Ulcerative colitis is an inflammatory disease of the large intestine, not caused by bacteria, which results in ulceration and bleeding. There is inflammation and ulceration of the mucosa and submucosa similar to that seen in infection. It is often characterised by alternating periods with no or few symptoms, and periods with frequent stomach pains and diarrhoea that is mixed with pus, blood, and mucus.
The symptoms depend on how much of the intestine is affected: if it is only the rectum then there may be constipation and blood stained stools: if it is the whole of the large intestine and the disease is very active there may be profuse, bloody diarrhoea with abdominal pain both day and night, fever and weight loss.
The exact cause of ulcerative colitis is unknown. There may be a genetic susceptibility in people with the tissue type HLA B27. Attacks can be prevented in some people with the use of anti-inflammatories prescribed by the doctor but steroid drugs may be needed in a severe outbreak.
Nutritional Supplements that could help. (Refer to the individual supplement for cautions in use.)
|Supplement/Herb||What it does||Dosage|
|Fish Oils||Fish oil supplementation may lead to a decrease in inflammation and an increase of the intestinal mucosal surface area, thereby increasing the absorption of nutrients.||1200 – 4800mg daily|
|Multi nutrient formula||A variety of nutrient deficiencies are common in Crohn’s and Colitis, mainly because of malabsorption issues relating to the condition.||As per manufacturer’s directions|
|Zinc||Zinc, B12 and folic acid are especially important. Zinc deficiency is found in approximately 45% of Crohn’s and Colitis patients, and many of the issues associated with IBD such as impaired healing, fissures, depressed immunity and loss of appetite are probably attributable to poor zinc status.||15 – 45mg daily|
|Folic Acid||Folic acid deficiency is also common in Crohn’s and Colitis which can affect the absorptive ability of intestinal cells, causing further nutrient deficiency. Folic acid deficiency is also associated with diarrhoea.||400 – 600ug daily|
|Vitamin BI2||B12 is absorbed in the part of the intestinal tract most often affected by Crohn’s so deficiency is common and traditional supplements may not help. Sublingual B12 supplements are the best form of oral B12 administration.||1000ug daily|
|Probiotics||Supplementation with probiotics can promote a healthy intestinal environment. A broad spectrum of organisms is advisable, but the most relevant are the Bifidobacteria strains, which are primarily inhabitants of the colon, the part of the intestinal tract affected by Crohn’s and Colitis.||5-15 billion organisms daily|
|Quercetin||Quercetin inhibits the release of inflammatory chemicals such as histamine by influencing two enzymes involved in their release. Additionally, quercetin is known to inhibit synthesis of inflammatory compounds from fatty acid metabolism making it particularly valuable in Crohn’s and Colitis.||1000 – 2000mg daily (between meals)|
|Proteolytic Enzymes bromelain||Inhibit inflammatory processes, such as those that occur in Crohn’s or Colitis. Proteolytic enzymes should be taken away from food to derive anti-inflammatory benefits, but can also be used with food to promote proper protein digestion.||750 – 1 500mg daily (between meals)|
|L glutamine||Recommended for repair of the tissues lining the digestive tract.||5gm morning and evening|
|Slippery Elm||Will help to soothe inflamed mucous membranes.||as directed on the label.|
Diet and Lifestyle Factors
Eat a well balanced diet, which includes lots of cooked fruit and vegetables.
Reduce or avoid:
Dairy products which are mucous forming.
Gluten rich foods such as wheat, barley, oats and rye as gluten contains a protein called gliadin which is known to irritate the walls of the intestine.
Refined and processed foods
Caffeinated drinks such as tea, coffee, chocolate, colas.
Sugar as it an immune suppressant.
Tomatoes, raw fruit and nuts.
Do not smoke as it increases the risk of Crohn’s and Colitis and worsens symptoms.
Increase your intake of:
Fibre (Not from wheat)
Green leafy vegetables
Oily fish like salmon, mackerel, sardines and pilchars which will provide the anit-inflammatory Omega 3 fatty acids to help reduce the severity and frequency of attacks.
Take regular, gentle exercise and make sure you get adequate rest.
Minimise impact of stress, which may be a trigger for Crohn’s and Colitis flare-ups (Also, cortisol slows tissue repair and suppresses the immune system)
Suggested further reading:
- Ulcerative colitis explained
- Management strategies