You are likely reading this because you suffer from some of the symptoms of UC (ulcerative colitis) and want to find out more. There are many ways to treat colitis, and we hope that this article will give you a sense of what your condition might be and how it may be treated.
Treatment for Ulcerative Colitis – 3 Powerful Alternatives to Contemplate
Ulcerative colitis is disease of chronic inflammation of the bowels. It is a worldwide disease, but less common in the Asia Pacific and South America.
Ulcerative colitis is a chronic inflammatory disease of unknown cause. The location of the inflammation is in the mucosa of the colon (large intestine). It almost always begins in the rectum and progresses to involve the sigmoid colon, the descending colon, transverse colon and ascending colon, at which point it can be called pancolitis, because the mucosa of the entire large intestine is in a state of inflammation.
Ulcerative Colitis Symptoms
Ulcerative colitis (UC) is characterized diarrhea mixed with mucus and blood.
It is often accompanied by tenesmus, which is the urge to defecate without the ability to open the bowels.
Other symptoms include discomfort in the lower abdomen, cramping and urgency to defecate.
Because you are frequently opening the bowels, UC often leaves you tired, fatigued and lethargic. You often will test as anemic with lower than normal level of hemoglobulin.
Ulcerative Colitis and IBD: What’s the difference?
IBD (Inflammatory Bowel Disease) is the umbrella term for diseases that involve chronic bowel inflammation. Ulcerative Colitis is one type of IBD where the inflammation is confined to the large intestine.
The other type of IBD is called Crohn’s Disease. where the inflammation can be found in any part of the gastrointestinal tract.
Symptoms of IBD include:
- pain, cramps or swelling in the lower digestive tract
- recurring diarrhea with mucus or blood in the stool
- weight loss and extreme fatigue
Not everyone has all of these symptoms. Some people may have additional symptoms like fever, vomiting and even joint pain.
What is the difference between UC and Crohn’s Disease?
Below are the main differences in bullet point form:
- Crohn’s can affect the large intestine as well as other parts of the digestive tract, from the mouth to the anus.
- Crohn’s causes inflammation and destruction beyond the mucosal lining of the digestive tract. It affects all three layers of the bowel wall.
- Malabsorption of nutrients is present in Crohn’s because the small intestine is affected, and the small intestine main role is nutrient absorption.
- Inflammation around the anus is common in Crohn’s.
- Mouth ulcers, swollen tongue and cracks in the corners of the mouth may present in Crohn’s.
- Fistulas are common in Crohn’s.
It does seem that Crohn’s Disease is far more severe than Ulcerative Colitis, although both belong to the umbrella term of Inflammatory Bowel Disease (IBD).
If you suffer from Crohn’s, you may experience inflammation in other parts of your body beyond the digestive tract!
- Skin conditions: 2% of Crohn’s sufferers in the active stage of the disease present with skin conditions like erythema nodosum and vasculitis.
- Inflammation of the eyes: uveitis and conjunctivitis, which clears when the colitis clears
- Joint inflammation: The joints in the hips, knees, ankles, elbows and wrists are often affected, often asymmetrically. The fingers are rarely affected, although you may see clubbing in the fingers. You may also suffer from pain in the lower back due to inflammation of the sacroiliac joint (SIJ).
- Liver disease: When the disease is the active phase, liver markers like AST, ALT and Alkaline Phosphatase may increase, but normalize once in the remission phase.
- Gallstones are common in those with terminal ileitis.
- Myocardial infarct: Crohn’s sufferers have a higher risk of heart attack.
Treatment for Ulcerative Colitis the Biomedical Way
In this article, we focus more on the treatment of UC, even though the same principles (and more) would apply to Crohn’s.
While we don’t know the exact cause of UC, dysfunction of the immune system is always involved.
If you have mild ulcerative colitis, you may need minimal or no treatment and remain well for prolonged periods of time. Treatment aims to relieve the symptoms and prevent them returning.
For mild cases, dietary and lifestyle changes, if done well, will be all you need.
For others suffering from more severe Inflammatory Bowel Disease, one or more of the following interventions are often used:
- Aminosalicylates: These are drugs that contain 5-aminosalicylic acid aka 5-ASA, which include, Sulphasalzine, Mesalazine and Mesalamin. These drugs bring down inflammation in the intestinal lining.
- Anti-inflammatories: Steroids are the common port of call.
- Antibiotics: to treat possible bacteria-induced inflammation.
- Immunosuppressants: drugs like Azathioprine or 6-MP are used to to reduce the activity of the immune system. If these don’t work, cyclosporine may be added as part of the treatment to suppress the inflammatory response.
- Biologics: These are specific antibody-based treatments given by injection that target a specific part of the immune system. The two most common are Infliximab (Remicade) and Adalimumab (Humira)
- Surgery: About 20% of people with severe UC may not get better with medication. Surgery takes out the part of the digestive tract that are too damaged by the condition. Around 60-75% of sufferers with Crohn’s disease may require surgery to repair damage to their digestive system. In about 20% of patients, an ileostomy or ileoanal anastomosis is performed.
Ulcerative Colitis Treatment Strategies
Most people know that steroids are not good for you and want to come of predni but don’t want to come off azathioprine, which is a TNF blocker. In cases where remicade works, then great. But the key is to see how your body responds to the medicine. There are also known side effect of biologics.
Bringing down the inflammation is a very important part of the treatment, especially if your UC is in the active phase. However, it is not just about stopping the inflammation, dousing the fire. We still need to build and regulate and restore function to the body, bringing it into homeostasis.
A house on fire is like being in the acute phase. Once put fire out, why keeping pouring on water (using immunosuppressant) over it? Instead, we should try other ways to help ventilate the house, ensure that the environment around is well-taken care of, ensure that another fire incident does not start again. Diet therapy is a good start, and herbal medicine is very effective for regulating and restoring function to the body.
Diet Therapy for Ulcerative Colitis
Even if you have mild ulcerative colitis, diet therapy should be considered. We outline 6 big ideas below to guide your dietary choices.
1. Fibers are triggering
If you use potatoes, take out the skin. Avoid vegetables from the cruciferous family – this includes broccoli, cauliflower, brussel sprouts, kale, swiss chard and cabbage. No nuts, seeds, beans and lentils.
2. Process all your food
This means you don’t want your digestive system to be doing more of the processing. You want to make digestion and absorption easier. And for most people, the increased peristalsis resulting from the digestive process often ends up with you going more times to the toilet.
Fruits: This is where the juicer comes in handy, because you are taking out most of the fibers. Applesauce, apricots, grapes, honeydew, peaches and watermelon are well-tolerated. Raisins and dried fruits are a no-no. You may also want to avoid berries, even though they are superfoods.
Vegetables: Juicing your vegetable is a good start. And if you are consuming whole vegetables, then you want to be cooking them until they are tender and easy to digest. Appropriate vegetables to be cooking include carrots, cucumber, lettuce, beet, alfafa sprouts, squash and peppers. Despite beans being a no-no, azuki beans tend to be well-tolerated if cooked long enough.
Grains: This is where it makes more sense to use enriched refined grains as opposed to whole grains in your diet. White rice is preferable to brown rice. Processed pasta or noodles are also good candidates.
Protein Sources: You are not advised to consume beans and lentils. For this reason, selected animal meats are still the best form of protein. You want all your meats cook well-done. The protein sources to choose from are tender white meat, fish and eggs (so long as eggs are not a trigger). No red meats.
Dairy: No dairy, for sure.
Raw food: Raw is out, clearly.
3. Learn your triggers
It usually takes some time to figure out what triggers you and to what extent. For example, for most sufferers, alcohol is a trigger, but cocktails are less triggering than red wines. This is likely because red wines contain sulphites.
4. Use porridge as your base.
Cooked white rice or millet made into a porridge is the best way to consume your grains. You can include simple vegetables as laid out above, including azuki beans.
5. Slowly step up into fibers (prebiotics) and fermented foods.
As you improve, you can gradually step up to introduce leafy vegetables and fibers as these fibers are an important source of prebiotics for healing your gut microbiome. Fermented foods like kefir and sauerkraut are also helpful in the recovery stages reduce rates of relapse – they are superfood for gut microbiome.
What you are doing here is to further improve your gut microbiome, which then reduces incidences of relapse.
Option #1: Consider drinking Chinese herbs!
Yes, those herbs may taste terrible, but you may see results very quickly.
How do you prescribe herbs for Ulcerative Colitis? It really depend on a few factors that we lay down below.
- Location of lesions: proctitis or pancolitis?
- What does the blood and mucus in your stool look like?
- What is your body type, more cold or more hot?
- What are your triggers? Food, alcohol, emotional, respiratory or gastro infectoion?
- Frequency of diarrhea?
- Appetite, level of fatigue, intensity of sweats?
We will then assess your condition and put together a formulation to treat your UC. Give yourself two weeks to evaluate your response to the treatment – it would often be more apparent when your UC is in the active phase.
We will definitely be using herbs that contain antimicrobial, anti-inflammatory compounds. Such compounds are important because one of the key strategies is to bring down the inflammation in the bowels without the use of steroids.
We will also choose certain herbs that help regulate the intestinal mucosa. This is important because it is not just about bringing down the fire; it also is about helping your body find its own footing so that it can regulate the inflammation on its own.
Lastly, we will always include herbs that are suitable to treating how inflammation presents in your body. This is the hallmark of using Chinese herbs to treat disease – we must always treat the person, not the disease.
In the end, the end result is a cessation of inflammation in the body, up to the point where the diarrhea and bleeding stops, appetite increase, there is weight gain and the body remember that it is still in charge.
Option #2: We do enemas and they are very effective!
You will be warming up some liquid herbs that we have pre-brewed for you, and you use an enema set to allow the liquid herbs to enter your colon via your anus. You may feel distended in the intestines if this is the first time doing it.
But the herbs are anti-inflammatory in action and can be very healing. The challenge is in keeping the enema liquids in, and it takes practices to get good at this!
Option #3: Acupuncture for Ulcerative Colitis
We will be putting needles in your entire abdomen.
We will also choose points on the head, arms and legs to regulate your body. For some patients, we may engage in moxibustion therapy.
Chinese Medicine can help. We will provide a consultation and will decide on the best herbal and enema treatment for you!