Ulcerative Colitis (UC) & Inflammatory Bowel Disease (IBD) What the Research says about its Symptoms, Causes, Prevention, and Treatment by Brian Benjamin Carter

I was in much pain and then they put me on sulfa drugs and antidepressants and I ended up in hospitals... What can I do in this situation? I try not to get upset, but lot's of time I find myself stressed out and unable to handle situations, most particularly at home.

I just lost an aunt to colon cancer and the death certificate stated cause of death was septicemia resulting from pseudomembranous colitis (PMC). I hope to keep healthy as I don't want to be put on ampicillin and other antibiotics to such an extent that they would cause me to experience what she did. Do I and members of my family need to worry about coming down with this monster of a disease?

Worry? Worry is never good!

But can I reframe your questions- Is it likely you will get PMC too? If so, what can you do?

As I said in the article on Pseudomembranous Colitis (PMC), it is an antibiotic-associated diarrheal condition. As long as you avoid antibiotics or at least take probiotics to keep your intestinal flora balanced, you should be able to avoid PMC.

You can also see an acupuncturist/chinese herbalist to treat intestinal imbalances. It's a good idea to have a healthcare provider who can supervise your colonic health- if your physician only knows drugs, you'll need to find help elsewhere.

Also, it stands to reason that if you can keep your Colitis under control and your intestine in good health and balance, you will be less likely to develop more disease there. So let's look at Colitis... its causes, symptoms, prevention, and how to treat it with diet and pharmacologic nutrition.

What is IBD?

Inflammatory bowel disease (IBD) generally includes Ulcerative Colitis (UC), and Crohn's Disease (CD). There is a risk of cancer associated with UC, but it is not yet clear how or why that happens.

Symptoms of Colitis & Crohn's Disease

IBD symptoms include increased bowel movements, blood loss, abdominal pain, nausea, vomiting, and loss of appetite.

This and other complications can lead to nutritional deficiencies. Crohn's Disease patients usually develop malnutrition slowly, while Ulcerative Colitis patients can develop deficiencies very quickly.

What causes IBD and how can you try to prevent it?

The exact cause of IBD is, as they say, idiopathic (they don't know). However, genetics, environment, and diet are contributing factors. What seems to happen is that in genetically susceptible people, the bowel's immunity over-reacts to bacteria (even the normal flora - the good bacteria) of the intestine. This is called auto-immunity; the body attacking itself. The areas of the intestine that don't move as much are especially vulnerable because they are more likely to stagnate.

What is Autoimmune Disease and what causes it?

Scientists still aren't quite sure what causes the the body to mistake its own cells for dangerous invaders. It appears to be a combination of genetics and environmental influences. Since we can't change our genes (yet!), we must control what comes into contact with our immune system. Some researchers speculate that immune-related gut problems have increased at too high a rate to be caused by genetics. Environmental influences, they say, are a much more likely cause.

Environmental influences can be broken down into two categories: hygiene and nutrition. Probiotics ("beneficial live microorganism cultures that are characteristic of the healthy, human gut microflora") have been shown to reinforce the gut's ability to defend itself properly, alleviate inflammation, normalize the bowel, and decrease sensitivities.

There is quite a bit of controversy about vaccines and how they might negatively impact the immune system. I've actually avoided this topic because it is one of the more emotional and divisive issues in medicine today… it deserves its own article. For now, I'll just say: Look into it, and think carefully about immunizing your children if your family has a history of autoimmune disorders.

Can You Prevent IBD?

If someone in your family before you has had colitis or crohn's, you need to watch out for it yourself, and try to prevent it from starting up. We don't know for sure how to prevent IBD, but from what the research says, we can reason that the following tips might help:

• Keep your bowels moving. Avoid constipation. It's best to do this naturally with proper diet. It's best to prevent constipation by drinking plenty of fluids (watch out for fluids loss with caffeine drinks that make you urinate), eating a fiber-rich diet, and taking fiber supplements. But if you have to use a laxative… Psyllium allergy, stimulants (bisacodyl, senna) may cause cancer, danthrons can harm liver, and magnesium or phosphates can cause metabolic disturbances - all should only be used occasionally.
• Keep your intestinal flora balanced and healthy. "Dysbiosis" is when there is too much of some intestinal bacteria and not enough of others. Avoid antibiotics except when absolutely necessary, since they can throw off the normal balance of intestinal flora. If you do have to take antibiotics, follow them up with probiotics, and have your healthcare practitioner monitor your intestinal health with stool tests (GSDL). Eat lots of fruits and vegetables.
• Diet. Not only might your family give you the genetic susceptibility to ulcerative colitis or crohn's, but also they may teach you bad dietary habits. How we eat as children, and how we are taught to relate to food make for stubborn habits later in life. We may use certain foods as "comfort foods." But what if these comfort foods lead to discomfort and life-threatening illness later on? Examine your eating habits and do everything you can to improve them.
• Further prevention ideas. You may want to consider the following advice for active IBD sufferers- some of the dietary advice and pharmacologic nutrition may help to stop inflammatory processes in their tracks. Consult your healthcare practitioner for guidance.

Nutritional Advice for People already diagnosed with IBD

Generally, normal diets are ok, but food intolerances require restrictions.

• Lactose intolerance- avoid dairy products
• Intestinal stenosis - avoid high fiber diet (corn grains, seeds, fruits and vegetables)
• Ilial disease or previous resection - eat a low fat diet
• Steatorrhea (fat in the stool) - eat medium chain triglycerides (coconut oil, palm kernel oil, butter) instead of common fat
• Prevent stone formation - restrict oxalate ingestion
• Find and address micronutrient deficiencies such as iron, calcium, cobalamine, etc.
• Iron deficient hypochromic microcytic anemia - take iron supplements, B12
• Crohn's Disease symptomatic patients- multivitamin and mineral supplements
• Prolonged diarrhea zinc deficiency: 20-50mg zinc daily
• Risk of osteoporosis (due to steroid therapy, post-menopause, long-term bed rest, smoking, family history): daily calcium 1000mg and vit D 400-800 IU
• During very bad episodes, to allow the bowel to rest (to reduce inflammation and/or before surgery): IV (intravenous) nutrition
• Liquid nutrition is another option, either to fix nutritional deficits, or as a therapy for active disease. It can be used as long as there is no intestinal obstruction

Pharmacologic Nutrition (treatment of disease with specific nutrients) for IBD

To prevent tissue damage, you must get enough

• Glutamine
• Glutathione
• Zinc
• Selenium
• Vitamins A, C & E, and
• Short-chain fatty acids (SCFA's)

Glutamine supplementation may help, but the research is not yet conclusive. Short-chain fatty acids (mostly acetate, propionate and butyrate) come from the interaction of your intestinal friendly flora and the carbohydrates you eat.

Short Chain Fatty Acids - Intestinal Fuel

SCFA's are the colon cell's main energy source. Butyrate is the most important one. In Ulcerative Colitis, its use and availability are impaired. Butyrate has been shown to increase wound healing and to reduce inflammation in the small intestine. Oral butyrate is safe and well tolerated. It also may improve the effectiveness of oral mesalazine. Researchers believe that butyrate induces enzymes to promote healing of the intestinal lining. An enema of SCFA's has been shown to help treat Ulcerative Colitis. Another way to get SCFA's is by eating germinated barley foodstuff (GBF). Patients with mild to moderate active Ulcerative Colitis experienced improvement with GBF after 4 weeks. A third option is oral Clostridium butyricum M588 (CBM588), an enterobacterium that produces butyrate. CBM588 has helped rats with colitis.

Omega-3 Fatty Acids (fish oils) for IBD

Omega-3 Fatty Acids (fish oils) have been shown in IBD patients to decrease symptoms, need for steroids, and to improve the condition of the intestinal cells.

Chinese Herbal Remedies

For information about chinese herbs for IBD, read the section in the PMC article called "The Chinese Medical Disease: Li Ji."

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