Dietary modification may reduce the symptoms of the disease.
Lactose Intolerance is noted in many ulcerative colitis patients. Those with suspicious symptoms should get a lactose breath hydrogen test. If lactose is restricted, calcium may need to be supplemented to avoid bone loss.- Patients with abdominal cramping or diarrhea may find relief or a reduction in symptoms by avoiding fresh fruits and vegetables, caffeine, carbonated drinks and sorbitol-containing foods.
- Many diatery approches have purported to treat UC, including the Elaine Gottschall's specific carbohydrate diet and the "anti-fungal diet" (Holland/Kaufmann).
Fats and oils
- Fish Oil . Eicosapentaenoic acid (EPA), derived from fish oil. This is an Eicosanoid that inhibits leukotriene activity. It is effective as an adjunct therapy. There is no recommended dosage for ulcerative colitis. Dosages of EPA of 180 to 1500 mg/day are recommended for other conditions.
- Short chain fatty acid (butyrate) enema. The colon utilizes butyrate from the contents of the intestine as an energy source. The amount of butyrate available decreases toward the rectum. Inadequate butyrate levels in the lower intestine have been suggested as a contributing factor for the disease. This might be addressed through butyrate enemas. The results however are not conclusive.
Herbals
- Herbal medications are used by patients with ulcerative colitis. Compounds that contain sulphydryl may have an effect in ulcerative colitis (under a similar hypothesis that the sulpha moiety of sulfasalazine may have activity in addition to the active 5-ASA component). One randomized control trial evaluated the over-the-counter medication methionine-methyl sulphonium chloride (abbreviated MMSC, but more commonly referred to as Vitamin U) and found a significant decreased rate of relapse when the medication was used in conjunction with oral sulfasalazine.
Probiotics & Bacterial Balance
Bacterial balance can be the most significant factor influencing gut ecology and health. With more than 400 microorganism species residing in the human gastrointestinal tract, their overall balance can profoundly influence gut ecology and health. Intestinal bacteria produce toxins and antitoxins, alter chemical composition of foods and drugs, produce and degrade vitamins, degrade dietary toxins and inhibit the growth of certain pathogens. Gut-derived products may also play a role in increasing the systemic immune inflammatory response. Bacterial lipopolysaccharides found in the cell walls of gram-negative bacteria, for example, have been shown to initiate immune responses and elevate pro-inflammatory cytokines.
A fundamental question is whether people with IBD have pathogenic flora, an unbalanced amount of flora, or simply an overly aggressive, improperly regulated immune response toward some of the normal bacteria.
Perhaps the most important function of probiotics is their antagonistic activity toward pathogens and other resident bacteria, which probiotics perform in a variety of complementary ways.
The first activity has been called colonization resistance — the ability of normal flora to protect against the unwanted establishment of pathogen populations.
Second, probiotics may produce various antimicrobial substances. For instance, Lactobacillus casei GG (L-casei or LGG) has been shown to produce substances inhibitory toward a broad spectrum of gram-positive and gram-negative pathogens. Other probiotics have demonstrated antimicrobial activity as well.
Competition for nutrients is a third activity. By competing for available nutrient substrate, beneficial bacteria can inhibit the growth of other, less favorable flora.
Competition for bacterial adhesion sites is probiotics' fourth strategic activity. For instance, Lactobacillus acidophilus inhibits the adhesion of several enteric pathogens to human intestinal cells. A related activity is enzymatically modifying a toxin receptor. Studies using Saccharomyces boulardii, a beneficial yeast, indicate that its interactions with host cell receptors may be important in reducing the pathological effects of infections.
A fifth activity involves a systemic effect. Human LGG, administered orally, has been shown to increase various markers of immune response.
These varied activities may also decrease the likelihood that pathogens will develop resistance against probiotic agents. Thus, probiotics may be viewed as a vehicle to neutralize or inhibit other bacteria in the gut, and increase or stimulate host immune stimulant activities as well.
Aloe Mucilaginous Polysaccharides
Aloe mucilaginous polysaccharides are long-chain sugar molecules composed of individual mannose and glucose sugar molecules connected together — which have been attributed to subduing and reducing symptoms associated with UC.