Bowel disease is on the increase and unfortunately it is not only affecting older people but more commonly younger people are also affected. In Australia there are about 61,000 people affected by bowel disease and 33,000 have Ulcerative colitis1
What is Ulcerative Colitis?
Ulcerative colitis is inflammation and ulceration of the bowel, and can affect any part or the whole of the colon. This differs from Crohn’s disease which can affect various parts of the whole gastrointestinal tract.
Types of Ulcerative Colitis
The different types of Colitis can include:
- Ulcerative proctitis which involves inflammation of the rectum.
- Universal colitis (pancolitis) involves inflammation of the entire colon.
- Fulminant colitis is a rare form of universal colitis that can be life threatening because it is such a severe inflammation.
- Prostosigmoiditis means an inflammation to the sigmoid colon as well as the rectum.
- Left sided colitis begins at the rectum and moves in the direction of the left colon.
Symptoms of Ulcerative Colitis
The exact symptoms that people will experience will depend on where the inflammation occurs but can involve:
- Bleeding from the Rectum.
- Anaemia is a lack of healthy red blood cells and occurs as a result of loss of blood from bleeding.
- An urgent need to defecate (empty the bowel – poo)
- Rectal pain
- Loss of fluids and nutrients from the body leading to nutritional deficiencies and malabsorption
- Children with UC may fail to develop normally
- Skin lesions
- Rectal Tenesmus means that the individual feels unable to empty their bowels when they are defecating.
- Abdominal cramps
- Weight loss – due to poor assimilation of food
- High body temperatures
- Night sweats
- Feeling tired all the time – due to anaemia and lack of nutrients.
Causes of Ulcerative Colitis
There is still some debate as to the exact cause of ulcerative colitis. In the past it was believed that stress, anxiety and fear seem to play a part but supporting evidence is difficult to find. It is likely that the condition is due to a number of factors including:
- It is likely that genetics plays a role in the development of ulcerative colitis. Those who have a parent or sibling with UC are more likely to develop the condition.
- It is also likely that this condition is originally triggered by some type of infection.
- It may occur because the immune system is mistakenly triggering an inflammatory response to kill a pathogen that is not there.
- Certain types of diets may encourage such inflammation ie. Highly processed foods.
- Those who are of Ashkenazi Jewish decent seem to be more likely to develop the condition. White people also have a higher risk of developing UC than non-whites.
- Those who are under thirty years of age have a higher risk of developing UC.
- Those individuals who have taken the drug Isotretinoin seem to be more at risk.
Ulcerative Colitis and Alcohol
Many people with UC may be able to tolerate a moderate amount of alcohol, but some individuals will find that even a small amount leads to flare ups. It is definitely recommended that people avoid drinking excessive amounts of alcohol as this is almost certainly going to make their condition worse. Some people have found that the symptoms of their UC improved greatly once alcohol was completely eliminated.
It therefore worth eliminating Alcohol completely for a season and look for marked improvements.
Orthodox Medical Treatment of Ulcerative Colitis
The goal of treatment for UC is to avoid inflammation and the best approach to this will be decided by the severity of the symptoms. The most common form of treatment for the condition is prescription drugs which include:
- Anti-inflammatory drugs work by reducing inflammation in the body. The usual anti-inflammatory drugs used to treat UC include corticosteroids, mesalamine, and sulfasalazine.
- Immune system suppressors such as azathioprine and cyclosporine work by preventing the inflammatory response occurring in the first place. However these often lead to depression of immunity and therefore more risk of infection.
- It can be necessary for people to take other medications for their UC including; anti-diarrhoea medication, antibiotics, iron tablets (to combat anaemia), and pain relievers.
- If medications are unable to keep the inflammation at bay it may be necessary to perform surgery. This may involve removing the entire colon and rectum. Once the procedure is performed the individual will need to wear a colostomy bag. There is usually no further inflammation after the surgery. This is why orthodox medicine is harsh and natural methods are encouraged to promote healing and good anagement of the disease.
Natural Options for the treatment of Ulcerative Colitis.
There are many constructive natural supports that people with UC can do to reduce the chances of inflammation including:
- Improving the gut microflora (good gut bugs)
The gut being the beginning of all disease is paramount in the treatment of UC. Good gut flora is created by the use of specific probiotics to generate healing of the gut lining. Don’t self-treat as specific strains are required.
- Repairing the lining of the bowel with Mucin (slippery elm bark powder) may protect the gut lining to prevent susceptibility to leaky gut.
- Keeping regular blood tests looking for deficiencies in Vitamin B12 and folate, Vitamin D, and iron which will assist in maintaining immunity by supplementation.
- Taking an IgG, IgA, and IgE food intolerance test would be a great way to ascertain if there are specific food allergies causing inflammation.
- Other tests could involve a complete digestive stool analysis (CDSA) to look at the overall health of the gut lining and to rule out parasites and bacteria that might be growing there.
- Prevent osteoporosis which can be due to poor absorption of calcium, magnesium and other cofactors.
- Avoiding Alcohol is a great idea especially if it appears to exacerbate symptoms. This will only increase inflammation.
- Avoiding dairy is advised to eliminate intolerance and inflammation
- Avoiding white bread, sugary carbs and food devoid of nutrition is encouraged.
- Ensure adequate amounts of protein are in the diet and the consumption of fish is encouraged.
- Drinking lots of water to keep hydrated is essential. This should be at least 24ml/kg of body weight.
- Maintaining Short Chain Fatty Acids (SCFA) in the gut that is shortened by the disease, improve wellbeing. These include psyllium seeds (not husks) which in some studies has been associated with significant improvement in symptoms by 69% compared to placebo 24%.2
- Caffeine will exacerbate acidity of the blood which will increase inflammation. It also is very irritating to the gut so avoiding it all together is going to make a difference to flare ups.
- Going for small regular meals rather than gorging the body will make digestion easier.
- Adding certain fibres to the diet may assist in reducing symptoms – these would include flaxseed, chia and psyllium (unless allergic to psyllium).
- Keeping Oxidative stress (damage to cells) at a minimum will reduce inflammation so using Antioxidants will assist this. Vit A, C, E, Zinc and Selenium are all crucial.
- Other nutrients to consider are Calcium & Magnesium, Fish oils, Glutamine, Glycine, N- Acetyl - Cysteine which are all precursors to making Glutathione which aids liver function, many biochemistry cycles and basically prevents disease and early aging.
*Seeking professional nutritional advice is essential and self- medicating is not advised as individual doses and needs differ from one person to another.
1. Anon. Crohns and Colitis Association of Australia. 2009. http://222.acca.net.au/module.asp?module=leftmenu&gotoid=What+is+IBD%3F
2. Hallert C, Kaldma M, Petersson BG. Ispaghula husk may relieve gastrointestinal symptoms in ulcerative colitis in remission. Scand J Gastroenterology 1991:26:747-50
3. Hechtman, L., Clinical Naturopathic Medicine. 2014., Elsevier Australia