This great guest post was written by Dr. Serena Goldstein, a naturopathic doctor specializing in natural hormone balance! I encourage you to go check out her website!
Belly pain, cramps, and diarrhea are more than just an inconvenience, especially when they happen virtually every day. But for people who have been diagnosed with ulcerative colitis, or suspect they might have it, there are ways to help manage it.
Ulcerative colitis (UC) is an autoimmune disease and one of many conditions that can benefit from any combination of a natural and/or pharmaceutical approach depending on symptoms and severity. Although there is no cure found yet, people with ulcerative colitis can live in remission for many years.
What Is Ulcerative Colitis?
UC is a chronic inflammatory, ulcerative disease of the large intestine, commonly described as the urgency to defecate about 10-20 times per day, usually with bloody diarrhea (sometimes pus) and painful abdominal cramping (especially in acute attacks).
Other symptoms may also include:
- weight loss
- skin changes
- liver disease
Ulcerative Colitis vs. Crohn’s Disease – What’s The Difference?
UC and Crohn’s disease (CD) make up Inflammatory Bowel Disease (IBD), though both have different pathologies. UC affects the colon only, while characteristic ‘skip lesions’ and cobblestone appearance in CD can occur anywhere from mouth to anus (Geboes & Collins, 1998). When you compare the symptoms of CD and UC, CD also has diarrhea, but less frequent attacks (and rarely bloody).
Who’s At Risk of Ulcerative Colitis?
According to the Lashner (2013), UC is most common at around 20 years old and 50 years old, and affects about 10-70 cases per 100,000 people. Both males and females are equally affected, with Caucasians and Ashkenazi Jews at a much higher risk of developing UC than the overall population.
Risk factors include:
- Food sensitivities
- Non-steroidal anti-inflammatory drugs
- Viral infections,
- Poor diet
- Poor stress management
- History of prior infection
Disrupted immune system.
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Studies have also demonstrated an association between exogenous hormones (e.g. oral contraceptives) and Irritable Bowel Disease (IBD) among young women, and now also show a link to UC in older women as well (Khalili, et. al., 2012).
Effects of Ulcerative Colitis
UC not only affects the gut, but can cause liver problems, like Primary Sclerosing Cholangitis (PSC), which causes the liver to undergo fibrosis and could lead to hepatic failure and death (Uko, Thangada, Radhakrishnan, 2012).
Ulcerative colitis can also increase risk of:
- colon cancer
- kidney stones
- toxic megacolon
- nutritional deficiencies
- and a variety of inflammatory conditions that can affect the eye, skin, and musculoskeletal system.
To avoid and/or treat these outcomes, conventional treatment includes: aminosalicylates, antibiotics, corticosteroids, immunomodulators, biologics, and then surgery if necessary (colostomy bag may be needed afterwards). Other times mild-moderate cases can be managed without hospital care.
Ulcerative Colitis Holistic Protocol
While there are multiple reasons someone may develop UC, fortunately, there are also various therapies that can be optimized to match each person’s health according to their lifestyle. Below is my general recommendation to anyone suffering from UC, that can then be tailored as they work with their healthcare practitioner.
As part of a holistic protocol, an good first step would be to conduct the following tests to see if there are other factors that could be worsening symptoms:
- General blood work
- A nutrition panel that includes iron, B12, folate, methylmalonic acid (MMA) homocysteine, and vitamin D3.
- Food allergy and saliva tests for cortisol, as consuming food allergies and either too low or too high cortisol can contribute to the diseases process (or general inflammation).
Nutritionally, a whole foods diet is recommended, and best cooked (e.g. steam, bake) to place less strain on our gut to digest and absorb nutrients. Some foods that are best to avoid are:
- Spicy foods,
- Fried/fatty foods
- Refined sugar
- Sorbitol, dried fruit
- Carrageenan (a common preservative found in foods)
Food allergens and intolerances (you can get tested for this or do an elimination diet)
While it may seem like a lot, a diet rich in whole foods usually does not contain those constituents above!
Supplements work to supplement, not replace, a healthful diet, as the goal is generally to decrease symptoms and provide palliation, reduce inflammation and oxidative stress, reduce incidence of diarrhea and bowel movements, and heal and soothe the gut.
Below are some of my top recommendations:
- Vitamin D3: Is great to support overall health
- Fish oil: (Free radical scavenger) has been demonstrated at 4.5 grams per day for two months to reduce plasma oxidative stress (Barbosa, et al. 2003).
- Supportive nutrients: Vitamin A, C, E, mixed carotenoids, and quercetin, as they have anti-inflammatory, anti-oxidant, immune boosting, and tissue healing properties.
Probiotics: May also be beneficial, especially lactobacilli and bifidobacteria, as they help reduce the growth of other harmful bacteria (Head & Jurenka, 2003).
Since UC is a chronic inflammatory condition, the first set of herbs to turn to are ones that can dampen inflammation and pain:
In addition to anti-inflammatories, demulcent herbs are good at soothing the gut lining:
Slippery elm (also an astringent to help diarrhea)
- Try a slippery elm tea by steeping 2 tablespoons of slippery elm powder for 3-5 minutes, daily (not safe during pregnancy).
- N-acetyl glucosaminoglycan both helps soothe the gut and helps rebuild the mucosal lining.
Although there are many more herbs and nutrients that can be incorporated and rotated into one’s lifestyle to promote healing, some other things to consider are emotional support such as support groups, counseling, or other energetic type therapies like homeopathy (also great for physical symptoms), craniosacral, and acupuncture.
Lastly, all of the above recommendations must be acted upon within the bigger context of health and integrating better habits such as proper sleep (helps regulate cortisol), and exercise, which can help prevent more serious outcomes.
- Barbosa, D.S., et. al. (2003). Decreased oxidative stress in patients with ulcerative colitis supplemented with fish oil w-3 fatty acids. Nutrition. 19(10):837-842. http://www.sciencedirect.com/science/article/pii/S089990070300162X
- Bassotti, G., Antonelli, E., Villanacci, V., Baldoni, M., & Dore, M.P. (2014). Colonic motility in ulcerative colitis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4245297/
- Geboes, K, & Collins, S. (1998). Structural abnormalities of the nervous system in Crohn’s disease and ulcerative colitis. Neurogastroenterology & Motility. 10:189-202.https://www.researchgate.net/profile/Karel_Geboes/publication/13624527_Structural_abnormalities_of_the_nervous_system_in_Crohn’s_disease_and_ulcerative_colitis/links/5412da700cf2fa878ad3c673.pdf
- Head, K.A. & Jurenka, J.S. (2003). Inflammatory bowel disease part I: Ulcerative colitis – pathophysiology and conventional and alternative treatment options. Alternative Medicine Review. 8(3):247-283.http://www.anaturalhealingcenter.com/documents/Thorne/articles/bowel_disease8-3.pdf
- Khalili, H., et al. (2012). Hormone therapy increases risk of ulcerative colitis but not crohn’s disease. Gastroenterology. 143(5):1199-1206.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480540/
- Lashner, B.A. (2013). Ulcerative colitis. Cleveland Clinic. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/gastroenterology/ulcerative-colitis/
- Uko, V., Thangada, S., Radhakrishnan, K. (2012). Liver disorders in inflammatory bowel disease. 2012:article ID 642923. https://www.hindawi.com/journals/grp/2012/642923/
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