IBD patients are notoriously concerned with food and diet. As it turns out, their concerns are entirely warranted.
For decades, Crohn’s disease and ulcerative colitis were considered Western diseases, believed to stem largely from genetic factors. But cases are rising dramatically in regions like India and South Asia, areas with previously few incidents. Researchers have also observed the increased rate of IBD in the children of those who immigrated to the west from regions with low incidences. This has led many to question whether diet may play a much larger role in disease pathogenesis than previously thought.
Western food is heavy on refined sugars and saturated fats, highly processed and preserved for long periods of storage, and often imported from one side of the world to the other. Researchers believe this kind of mass production and daily eating habits increase pro-inflammatory cytokines and intestinal permeability, and can negatively impact gut microbiota, resulting in chronic intestinal inflammation.
Does diet effectively treat ulcerative colitis?
While there’s been considerable advancement in diet as a therapy for Crohn’s disease, the research is still thin for dietary treatments for ulcerative colitis.
As of now, there is no single diet that can eliminate UC. Dietary treatment is still essential for UC patients in terms of providing much-needed nutrition. But diet alone is not an adequate therapy for severe and chronic inflammation. Rather, we must think of diet as a supportive treatment that helps UC patients maintain nutrition and address deficiencies. But, when dietary support is used with an anti-inflammatory therapy, it can absolutely help patients with their overall health on their journey to remission.
The Importance of Nutrition for Ulcerative Colitis
Nutritional support is essential for IBD patients. Not only do certain pharmaceuticals deplete vitamin and mineral levels, but the condition itself can hinder the body’s absorption of nutrients (malnutrition), or flush them out altogether (malabsorption). If you’re experiencing ongoing diarrhea, bloating, weight loss, or changes in your menstrual cycle, you may be suffering malabsorption.
While all IBD patients may suffer loss in calcium, B12, B6, Vitamin D, Folate, calcium, and zinc, the following deficiencies are more specific to ulcerative colitis.
UC patients are more prone to blood loss, which can lead to iron-deficiency anemia. This may manifest as fatigue, pale skin, and a strange craving for ice, clay, soil, or paper (doctors call this strange craving for non-food items ‘pica’).
While diet alone may not suffice, absorption of iron supplements and iron-rich foods may be enhanced when consumed with a source of vitamin C.
A 2017 study found lower levels of urinary potassium levels in UC patients with active disease. And a follow-up study showed that increasing potassium actually reduced inflammatory cell activity. The deficiency itself may stem from the fact that the colon is the last area in the body in which potassium is absorbed and sent into the bloodstream. Corticosteroid treatment has also been linked to deficiency, and supplementation for calcium and vitamin D is recommended.
Low potassium may show as muscle cramps, an irregular heartbeat, dizziness, or fainting. While it can be corrected through potassium-rich foods, treatment with supplements needs to be monitored by a professional, as too much potassium can cause muscle weakness or breathing difficulties.
UC patients with chronic diarrhea are especially at risk of magnesium deficiency. You can tell you’re low on magnesium if you’re experiencing numbness, muscle twitching, tinging, and mood swings.
Magnesium absorption can be enhanced with oral supplements and magnesium-rich foods like peanut butter, fish, and spinach. But before you run for the supplements, it’s important to consult with a professional, as too much magnesium can worsen symptoms of UC.
Foods to eat and avoid with ulcerative colitis
Supportive Nutritional Treatment for UC
Few studies have focused on dietary or supplementary treatment for UC, but treatment with short-chain fatty acids has shown “some benefit in reducing colitis”. For instance, studies on mice models of colitis have shown that dietary fiber may inhibit pro-inflammatory cytokine production. And in a separate animal model of colitis, a fiber-rich diet reduced inflammation by altering the composition of the host microbiota via the production of short-chain fatty acids.
And a study on probiotics for UC patients recently concluded that probiotic therapy with E.coli (Nissle 1917) was “equivalent to 5ASA in maintaining remission”.
While dietary and nutritional support is pivotal for patients with UC, neither has been found to sufficiently reduce inflammation. But there is one medical food that, when used correctly, can actually induce remission by targeting inflammation and helping patients maintain remission for long periods of time.
Curcumin Supplementation for Ulcerative Colitis
If you’re seeking a purely natural therapeutic treatment for UC, Curcumin may be your best bet.
Curcumin is the active ingredient of turmeric. The compound has multiple anti-inflammatory and antioxidant properties that work together to target inflammation and the damage caused by inflammation.
The compound, especially when used carefully with qing dai (indigo naturalis) has the most evidence to support its efficiency in inducing remission. Curcumin has also been shown to help patients maintain long-lasting remission, contribute to mucosal healing, and can be used as a preventative measure against future flare-ups.
By reducing the production of inflammatory cytokines, healing intestinal permeability, and recomposing imbalances in the gut microbiota, curcumin serves as a natural antidote to the damage caused by the Western diet.
Disclaimer: Please note that nutritional support for UC depends largely on the state of condition, age, body size, and specific medications. If you or a loved one suffers from UC and require dietary support, we highly advise consultation with your physician or dietitian.