Ulcerative Colitis diet by Ray Sahelian, M.D. Natural and alternative treatment for Ulcerative Colitis

Ulcerative colitis is a severe inflammatory bowel disease of the colon that produces bloody diarrhea. With Crohn's disease the inflammation typically involves the small intestine, but it can affect any part of the gastrointestinal tract, whereas with ulcerative colitis, the disease is usually confined to the colon and rectum. This page focuses on natural and alternative treatment for ulcerative colitis.

Nutritional treatment to Ulcerative Colitis symptoms
Doctors are still trying to figure out the best option for a natural approach to the treatment of ulcerative colitis. Little by little more data is coming in, however, as of September 2008, I am only aware of a few studies with natural supplements that have shown some promise. I am not sure if the supplements discussed below will help a particular person with ulcerative colitis get better. Discuss these findings with your doctor and see what he or she says.

Aloe vera information and a source of Aloe-Vera product.
Curcumin information and a source of Curcumin product.
N-acetyl cysteine, also knows as NAC, has been tested.
Phosphatidylcholine may be helpful
Probiotics information and a source of Probiotic product.

Aloe Vera for Ulcerative Colitis
Randomized, double-blind, placebo-controlled trial of oral aloe vera gel for active ulcerative colitis.
Aliment Pharmacol Ther. 2004 Apr 1;19(7):739-47. Centre for Gastroenterology, Institute of Cellular and Molecular Science, Barts and The London, Queen Mary School of Medicine and Dentistry, London, UK.
The herbal preparation, aloe vera, has been claimed to have anti-inflammatory effects and, despite a lack of evidence of its therapeutic efficacy, is widely used by patients with inflammatory bowel disease. We performed a double-blind, randomized, placebo-controlled trial of the efficacy and safety of aloe vera gel for the treatment of mildly to moderately active ulcerative colitis. Forty-four evaluable hospital out-patients were randomly given oral aloe vera gel or placebo, 100 mL twice daily for 4 weeks, in a 2 : 1 ratio. Clinical remission, improvement and response occurred in nine (30%), 11 (37%) and 14 (47%), respectively, of 30 patients given aloe vera, compared with one (7%), one (7%) and two (14%), respectively, of 14 patients taking placebo. The Simple Clinical Colitis Activity Index and histological scores decreased significantly during treatment with aloe vera, but not with placebo. Sigmoidoscopic scores and laboratory variables showed no significant differences between aloe vera and placebo. Adverse events were minor and similar in both groups of patients. CONCLUSION: Oral aloe vera taken for 4 weeks produced a clinical response more often than placebo; it also reduced the histological disease activity and appeared to be safe.

Anti-inflammatory effects of aloe vera gel in human colorectal mucosa in vitro.
Aliment Pharmacol Ther. 2004 Mar 1;19(5):521-7. Centre for Adult and Paediatric Gastroenterology, Institute of Cellular and Molecular Science, Barts and the London, Queen Mary School of Medicine and Dentistry, London, UK.
Oral aloe vera gel is widely used by patients with inflammatory bowel disease and is under therapeutic evaluation for this condition. The anti-inflammatory actions of aloe vera gel in vitro provide support for the proposal that it may have a therapeutic effect in inflammatory bowel disease.

Curcumin for Ulcerative Colitis
Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial.
Clin Gastroenterol Hepatol. 2006 Dec;4(12):1502-6. Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan; Center for Gastroenterology, Hamamatsu South Hospital, Hamamatsu, Japan.
The aim in this trial was to assess the efficacy of curcumin as maintenance therapy in patients with quiescent ulcerative colitis. Eighty-nine patients with quiescent ulcerative colitis were recruited for this randomized, double-blind, multicenter trial of curcumin in the prevention of relapse. Forty-five patients received curcumin, 1g after breakfast and 1g after the evening meal, plus sulfasalazine (SZ) or mesalamine, and 44 patients received placebo plus SZ or mesalamine for 6 months. Of 43 patients who received curcumin, 2 relapsed during 6 months of therapy (4%), whereas 8 of 39 patients (20%) in the placebo group relapsed. Recurrence rates evaluated on the basis of intention to treat showed significant difference between curcumin and placebo. A 6-month follow-up was done during which patients in both groups were on SZ or mesalamine. Eight additional patients in the curcumin group and 6 patients in the placebo group relapsed. Conclusions: Curcumin seems to be a promising and safe medication for maintaining remission in patients with quiescent ulcerative colitis. Further studies on curcumin should strengthen our findings.

N-acetyl-L-cysteine for ulcerative colitis treatment
N-acetyl-L-cysteine combined with mesalamine in the treatment of ulcerative colitis: randomized, placebo-controlled pilot study.
World J Gastroenterol. 2008 May. Guijarro LG, Mate J, Gisbert JP, Perez-Calle JL, Marin-Jimenez I, Arriaza E, Olleros T, Delgado M, Castillejo MS, Prieto-Merino D, Gonzalez Lara V, Pena AS. Unidad de Toxicologia Molecular Hepatica, Department de Bioquimica & Biologia Molecular, Universidad de Alcala, E-28871, Alcala de Henares, Spain.
To evaluate the effectiveness and safety of oral N-acetyl-L-cysteine (NAC) co-administration with mesalamine in ulcerative colitis (UC) patients. Thirty seven patients with mild to moderate ulcerative colitis were randomized to receive a four-wk course of oral mesalamine (2.4 g/d) plus N-acetyl-L-cysteine (0.8 g/d) (group A) or mesalamine plus placebo (group B). Analysis per-protocol criteria showed clinical remission rates of 63% and 50% after 4 wk treatment with mesalamine plus N-acetyl-L-cysteine (group A) and mesalamine plus placebo (group B) respectively. Clinical responses were 66% (group A) vs 44% (group B) after 4 wk of treatment. Clinical improvement in group A correlated with a decrease of IL-8 and MCP-1. Rates of adverse events did not differ significantly between both groups.  In group A (oral NAC combined with mesalamine) contrarily to group B (mesalamine alone), the clinical improvement correlates with a decrease of chemokines such as MCP-1 and IL-8. NAC addition not produced any side effects.

Phophatidylcholine for ulcerative colitis
Low levels of phosphatidylcholine in the mucous tissues of the colon may contribute to the development of ulcerative colitis. Dr. Wolfgang Stremmel, from University Hospital Heidelberg in Germany, and colleagues randomly assigned 60 patients to receive phosphatidylcholine or a placebo four times daily for 12 weeks. The preparations were encapsulated so that they would not be released until they reached the intestines. Fifteen of 30 patients in the phosphatidylcholine group were able to stop using steroids while maintaining a low clinical disease activity index or improving the index. By contrast, just 3 of 30 patients in the placebo group achieved this outcome. Mild bloating was the most common side effect seen with phosphatidylcholine use. Annals of Internal Medicine, November 6, 2007.

Probiotics for Ulcerative Colitis
Taking a mixture of several probiotic bacteria reduces symptoms in patients with ulcerative colitis that doesn't respond to conventional medications. The probiotic mixture contained four strains of Lactobacillus, three strains of Bifidobacterium and one strain of Streptococcus salivarius -- all well-known species of good bacteria. Researchers from the University of Alberta in Edmonton, Canada enrolled 34 patients with active ulcerative colitis who were treated with the probiotic mixture twice daily for 6 weeks. A variety of standard treatments had been tried on the patients first, with no help. Remission occurred in 53 percent of the patients and an additional 24 percent experienced some degree of improvement in symptoms. A few patients experienced no improvement or worsening of their symptoms. The only apparent side effect from the probiotic mixture was increased bloating. Testing of sampled colonic tissue provided direct evidence that the probiotic bacteria had, in fact, reached the diseased sites of the colon.  American Journal of Gastroenterology, July 2005.

Natural and alternative Ulcerative Colitis treatment questions
Q.  I was recently diagnosed with ulcerative colitis and am trying both prescription and natural ways to get into remission. I was reading about the studies done of germinated barley foodstuff and how it helps those with ulcerative colitis. I can't find any supplements however that are called germinated barley foodstuff . According to the studies the barley must be germinated to be effective for ulcerative colitis. Can you help me locate a supplement (prebiotic) germinated barley foodstuff.
   A. We can't find a product yet that is called germinated barley foodstuff but we will keep our eyes open.

Q. This is briefly mentioned on your ulcerative colitis page. Just FYI, germinate barley foodstuffs are widely prescribed for mild cases of ulcerative colitis in Japan, and I believe the manufacturer is a Japanese beer manufacturer - can't remember if its Kirin or Asahi. It might be hard to get in the US but is easy to find in Japan.

Q. I would appreciate your view on the use of AMP ( aloe mucilagenous polysaccharides ) for the treatment of ulcerative colitis.
   A. A short term study with aloe vera for a month showed some improvement, but longer studies are not available to determine how effective aloe is for ulcerative colitis. 

Q. Has there been any research into natural herbs on the effects of ulcerative colitis and the duration it took for a positive response? Would Cats Claw or boswellia be worth researching for effects on Ulcerative Colitis? Can you point toward this research or a physician that is aware of the natural substances?
   A. Both cat's claw and boswellia have anti-inflammatory properties but we have not yet seen any thorough human research on these herbs for the natural treatment of ulcerative colitis.

Q.  My husband, 74, has chronic ulcerative colitis for years, however, the last year and half, his condition is getting worse. According to his primary doctor, there is no lining (or very thin) in his colon, and needs to have his whole colon removed. He has diarrhea 30 times a day which also causes hemorrhoid. We have been referred to take extra flora, which seems little help. Shall he continue to take the medication that doctor has prescribed to him for life, Sulfasalazine, which is an antibiotic, and this medication will kill whatever bacteria in the intestine. Would this contradict to taking flora and also the Sulfasalazine? Please help and suggest a nutritional regiment. Thank you as we are desperate for natural healing, rather than to have surgery which has no guarantee.
   A.