Ulcerative Colitis Remission With Diet and Supplements

Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that causes long-lasting inflammation and ulcers in the digestive tract (1). The disease leads to malabsorption of nutrients, macro- or micronutrient deficiencies, severe weight loss, and osteoporosis [2-6].

The disease often begins gradually and may become worse over time. Most people who have ulcerative colitis have periods of remission when the symptoms disappear entirely. Remission periods can last for weeks or even years. While there is no recognized cure for ulcerative colitis, there are natural remedies that can significantly reduce the symptoms and lead to long-term remission.

Diet

Many people go for years suffering from painful and embarrassing symptoms, often seriously affecting their quality of life.

Certain foods and diets have been shown to lead to ulcerative colitis flare-ups.   

While everyone reacts differently, certain foods have been known to be common triggers of UC. 

Foods that increase the risk of flare-ups

Increased consumption of sweets is positively associated with UC [7]. 

The European Investigation into Cancer and Nutrition study reported that increased consumption of sugar and soft drinks with low vegetable intake was positively associated with UC risk. [8]

High fat foods and processed foods have also been associated with UC.

Furthermore, the common food additive carrageenan has been shown to affect clinical relapse rates and to aggravate disease activity [9] 

Alcohol is also something you definitely want to avoid.

Foods that decrease the risk of flare-ups

High vegetable intake was also found to be associated with decreased risk of UC [10].

Fiber is essential for reducing pain and other symptoms of UC. Fiber also soaks up extra water in your body and firms stools. This is very important in reducing the pain accompanied by the growth of the digestive tract. 

Furthermore, studies show that a diet lacking in dietary fiber may accelerate microbial imbalance in the gut of people with UC, which is detrimental for the condition [17-18].

For this reason, consuming whole grains, especially rice, quinoa, and oats, is beneficial for people with UC.

Exclusion diets 

For some people, food exclusion diets may be beneficial:

FODMAP — Research has shown that for some people with very sensitive guts, Fermentable foods, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols, or otherwise known as FODMAPs, can trigger symptoms of UC when these foods are poorly absorbed in the small intestine.

Researchers from Monash University in Melbourne developed a low-FODMAP diet for people suffering from UC. 

This diet is not one that should be considered for long term use since it is a restrictive diet preventing sufficient nutrient intake.

It is recommended to follow it strictly one month for it to be effective. After this, slowly reintroduce foods back into your diet to determine their effect on your condition.

Other exclusion diets — these diets remove and slowly reintroduce eggs, wheat, milk, corn, tomatoes, rice, soybean, cod, shrimp, mushrooms, beef, chicken, and pork were also shown to be helpful.[11] Studies show that in comparison to the control diet, following an exclusion diet was associated with a significant decrease in Mayo scores and improvement in the quality of life. [12]

It is wise, therefore, to keep a food diary to help you identify which foods trigger flare-ups. The only way to know for sure if a particular food is causing you problems is to remove it from your diet and then, after some time, slowly start to eat it again.

You will want to reintroduce foods to your diet one at a time to see which ones trigger symptoms. For example, you may first reintroduce a particular fruit for three days. If you have no symptoms, you may then reintroduce another grain as well, and so on.

Once the triggering foods are identified, you will know what to avoid and what you can eat. You can then use this information to formulate your own personalized menu that keeps your symptoms to a minimum.

Frequent meals and hydration 

If you are losing weight because of the ulcerative colitis, try to eat smaller meals throughout the day to prevent discomfort from inflammation. Eating little and often (four to six times a day) is proven to be helpful during flare-ups. If you have chronic diarrhea, drink a lot of water to stay hydrated. [22]

Supplements Shown To Alleviate Symptoms of Ulcerative Colitis

Some supplements have been proven to lengthen remission periods and reduce symptoms during flare-ups. These include:

Omega 3 Fatty acids

Many dietary studies have shown that the omega-3 fatty acid known as eicosapentaenoic acid (EPA) can combat inflammation. (13) The adequate daily intake of EPA for adults should be at least 220 mg per day.

If you choose fish oil supplements, read the label to check the EPA levels in the supplement since it is not the same as the amount of fish oil written on the label. 

People who take blood-thinning medication must consult with their doctor before taking any omega 3 fatty acid supplements to check if there is a safe dose or if these supplements can replace their blood thinning medication.

Probiotics. 

Probiotics have shown to be effective in treating UC because they provide you with good bacteria, reducing immune responses. (14) Best probiotic foods include sauerkraut, natto, kimchi, miso, kombucha. Another kind of food that helps fight UC is Manuka honey.

One meta-analysis showed that probiotics could prevent relapse of UC as effectively as the prescription medication used to treat all types of inflammatory bowel syndrome mesalazine. [16]. 

Iron

Iron prevents anemia and is a nutrient needed to maintain overall health and metabolism. Iron-rich foods include navy beans, spinach, or black beans. I wouldn’t recommend supplementing with iron unless you are found deficient through blood tests. If you are lacking, I wouldn’t recommend taking more than 25 mg iron bisglycinate 2-5 times a week depending on the deficiency.

Folate. 

Folate is also an essential vitamin for people with UC because it helps the body produce new cells. Folate rich foods include chickpeas, lentils, asparagus, avocado, beets, and broccoli. You may take folate as a supplement to ensure sufficient intake. 

Turmeric

One of the best benefits of turmeric, or curcumin, is the ability to prevent inflammation. An analysis of all the studies made about curcumin’s ability to control inflammatory bowel issues showed that many patients could stop taking their corticosteroids because their condition improved so drastically by taking curcumin.

A randomized controlled trial of 82 subjects with UC demonstrated that curcumin at a dose of 2 g/day (1 g/day following breakfast and 1 g/day following supper), when added to standard therapy, significantly reduced relapse rates [19]. 

Vitamin D

Vitamin D, has a very wide variety of critical activities within the body. Vitamin D deficiency is widespread among UC patients [20]. One study reports that patients with UC had more than double the odds of vitamin D deficiency compared with healthy controls [21].

Given that vitamin D status appears to be an independent risk factor for potential poorer outcomes in IBD, supplementation of vitamin D in this population is crucial.

Daily doses of 1800-10,000 IU of vitamin D3 (cholecalciferol) are recommended depending on the baseline vitamin D serum concentration.

To summarize:

Eat little and often, drink adequate fluids, decrease excess intake of fat, decrease simple carbohydrates including sugar, and eliminate dairy products, during flare-ups.

Consume complex carbohydrates daily, including fruit, vegetables, and fiber-rich foods such as legumes and whole grains.

Supplement with the nutrients recommended in this article if you have deficiencies and to help reduce inflammation.

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References:

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