Ulcerative Colitis

Ulcerative colitis (UC) is more common in Western and Industrialized countries and seems to be increasing in developing countries as they adopt Western habits, such as poor diet. Approximately 0.2% of the U.S. population suffers from UC.¹

Some of the potential explanations of this geographical trend include Westernized factors, such as antibiotic use, hygiene, exposures to certain infections, pollution, and diet. A higher risk follows those with a family history of the disease as well. Intestinal permeability (leaky gut) and altered intestinal bacteria seem to play an important role, but it is still not known exactly what causes UC.

Those with UC may experience some or all of the following symptoms:

• Abdominal pain
• Diarrhea
• Dehydration
• Weight loss
• Nausea
• Rectal bleeding
• Fever
• Possible joint pain

Nutrition plays a key role to help those with UC. Improvements in lower inflammation and intestinal bacterial balance precede improvements in symptoms, and even remission is possible.

Diet

• Modern Western diets are pro-inflammatory, and higher intake of animal products, fast food, and high-glycemic refined carbohydrates is associated with an increased risk of inflammatory bowel diseases (IBD; Crohn’s disease and ulcerative colitis).^1,2
• A modified Nutritarian diet may be used to help manage ulcerative colitis (UC). It is important to avoid processed grains, oils, commercial baked goods, fried foods, and most animal products.
• Maximize the intake of high-fiber, immune-system-regulating, anti-inflammatory foods, such as cruciferous vegetables, other vegetables, berries, beans, onions, garlic, nuts, and seeds. Vitamins and minerals are essential for proper immune function, and carotenoids, flavonoids, cruciferous-derived isothiocyanates, and other phytochemicals have anti-inflammatory effects and promote a healthy microbiome. Cruciferous vegetables may be especially beneficial for intestinal immune function.^3-7
• Anti-inflammatory spices such as turmeric, ginger, cayenne pepper, cloves, garlic, and cinnamon should be used in seasoning dishes.^8-11
• Modifications to the Nutritarian diet may be needed and may need to be personalized, particularly during a flare-up. When experiencing a flare-up, raw and higher fiber (especially insoluble fiber) foods, such as raw vegetables, salads, fresh fruits, and beans, for example, may make symptoms worse. The use of more cooked, soft, starchy vegetables, such as butternut and acorn squash, cooked turnips, parsnips, peas, and carrots are recommended and may be tolerated better. Additional modifications that may be helpful during a flare-up are to blend more food (smoothies and pureed soups) and add vegetable juices.
• Fruit intake may need to be reduced to low or moderate amounts for some people with UC.
• During a flare-up, medication may be required to control the inflammation and/or bleeding. Medically supervised fasting may also be appropriate.
• Many with UC will find they are sensitive to gluten, processed foods such as sugar, and animal products, and removing or reducing them may help. Other foods may be triggers and may be unique to each person. Fruit intake may need to be reduced to low or moderate amounts in some people with UC.
   

Supplements

• Dr. Fuhrman’s general supplement protocol for adults (see Vitamin Advisor for details) includes:

  • Multivitamin (without beta-carotene, vitamin A, vitamin E, folic acid, copper), such as Women’s Daily Formula +D3, Men’s Daily Formula +D3, or Gentle Care Formula.

  • Omega-3 DHA and EPA, such as DHA+EPA Purity.

  • Optional: Consider adding a mixed mushroom immune supplement, such as Immune Biotect, because of the potential immune system benefits throughout life from assorted mushroom phytochemicals not normally consumed in the diet.

• Additional supplements:

  • Probiotics: UC and Crohn’s disease are both associated with alterations in the gut microbiome that are thought to be involved in the disease process.12 Studies suggest probiotics may be helpful for promoting remission in ulcerative colitis.¹³ Eating foods rich in fiber and resistant starch also helps to maintain a healthy gut microbiome.

  • Omega-3 fatty acids: High-dose DHA and EPA have anti-inflammatory effects that may be beneficial in Crohn’s disease.^14,15 Talk to your doctor to find out if high-dose omega-3s are appropriate for you.

  • Curcumin: Curcumin, a collection of phytochemicals from turmeric, has anti-inflammatory effects. Limited evidence suggests curcumin supplements help to maintain remission in ulcerative colitis.^16,17

Read

• Eat For Life
• Position Paper: Inflammatory Bowel Disease