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Inflammatory bowel disease (IBD) is a common disorder that includes Crohn's disease and ulcerative colitis. Worldwide more than 50 million people are affected. In this article, we will discuss ulcerative colitis, specifically, and some natural approaches that may help to improve health.
Ulcerative colitis occurs in both men and women, primarily between the ages of 15 to 35. However, sometimes it can occur as late as age 60. It is considered an autoimmune condition and may be triggered by bacteria, viruses, and certain foods. There also appears to be a genetic component to this, possibly related to chromosome 16.
Those with a first-degree relative (parents or siblings) with ulcerative colitis are 3 to 20 times more likely to be affected than the general population. Although individuals from any ethnicity can be affected, those of European or Ashkenazi Jewish descent are at higher risk.
Clinical symptoms of ulcerative colitis include abdominal pain, bloating, rectal bleeding, and continuous colon inflammation. While inflammation occurs superficially in the colon lining, the rectum is almost always involved.
Anemia is common in those who suffer from this condition due to chronic blood loss and iron deficiency. The absorption of vitamins and minerals can be affected, too.
Chronic anemia and fatigue are common in those with ulcerative colitis and joint pain, and skin rashes. Those with this condition are also at increased risk for developing colon cancer, so it is essential that regular colon cancer screening exams, such as a colonoscopy, occur. Consult with a doctor regarding this.
Dietary habits play a significant role in overall health and the prevention of ulcerative colitis flare-ups. For example, avoidance of sulfur-containing foods, including turkey, beef, milk, eggs, and cheese, may be beneficial to those with ulcerative colitis as they can increase gut bacteria production of hydrogen sulfide. Studies show this gas increases the risk for flare-ups of ulcerative colitis.
The following supplements may also be beneficial.
A probiotic supplement contains healthy bacteria, which can help restore beneficial bacteria to the intestinal tract.
Lifestyle choices can quickly alter the gut microbiome. For example, commonly overused antibiotics can kill healthy gut bacteria. In addition, chronic use of acid reducers can alter the gut microbiome by changing the acid levels throughout the intestine. Those with ulcerative colitis and other digestive issues need to pay extra attention to their gut health.
A 2006 study concluded, "Lactobacillus GG seems to be effective and safe for maintaining remission in patients with ulcerative colitis, and it could represent a good therapeutic option for preventing relapse in this group of patients."
A 2016 study showed that a probiotic supplement containing lactobacillus and bifidobacteria could be helpful to those with ulcerative colitis and may reduce the need for steroids. A 2019 study of the bifidobacteria probiotic and ulcerative colitis also showed beneficial results with supplementation.
Suggested dose: 5 to 100 billion units per day.
Prebiotic foods help improve the gut microbiome by assisting healthy bacteria in growing. Examples of these foods include apples, asparagus, bananas, dandelion greens, and flaxseed, to name a few. These foods help encourage the growth of beneficial bacteria, which produce fructans, a helpful aid in reducing inflammation in the gut of those with ulcerative colitis.
A 2011 study found insufficient data to recommend omega-3 fatty acids to maintain remission of ulcerative colitis and Crohn's disease.
Vitamin D deficiency is one of the most common vitamin deficiencies around the world. Low levels of vitamin D have been associated with many diseases. In my Southern California practice, four in five of my patients were vitamin D deficient when tested. I have been recommending vitamin D to the majority of my patients since 2007. Low levels of vitamin D are associated with ulcerative colitis.
A 2019 study showed that those with ulcerative colitis are more likely to have lower blood levels of vitamin D, and those with the lowest levels have the most symptoms.
A 2014 study showed those with ulcerative colitis who had higher blood levels of vitamin D had fewer symptoms than those with lower levels. Similarly, a 2018 study showed that vitamin D supplementation was associated with reducing inflammation in patients with ulcerative colitis.
Suggested dose: Most need 1,000 to 5,000 IU of vitamin D daily.
In Indian culture, practitioners of ancient Ayurvedic medicine have recommended herbs and minerals as sources of medicinal healing. Turmeric, in paste form, has been applied to the skin for a multitude of conditions. It has also been inhaled as vapor for respiratory congestion. Though clinical trials on the use of turmeric for these purposes are limited, modern practitioners of Ayurveda still recognize that over the past 3,000 years, turmeric has anecdotally provided symptomatic relief and continues to do so.
Traditional Chinese Medicine's use of turmeric or Jiang Huang involved its perceived effect of moving a person's "qi" or vital energy. In addition, people believed turmeric improved blood flow and alleviated abdominal pain. There are studies to support it may help with ulcerative colitis.
A 2017 study concluded "..curcumin has the potential to induce and maintain remission in ulcerative colitis patients with no serious side effects."
Evaluating the dual use of curcumin and the prescription medication mesalamine in 142 patients, researchers in a 2018 study concluded that the combination results in higher remission rates than the medication alone. No adverse side effects were noted.
A 2019 study evaluated six randomized controlled trials, which included 349 patients and had similar findings. This study also showed the combination of curcumin and mesalamine to be beneficial.
L-carnitine is an essential compound in the human body necessary for metabolism. About one in 350 people are unable to synthesize it. However, among those who do, some may have higher requirements than their bodies can make. Those with ulcerative colitis included.
A 2012 study evaluated L-carnitine in individuals with ulcerative colitis. Those with mild to moderate ulcerative colitis activity saw improvement when they had colonoscopies.
Glutamine is one of the most abundant free amino acids present in the human body. Responsible for many metabolic processes, it is considered a "glucogenic" amino acid. This implies that should your body require additional glucose, it can convert glutamine into glucose and provide the body with the energy it needs. The gut also appears to need glutamine to help intestinal fuel cells.
A 2014 study concluded that glutamine supplementation could be helpful in those with ulcerative colitis. Glutamine was also shown, in a 2018 study, to help reduce the pathways which cause inflammation in those with ulcerative colitis.
Most people think of melatonin as a sleep medication. However, its powerful antioxidant properties may be helpful in those with ulcerative colitis.
A 2011 study showed that melatonin could be helpful. The researchers concluded, "… melatonin has a dual action as an effective anti-inflammatory and an antioxidant, and maybe a hopeful therapeutic agent for ulcerative colitis."
More recently, a 2018 study investigated melatonin using a mouse model for ulcerative colitis. The results showed the melatonin's antioxidant properties could help prevent the formation of colitis.
Other studies show that N-acetyl cysteine and berberine may also help control and possibly even prevent ulcerative colitis. In addition, those with ulcerative colitis should also consider supplementing with fat-soluble vitamins — A, K, and E — as they are poorly absorbed.
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By Dr. Eric Madrid, M.D.
