Conditions:
Ulcerative Colitis
Related Terms
•
Inflammatory Bowel Disease (Ulcerative Colitis, Crohn's Disease)
Principal Proposed Treatments
•
Nutritional Support
Other Proposed Treatments
•
Essential Fatty Acids, Probiotics, Wheat Grass Juice, Glutamine, Boswellia, Bromelain, Blue-Green Algae, Glycosaminoglycans, Food Allergies
Ulcerative colitis is a disease of the colon that is closely related to Crohn's disease. The two are grouped in a category called inflammatory bowel disease (IBD), because they both involve inflammation of the digestive tract.
The major symptoms of ulcerative colitis include abdominal pain and bloody diarrhea. When the disease becomes severe, fever, weight loss, dehydration, and anemia may develop. Sometimes, constipation develops instead of diarrhea. Arthritis, skin sores, and liver inflammation may occur as well.
One of the most feared consequences of ulcerative colitis is dramatic dilation of the colon, which can lead to fatal perforation of the colon. Ulcerative colitis also leads to a greatly increased risk of colon cancer.
Ulcerative colitis tends to wax and wane, with periods of remission punctuated by severe flare-ups. Medical treatment aims at reducing symptoms and inducing and maintaining remission.
Sulfasalazine is one of the most common medications for ulcerative colitis. Given either orally or as an enema, it can both decrease symptoms and prevent recurrences. Corticosteroids such as prednisone are used similarly in more severe cases, sometimes combined with immunosuppressive drugs such as azathioprine. Partial removal of the colon may be necessary in severe cases.
Principal Proposed Treatments for Ulcerative Colitis
Individuals with ulcerative colitis can easily develop deficiencies in numerous nutrients. Chronic bleeding leads to iron deficiency. Malabsorption, decreased appetite, drug side effects, and increased nutrient loss through the stool may lead to mild or profound deficiencies of protein, vitamins A, B12, C, D, E, and K, folate, calcium, copper, magnesium, selenium, and zinc.1–10 If you have ulcerative colitis, supplementation to restore adequate body stores of these nutrients is highly advisable and may improve specific symptoms as well as overall health. We recommend working closely with your physician to identify any nutrient deficiencies and evaluate the success of supplementation in correcting them.
Other Proposed Treatments for Ulcerative Colitis
Essential Fatty Acids
Small, double-blind trials suggest that essential fatty acids such as those in fish oil might be helpful for reducing symptoms of ulcerative colitis.11–14 However, another small, double-blind, placebo-controlled trial found no such benefit.15 Larger studies will be necessary to discover for certain whether fish oil helps or not. Regular use of fish oil has not been found effective for preventing disease flare-ups16,17 or (in combination with gamma-linoleic acid) in maintaining remission.35
A small, double-blind, placebo-controlled trial found some benefit in ulcerative colitis with evening primrose oil, a source of gamma-linoleic acid (GLA).18
Probiotics
Friendly bacteria, or probiotics, might be helpful in ulcerative colitis.
A double-blind trial of 116 individuals with ulcerative colitis compared probiotic treatment against a relatively low dose of the standard drug mesalazine.19 The results suggest that probiotic treatment might be equally effective as low-dose mesalazine for controlling symptoms and maintaining remission. Evidence of benefit was seen in other trials as well.20
Probiotics might be useful for individuals with ulcerative colitis who have had part or all of the colon removed. Such individuals frequently develop a complication called "pouchitis," inflammation of part of the remaining intestine. A 9-month, double-blind trial of 40 individuals found that a combination of three probiotic bacteria could significantly reduce the risk of a pouchitis flare-up.21 Participants were given either placebo or a mixture of various probiotics, including four strains of Lactobacilli, three strains of Bifidobacteria, and one strain of Streptococcus salivarius. The results showed that treated individuals were far less likely to have relapses of pouchitis.
Other Natural Treatments
A double-blind, placebo-controlled study of 24 individuals with ulcerative colitis examined the effects of wheat grass juice taken at a dose of 100 cc daily for one month.36 According to various measures of disease severity, participants given wheat grass juice improved to a greater extent than those given placebo.
However, wheat grass juice is rather bitter, and it seems unlikely that the study could truly be blind, meaning that participants and doctors did’t know who was getting the wheat grass juice and who was getting the placebo. Indeed, when researchers polled the participants, a majority of those given wheat grass juice correctly identified it. For this reason, as well as its small size, the results of the study are not convincing.
Glutamine,22–25boswellia,26bromelain,27blue-green algae, 28 and glycosaminoglycans (Gags) have been suggested for the treatment of ulcerative colitis, but the evidence that they work is highly preliminary at best.
There are indications that allergies to foods such as milk may play a role in ulcerative colitis,29–34 although the evidence is not yet solid.
View References
Last reviewed August 2002 by Medical Review Board
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