Colitis refers to the inflammation of the colon. The two forms of colitis are Ulcerative Colitis (previously known as ileitis) and Crohn’s Disease (previously known as enteritis) and are referred to collectively as Inflammatory Bowel Disease (IBD), although they exhibit different T-helper cell profiles.
The symptom picture is similar for each: bloody diarrhoea; shooting pain up the backside (tenesmus); faecal urgency; mucous motions and abdominal pain. The cause of the inflammation is unknown but may be due to a) food sensitivity, b) viral or bacterial infection or c) auto immune disease. The cause remains unknown although lifestyle factors appear to play a part such as diet and stress.
Ulcerative Colitis Or Crohn's Disease?
Ulcerative colitis and Crohn's disease cause similar symptoms that often resemble other conditions such as irritable bowel syndrome (spastic colitis). The correct diagnosis may take some time. Ulcerative colitis causes ulceration and inflammation of the inner lining of the colon and rectum, while Crohn's disease is an inflammation that extends into the deeper layers of the intestinal wall.
Crohn's disease usually involves the small intestine, most often the lower part (the ileum). In some cases, both the small and large intestine (colon or bowel) are affected. In other cases, only the colon is involved. Sometimes, inflammation also may affect the mouth, oesophagus, stomach, duodenum, appendix, or anus. Crohn's disease is a chronic condition and may recur at various times over a lifetime. Some people have long periods of remission, sometimes for years, when they are free of symptoms. There is no way to predict when a remission may occur or when symptoms will return.
In ulcerative colitis, the inflammation usually occurs in the rectum and lower part of the colon, but it may affect the entire colon. Ulcerative colitis rarely affects the small intestine except for the end section, called the terminal ileum. The inflammation makes the colon empty frequently, causing diarrhoea. Ulcers form in places where the inflammation has killed the cells lining the colon; the ulcers bleed and produce pus.
One of the most important products to be taken for any form of Colitis is a probiotic. Ethical Nutrients have brought out a product called IBS Support. This product uses the Lactobacillus plantarum 299v strain, which has had numerous animal and human clinicial trains and shown its effectiveness in inhibiting the excessive production of inflammatory cytokines.
In a trial of 19 patients with ulcerative colitis who had been treated with corticosteroids and 5-aminosalyclic acid therapy and were unresponsive were given a treatment of L. plantarum 299v or a placebo. Seven out of the ten patients who recieved the probiotic treatment achieved clinicial and colonoscopic remission. One had a partial responce and only two didn't respond at all. In the placebo group, which was made up of 9 patients, non of them achieved remission and only 2 had a partial improvement¹
Glutamine is a non-essential amino acid, which means that it can be synthesised in the body by other essential amino acids. Factors like stress (in all forms) mean that the body might not be able to keep up with the synthesis of Glutamine and we may need to supplement with this. Glutamine has been shown to stimulate the absorption of water and electrolytes across the intestinal wall and has been suggested for the treatment of IBD², as it helps with healing as it increases cell differentiation and improves the gut barrier function³.
Due to inflammation in the bowel, the body finds it more difficult to absorb nutrients from the food that is being digested It is important to supplement with a multi-vitamin and mineral supplement. Specific minerals should also be supplemented like Iron and Magnesium.
To aid with digestion and also to ease pain and discomfort a digestive enzyme can be used at meals to help the body break down your food better, which may also help with the absorption of nutrients.
To help with the discomfort a supplement like the Advanced Bowel Support can be used. This contains Peppermint Oil and Aloe Vera Juice to help soothe the lining of the stomach and also helps with symptomatic relief of gastrointestinal discomfort, spasms, bloating, abdominal pain and cramping.
The Digestive Ease Tea can also be used as a warming and soothing drink that can help with pain and nausea as well as soothing with irritation caused by IBD.
Ginger or ginger extract should be taken regularly. Ginger has powerful anti-inflammatory properties. Slippery elm is a great nutritive herb with wonderful soothing properties for the intestinal wall and is available in capsules or as a powder. See the recipe at the end of this section.
Colitis is a particularly painful and temporarily disabling condition. Diet is probably the most significant factor in the remission of colitis. Shari Lieberman, nutritionist and author, recommends the following dietary guidelines for controlling and abating colitis.
The most important thing to do is to keep a daily record of what you have eaten. This way you can see which foods have aggravated or improved your condition. Some people are sensitive only to certain foods, such as yeast products, wheat products or dairy products. By checking your daily record, you can see which food caused a flare-up or made you feel great.
If you are struggling to identify which foods precipitate attacks, a grand elimination diet may be needed. This should be conducted under the guidance of a health professional (naturopath).
Milk and lactose containing foods should be avoided. Ice cream, cottage cheese and milk chocolate contain the stabiliser carrageenan that has been shown to be acted on by bacteria and thus produces an intestinal irritation. Some people with a lactose intolerance can tolerate low-fat yoghurt. Try soy-based cheese and soy milk instead of dairy milk. Avoid all sugars. Spicy foods and coffee may also irritate this condition.
A high protein diet should be followed. Fish should be the preferable protein source. Or obtain your protein from turkey or chicken without the skin.
Eat a high fibre diet. Oat bran, brown rice, barley and other whole grains, lentils and related products such as rice cakes are good.
If you want to eat fruit, do not eat it on an empty stomach; eat fruit at the end of a meal. Fruit juice should be diluted with spring water or club soda and taken during or after a meal.
Eat lots of vegetables. Lightly steam them to help break down the cellulose fibre.
Five or six small meals should be taken in preference to large meals.
Increase intake of the essential fatty acids. This can be achieved by supplementing with Flaxseed oil, cod liver oil or tuna oil.
Fluid intake should be high. Drink spring water to make up for the fluid lost with diarrhoea. All water should be filtered as chlorinated water may cause further irritation of the bowel.
Aloe vera juice is very good, especially for ulcerative colitis (and regular ulcers, too). It is a natural juice made from the aloe vera plant. Make sure you use a good brand, that does not add other ingredients, such as sugar. Aloe juice does not cause a laxative effect, but is more soothing to the digestive tract, due to the high content of mucopolysaccharids.
Foods rich in mucopolysaccharide such as aloe vera, tripe, oats, onion and the herb, slippery elm may reduce inflammation considerably.
Cabbage juice should be tried as it contains ‘substance U’ which has ulcer healing properties.
Nutrient supplements rich in minerals, B vitamins and amino acids must be taken by all patients.
Stop smoking and avoid the contraceptive pill as these factors make Crohn’s disease more severe.
N.B. A vitamin K deficiency has been linked to gastrointestinal disorders and ulcerative colitis. Alfalfa supplies needed vitamin K and chlorophyll for healing. However, it is thought that Alfalfa can aggravate SLE, an autoimmune disorder, therefore should be used with caution in other disorders with a possible autoimmune aetiology. Vitamin K is also found in green leafy vegetables.
Stretching exercises such as yoga or Pilates can be of particular benefit in assisting with digestion. The strength of the abdomen is also important. Staying active is beneficial in all aspects of life, especially in improving the emotional (stress and anxiety) factors of IBD sufferers.
Various options exist in order to manage stress such as meditation, yoga, other forms of exercise and neuro-linguistic programming (NLP). Nutritional supplementation can also prove helpful. Some people may have to make lifestyle changes that involve better job practices (i.e. career change or working less hours).
Slippery Elm Gruel
(strengthening, soothing and healing of inflamed surfaces)
The powder made into a mucilage beverage or gruel is a bland and nutritive food for babies, the elderly, or convalescents (it possesses as much nutrition as oatmeal, and is an excellent sustaining food). The gruel is a valuable remedy in all cases of weakness, pulmonary complaints, stomach inflammation, diarrhoea, lung haemorrhage, etc.
1/2 tsp. Slippery elm, powder (Ulmus fulva)
1/2 pint Almond, Rice, Soy (not for infants) Milk
1 tsp. Honey
A dash of cinnamon or nutmeg, powdered
Make a paste out of the slippery elm and honey (press out the lumps); bring the milk to a boil and stir in the slippery elm mixture as the milk reaches the boiling point. Remove from the heat and stir 5-10 seconds, adding the cinnamon or nutmeg. If the finished product contains lumps of slippery elm run it through a blender for a few seconds.
1 - Abstract from Ethical Nutrients Technical Data Manual. Reference used Kordecki H, Niedzielin K. New conception in the treatment of ulcerative colitis: Probiotics as a modication of the micro flora of the colon (Abstr). IN Proceedings of Flak Symposium No. 105, 1998, 45
2 - Absract from Essential Guide to Amino Acids, Dr Barrie Finnin BPharm, PhC, PhD, FPS.
3 - http://www.progressivehealth.com/learn-how-l-glutamine-can-help-ibd.htm
Nutritional Almanac, Gayla and John Kirschmann
Prescription for Nutritional Healing, James and Phyllis Balch
The Physician’s Handbook of Clinical Nutrition, Henry Osiecki