Health Strategies for Ulcerative Colitis

Ulcerative colitis is one of the most common forms of inflammatory bowel disease. Approximately 170,000 Canadian men, women, and children have inflammatory bowel disease and Canada is believed to have one of the highest incidence rates in the world.

Supplements may be useful in managing this condition, which appears to be related to a combination of genetic and environmental factors such as stress, antibiotics, and non-steroidal anti-inflammatory drugs. If a close relative is afflicted with this disease, our risk of developing it slightly increases.

In 2003, Alternative Medicine Review published a comprehensive appraisal of conventional and alternative treatment options for ulcerative colitis and suggested doses. Some of these options include vitamins A and C, folic acid, calcium, magnesium, selenium, zinc, and, in cases of zinc supplementation, copper.

Supplements such as wheat grass and probiotics may also be useful, as people with ulcerative colitis can develop nutrient deficiencies. Malabsorption, decreased appetite, drug side effects, and increased nutrient loss through the stool may lead to mild or profound deficiencies.

One proviso, though: treatment of ulcerative colitis may require surgical removal of the bowel and is associated with an increased risk of colon cancer. Consequently the potential seriousness of this disease dictates that patients are advised to consult with a health care practitioner before embarking on the use of any of these supplements as a healing strategy.

Take These Supplements

Vitamin A: Vitamin A plays an essential role in enhancing the mucosal integrity of the gut. In 2001 the Journal of Physiology, Paris, reported research that demonstrated vitamin A absorption rates may be decreased in patients with severe ulcerative colitis. In cases of zinc deficiency, hypovitaminosis A may result. Dosage: 10,000 IU daily.

Vitamin C: The extent of disease activity also influences antioxidant levels. Free Radical Research in 1995 published the finding that the normal environment within the bowel is thought to be strongly oxidizing in character and the oxidant stress resulting from inflammatory cells is amplified, contributing to a significant loss of vitamin C. Dosage: 500 to 1,000 mg daily.

Folic acid (folate): Individuals with ulcerative colitis have an increased risk for developing colon cancer compared to the general population, as reported in the Italian Journal of Gastroenterology and Hepatology in 1998. Therefore folic acid (and its anion folate), studied for the prevention of colon cancer in inflammatory bowel disease, is recommended. Dosage: 400 mcg to 1 mg daily.

Calcium: Calcium deficiency in ulcerative colitis patients may result from a variety of factors, including decreased dietary intake, malabsorption, enteric losses, possible vitamin D deficiency, and corticosteroid treatment. Dosage: 500 to 1,000 mg daily.

Magnesium: Magnesium deficiency, a frequent complication, may be due to decreased oral intake, malabsorption, and increased intestinal losses. Dosage: 300 mg daily.

Selenium: An article in the European Journal of Clinical Nutrition in 2000 noted that serum and plasma selenium levels are often significantly lower, especially in newly diagnosed ulcerative colitis patients. Dosage: 200 to 400 mcg daily.

Zinc: Studies assessing zinc status in ulcerative colitis patients have generated mixed results; however, the general consensus is that zinc levels are decreased. When supplementing with zinc, small doses of copper are generally indicated. Dosage: 15 to 45 mg daily.

Copper: While excess copper may increase oxidative stress in the colonic mucosa aggravating inflammation, zinc supplementation may result in a copper deficiency as illustrated in an article in the Central African Journal of Medicine in 2002. Dosage: 1 to 3 mg daily.

Wheat grass juice (freshly extracted): Wheat grass (Triticum aestivum) juice is produced from wheat harvested much earlier in its life cycle than regular wheat. A trial published in the Scandinavian Journal of Gastroenterology in 2002 demonstrated its ability to improve overall disease activity, including the severity of rectal bleeding and abdominal pain. Dosage: 20 to 100 ml daily.

Probiotics: Various strains of Lactobacilli, Bifidobacteria, and Streptococcus salivarius may be helpful in controlling symptoms and maintaining remission. Alimentary Pharmacology and Therapeutics reported research in 1999 that demonstrated the effectiveness of a daily dose of Bifidobacteria, four Lactobacilli strains, and Streptococcus salivarius, subspecies thermophilus, for ulcerative colitis patients in remission. Dosage: 300 billion colony-forming units/gram daily.

More Help is on its Way

Slippery elm, fenugreek, and devil's claw warrant further evaluation as novel therapies for inflammatory bowel disease as demonstrated in a laboratory study published in Alimentary Pharmacology and Therapeutics in 2002. These herbs act as antioxidants against potentially pathogenic reactive oxygen metabolites produced by inflamed colonic mucosa in a way similar to aminosalicylates, the most commonly prescribed medication for ulcerative colitis.