What is ulcerative colitis? An integrated treatment approach

Inflammatory bowel disease (IBD) is a general term that covers a number of conditions that involve inflammation of the bowel. The two main types of IBD are Crohn’s disease and ulcerative colitis. In this week’s blog we will discuss ulcerative colitis, and you can find out more about Crohn’s disease in last week’s blog.

What is ulcerative colitis?

Ulcerative colitis is a chronic autoimmune disease characterized by inflammation of the large bowel (colon and rectum). Unlike Crohn’s disease, it only affects the inner layer of the bowel wall.

Cause of ulcerative colitis

Like many of the conditions we see at The Health Lodge, the cause of ulcerative colitis remains unknown. Ulcerative colitis is considered an autoimmune disease, where the body’s immune system attacks its own healthy tissues. However, some researchers suggest it arises from an abnormal immune response of the bowel mucosa to gut flora in genetically susceptible individuals.

While the exact cause of ulcerative colitis it not yet understood, researchers do agree that a number of factors, including genetics, environmental factors, infectious agents (bacteria/virus), and immunological factors may all play a role in the development of the disease, and that the interaction of these factors may lead to the development of ulcerative colitis in susceptible individuals.

Symptoms of ulcerative colitis

The most common symptoms of ulcerative colitis include abdominal cramping and pain, diarrhoea (which is often bloody), and rectal bleeding. Other common symptoms include loss of appetite, fatigue, and anaemia due to blood loss. Some people may also experience symptoms or manifestations outside the digestive tract, including swollen joints, inflamed eyes, skin lumps or rashes, liver disorders, and osteoporosis.

Symptoms can range from mild to severe depending on the individual, and the disease process often follows a pattern of flare-ups (when the disease is in its active stage and the bowel is inflamed) and remissions (where there is minimal inflammation and mild or no symptoms).

 Treatment for ulcerative colitis

Ulcerative colitis can be an incredibly debilitating disease to live with, and can have a high impact on your quality of life. It is essential that you receive adequate care so you can function happily in day-to-day life.  Treatment of ulcerative colitis is aimed at controlling symptoms, preventing flare-ups, improving quality of life, and minimising complications. There is a range of treatment options available to you, and we recommend an integrated “team approach” to your health management.

  • Medical care: Depending on your symptoms and the severity of condition, your GP may recommend anti-diarrhoeal medications, antibiotics, anti-inflammatory medication, or immunosuppressive agents.
  • Acupuncture: Several studies have found that acupuncture may be of benefit to people with ulcerative colitis.
  • Dietetics: A dietitian may be able to help identify problem foods, and to design a diet tailored to your needs to prevent nutritional deficiencies and weight loss.
  • Psychotherapy: Stress may trigger or worsen symptoms of ulcerative colitis. A psychologist may assist you in identifying areas in your life that cause you stress, and help you develop stress management techniques. Psychotherapy may also help you understand manage the emotional impact of your condition.

 

Naturopathic approach to ulcerative colitis

This section will discuss some of the naturopathic approaches to management of ulcerative colitis. We advise you to consult your health carers before considering commencing any of these therapies.

Diet

There is no single diet for ulcerative colitis. Each individual will react to foods differently, and your diet needs to be tailored to your individual needs. Some dietary changes commonly beneficial to people with ulcerative colitis include:

  • Low fibre diet - a low fibre diet may help to ease diarrhoea and reduce abdominal cramping during flare-ups.
  • Identifying and avoiding problem foods- Certain foods may increase cramping and abdominal pain. It is important that you identify any foods that cause such problems and try to avoid them. Common problem foods include fruit and fruit juice, cabbage, beans, broccoli, spicy food, and chocolate.
  • Drinking plenty of water- Try to drink plenty of water to prevent dehydration, especially during times of frequent diarrhoea. Try to avoid alcohol and caffeinated beverages as these stimulate your intestines and can make diarrhea worse. Soft drinks and other carbonated drinks frequently produce gas.
  • Avoiding dairy – Some people with ulcerative colitis are lactose intolerant, and avoiding diary products may be helpful in these individuals.

Lifestyle

Stress reduction: As we’ve already mentioned, stress can trigger or exacerbate symptoms. Techniques such as exercise, yoga, meditation, and massage may help to reduce stress levels.

Correcting nutritional deficiencies

People suffering from ulcerative colitis are at risk of a number of nutrient deficiencies as a result of chronic diarrhoea, blood loss, the use of certain medications, and chronic inflammation. Your naturopath, with your other health care providers, will identify those nutrients you may be deficient in, and may adjust your diet or suggest supplements to correct them.

Identifying food allergies

While there is much contention as whether food allergies play a role in ulcerative colitis, some researchers suggest that food allergies may trigger ulcerative colitis and exacerbate symptoms. If food allergies are present, it is important to identify the problem food, remove it from the diet, and adjust the diet to prevent possible nutrient deficiencies caused by elimination of that food.

Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of ulcerative colitis. Depending on your needs, your multidisciplinary team may include general practitioners, gastroenterologists, naturopaths, dieticians, osteopaths, massage therapists, acupuncturists, counsellors, and psychologists. This comprehensive and holistic approach is designed to support your physical, mental, and emotional wellbeing.