG. AGA Clinical Practice Update on Diet and Nutritional Therapies in Patients With Inflammatory Bowel Disease: Expert Review. Gastroenterology. Mar 2024;166(3):521–532. doi:10.1053/j.gastro.2023.11.303 Conflict of interest: Dolan, Conor: No conflict of interest O’Keeffe, Majella: No conflict of interest Fitzgerald, Rhian: No conflict of interest Dr. Sawbridge, David: No conflict of interest