Ulcerative Colitis: Diet and Treatment


The most severe complication of ulcerative colitis is toxic megacolon. It is a condition in which the colon becomes paralyzed, preventing any passage of gas or material; symptoms include fever, sweating, and weakness. If the condition is not treated, the colon can stretch to the point of rupture, an eventuality that is quite dangerous for the very survival of the individual.

Further complications of ulcerative colitis: as a result of the severe inflammatory state and persistent diarrhea, feverish increases, dehydration, iron deficiency anemia, vitamin and mineral deficiencies, loss of strength and appetite, growth retardation may arise. Possible extraintestinal disorders such as arthritis, eye and skin lesions, liver and biliary tract diseases, ankylosing spondyloarthritis. Immunosuppressive drug therapy can also increase susceptibility to infectious diseases.
Patients with ulcerative colitis have an increased risk of developing colon cancer; nevertheless more than 90% of them will not go against the disease in their lifetime. The risk is greater for those patients in whom the inflammation extends to the entire colon and lasts for at least eight to ten years; in such conditions it is recommended to perform a colonoscopic examination every 12-24 months.

Diet and ulcerative colitis

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At present there is no certain evidence on the link between the consumption of certain foods and the onset of ulcerative colitis. Numerous theories have been proposed in this regard, but none has ever been confirmed and universally accepted. One of the first, just to cite a few examples, identified the triggering element in milk, especially for those who are allergic or intolerant to lactose. Chemical food additives have also been investigated for a long time, without however obtaining confirmation of the initial suspicions.
It is currently believed that a diet rich in calories, fats and sugars, but at the same time low in fibres, while not representing a certain etiological agent, can in some way favor the onset of the disease. In confirmation of this, the incidence of ulcerative colitis is markedly higher in the United States and England than in Asian and African countries, which suggests the existence of a link between typically Western dietary habits and disease.

There are also certain foods that can aggravate symptoms, particularly during acute inflammatory episodes. Dairy products, for example, can amplify intestinal disorders, especially if the patient is lactose intolerant. Similarly, meals that are too abundant and an excessive consumption of fibers could accentuate abdominal swelling and bowel disorders. Finally, stress should be kept under control, since the continuous succession of stressful stimuli increases gastric acidity, interferes with normal intestinal transit and facilitates the flare-up of ulcerative colitis.

Diet and ulcerative colitis, some advice

  • Abolish spices, spicy foods (pepper, chilli pepper, curry, nutmeg), alcohol, carbonated drinks, tea (decaffeinated one allowed), coffee (decaffeinated one allowed) and chocolate.
  • Reduce or even eliminate the consumption of milk; on the other hand, small quantities of yoghurt and dairy products are tolerated (with the exception of spicy cheeses). The consumption of probiotic foods may be useful, which must in any case be evaluated by the doctor.
  • Reduce the presence of meteorizing foods, such as legumes, in your diet.
  • Also moderate the consumption of fibers, preferring refined foods to whole foods.
  • Avoid fiber supplements and do not overdo the consumption of fruit (which must be peeled) and vegetables (which can be centrifuged, but not blended to keep meteorism under control).
  • Increase the consumption of fish and flaxseed, while reducing that of nuts and seed oils. In this way you will rebalance the relationship between omega-six and omega-three in your diet, taking full advantage of the beneficial anti-inflammatory action of the latter.
  • In the presence of steatorrhea (excessive amount of fat in the stool), supplements of medium and short chain fatty acids (for example MCT oils) can be used, which are absorbed directly by the intestinal mucosa without undergoing any digestive process.

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