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This disease typically begins in the sigmoid colon and/or rectum, and then usually progresses until the entire colon is affected. Ulcerative colitis involves only the colonic mucosa, and the lesions are uniform and continuous with no areas of normal tissue interspersed between the diseased mucosa.
Incidence
It is seen in both sexes equally, although white and Jewish people are more often affected. A person is five times more likely to get it if one parent has the condition. Peak occurrence is from 15-35 years of age, although any age is susceptible.
Signs & Symptoms
About half of patients with ulcerative colitis have mild symptoms. Ulcerative colitis may also cause problems such as arthritis, inflammation of the eye, liver disease (fatty liver, hepatitis, cirrhosis, and primary sclerosing cholangitis), osteoporosis, skin rashes, anemia, and kidney stones. No one knows for sure why problems occur outside the colon. Scientists think these complications may occur when the immune system triggers inflammation in other parts of the body. These problems are usually mild and go away when the colitis is treated.
Systemic and extracolonic symptoms include: skin changes; liver disease; posterior uveitis, etc.; decreased growth and development; and failure to thrive (in children).
Diagnosis & Tests
In order to confirm the diagnosis, testing may include barium X-rays of the upper and lower GI tract, flexible sigmoidoscopy, and sometimes colonoscopy. During these tests, biopsies may be obtained.
Laboratory findings:- Definitive diagnosis requires a colonic mucosal biopsy
- Normocytic anaemia (acute blood loss) or microcytic anaemia (iron deficiency due to chronic blood loss)
- Gross or occult blood in stool; WBC in stool
- Leukocytosis during acute exarcerbation
- Increased sedimentation rate - indicates active inflammation
- Decreased serum K, Na CI - due to diarrhoeal loss
- Decreased serum albumin due to loss of protein from the diseased bowel wall; the degree of hypoalbuminaemia parallels the severity of the disease
- Increased alkaline phosphatase, SGOT (AST) and bilirubin due to associated liver disease.
Treatment & Prevention
If candida or a bacterial overgrowth is present, further recovery in ulcerative colitis can be achieved by correcting the imbalance through antimicrobial or antifungal agents.
Complications
Carcinoma of the colon, gastrointestinal bleeding, arthritis.
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Signs, symptoms & indicators of Ulcerative Colitis:
Conditions that suggest Ulcerative Colitis:
Risk factors for Ulcerative Colitis:
Ulcerative Colitis suggests the following may be present:
Ulcerative Colitis can lead to:
Recommendations and treatments for Ulcerative Colitis: | | | | | Botanical |  Robert's Formula
 Boswellia | One small, controlled, double-blind trial has shown that boswellia extract may be helpful for ulcerative colitis. [Eur J Med Res 1997;2: pp.37-43] |
Comfrey |
Diet |
Gluten-free Diet
Therapeutic Fasting| | Short fasts can be beneficial, giving the entire organism an opportunity to restore its cellular and immunogenic integrity. |
High/Increased Fiber Diet| | Approach a high fiber diet cautiously during periods of inflammation, as it may aggravate the condition. As you stabilize, fiber and unrefined foods are important to continue the health of the colon.
A study found Plantago ovata seed (the whole psyllium seed, not just the husk) at 10gm bid to be as effective as the drug mesalamine for maintaining remission in patients with ulcerative colitis. In addition, the Plantago ovata seed may help prevent colon cancer, a common complication of ulcerative colitis, because it increases colonic butyrate levels. |
Food Additive Avoidance| | It may be wise to avoid the food additive carrageenan, found in various foods such as apple cider, hot dogs, most ice creams and prepared sauces and jellies, as it can produce inflammation and immunodeficiency and has been found to cause colitis and anaphylaxis in humans. |
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Digestion |
 Hydrochloric Acid (Trial)
Digestive Habit Changes| | Foods should be eaten slowly and be well chewed. Eat in a calm atmosphere; do not read or watch television while eating. Any influence that may disrupt good digestion should be avoided. |
Probiotics| | Dr. McCann, originally with Kaiser Permanente in Ohio, has pioneered a dramatic, experimental treatment for inflammatory bowel disease which has induced a rapid remission in 16 out of 20 patients with ulcerative colitis. A two-day course of multiple broad-spectrum antibiotics to "decontaminate" the gut is followed by administration of defined strains of E. coli, and Lactobacillus acidophillus to produce a "reflorastation" of the colon. Others have not achieved this same degree of success. It may need to be combined with the specific carbohydrate diet described in the book Breaking the Vicious Cycle. |
Digestive Enzyme (Trial)| | Stool analysis or a pancreatic trial will reveal if pancreatic enzymes are necessary. |
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Drug |
LDN - Low Dose Naltrexone |
Habits |
Tobacco Avoidance| | Smokers have lower than average rates of ulcerative colitis, but higher than average rates of Crohn's disease. Some patients with ulcerative colitis, in fact, have reported that their disorder began after they quit smoking, and many studies have reinforced the association between smoking and protection against ulcerative colitis. Studies are showing that the nicotine patch helps to induce remission and reduce symptoms in almost 40% of patients who use it for four weeks. Another study found, however, that patches are not useful for maintaining remission. Side-effects, particularly in nonsmokers, include nausea, lightheadedness, and headache. Investigators are studying methods of applying nicotine directly into the colon. (No one should smoke for relief of ulcerative colitis symptoms; the risks from cigarettes far outweigh the potential benefits of their nicotine.) |
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Hormone |
Hydrocortisone| | Ulcerative colitis is both an autoimmune disorder and sensitive to stress. Using hydrocortisol to reduce inflammation followed by physiologic replacement doses when indicated is a reasonable supportive therapeutic strategy. |
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Lab Tests/Rule-Outs |
Test for Food Allergies| | As many as 50% of sufferers will improve by avoiding food allergens such as dairy, wheat, corn and eggs. |
Test for DHEA |
Mineral |
Calcium-2AEP
MSM (Methyl Sulfonyl Methane)| | Some doctors have reported reduced pain with the use of MSM. |
Zinc| | Zinc supports tissue regeneration and can be especially useful if levels are deficient. |
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Nutrient |
Butyrate| | Whether by supplement or by enema, pilot studies suggest butyrate is useful in reducing symptoms and restoring indicators of colon health in ulcerative colitis, although one study showed no benefit over placebo. Several doctors claim that many people are helped by butyrate enemas.
Butyrate by enema has substantially reduced the number of bowel movements and amount of bleeding in patients who have not responded to other therapies. This is especially true when the distal colon is involved - an area where the enema can easily reach. |
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Oxygen / Oxidative Therapies |
Ozone / Oxidative Therapy| | Rectal insufflation of ozone can hasten tissue repair and kill bacteria that may be slowing the healing process. |
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Psychological |
Counseling| | Unresolved grief is sometimes a hidden contributing factor. Resolving the issue as completely as possible may hasten healing and reduce relapses. |
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Vitamins |
Vitamin A
Vitamin E
Vitamin C (Ascorbic Acid) |
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KEY | | Weak or unproven link |  | | Strong or generally accepted link |  | | Proven definite or direct link |  | | Strongly counter-indicative |  | | Very strongly or absolutely counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Alkaline
A substance having a pH above that of neutral water (7.0) when in solution. Signified as pH (potential of Hydrogen), alkaline fluids, such as the blood (pH about 7.4), have the ability to neutralize acids (solutions below pH 7.0). Metabolic wastes are acids, and the alkaline reserve of the blood neutralizes them until they are excreted.
Allergen (Allergens)
A substance that is capable of producing an allergic response in the body.
Anaphylactic Shock (Anaphalactic Shock, Anaphylaxis)
A serious and rapid allergic reaction usually involving more than one part of the body which, if severe enough, can kill. It is characterized by decreased blood pressure and impaired respiration.
Anemia (Anaemia, Anemias)
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.
Antifungal (Antifungals)
An agent that kills or inhibits fungi, or a compound that inhibits either a dermatomycosis like ringworm or athlete's foot, or
one that inhibits Candida albicans either externally as a douche or internally as a systemic antifungal. Examples: Nystatin, griseofulvin, Tabebuia.
Antimicrobial
Tending to destroy microbes, hinder their multiplication or growth.
Arthritis (Arthritic)
Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis. Osteoarthritis, the most common form, is characterized by a gradual loss of cartilage and often an overgrowth of bone at the joints.
Autoimmune Disease (Autoimmune, Autoimmunity)
One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
BID
Twice per day.
Bilirubin
A waste product of hemoglobin recycling, it is primarily excreted in feces, oxidizing into that familiar brown color (except for beets).
Biopsy
Removal of a sample of tissue from a living being for diagnosis. A pathologist later uses a microscope to look for certain features, such as cancer cells, in the sample. A fine-needle aspiration biopsy involves inserting a thin needle to remove a small amount of tissue, sometimes using CT or ultrasound to guide the needle. A core biopsy involves obtaining a sample of tissue with a thick needle or by inserting a thin, lighted tube (laparoscope) into a small incision in the abdomen. Another biopsy method is to remove tissue during an operation.
Butyrate
Butyrate is an important short chain fatty acid that provides fuel for colon cells and may help protect against colon cancer. The most potent dietary source is butter (3%).
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Candidiasis (Candida)
Infection of the skin or mucous membrane with any species of candida, usually Candida albicans. The infection is usually localized to the skin, nails, mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a common inhabitant of the GI tract, only becoming a problem when it multiplies excessively and invades local tissues. Growth is encouraged by a weakened immune system, as in AIDS, or with the prolonged administration of antibiotics. Vaginal symptoms include itching in the genital area, pain when urinating, and a thick odorless vaginal discharge. Candidiasis is also known as: Candida; Candida albicans; Candida Related Complex; Chronic Candida Syndrome; (Chronic) Systemic Candidiasis; Monilia; Candidiasis Hypersensitivity Syndrome; Candidosis; (Chronic) Mucocutaneous Candidosis; Thrush (oral or vaginal); Moniliasis; Polysystematic Candidiasis.
Carbohydrates (Carbohydrate)
The sugars and starches in food. Sugars are called simple carbohydrates and found in such foods as fruit and table sugar. Complex carbohydrates are composed of large numbers of sugar molecules joined together, and are found in grains, legumes, and vegetables like potatoes, squash, and corn.
Carcinoma
Malignant growth of epithelial cells tending to infiltrate the surrounding tissue and giving rise to metastasis: An invasive malignant tumor derived from epithelial tissue that tends to metastasize to other areas of the body.
Celiac Disease (Gluten Sensitivity)
A digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten. Common symptoms include diarrhea, increased appetite, bloating, weight loss, irritability and fatigue. Gluten is found in wheat (including spelt, triticale, and kamut), rye, barley and sometimes oats.
Cholangitis
Bile duct inflammation.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Cirrhosis (Liver Cirrhosis)
A long-term disease in which the liver becomes covered with fiber-like tissue. This causes the liver tissue to break down and become filled with fat. All functions of the liver then decrease, including the production of glucose, processing drugs and alcohol, and vitamin absorption. Stomach and bowel function, and the making of hormones are also affected.
Cobalamin (B12, B-12, Cobalamine, Vitamin B12)
Essential for normal growth and functioning of all body cells, especially those of bone marrow (red blood cell formation), gastrointestinal tract and nervous system, it prevents pernicious anemia and plays a crucial part in the reproduction of every cell of the body i.e. synthesis of genetic material (DNA).
Colitis
Colon inflammation, usually involving the mucus membranes. Mucus colitis is a type with cramps, periods of constipation, and copious discharge of mucus with feces. Ulcerative colitis has pain, inflammation, ulceration, fever, and bleeding, all interspersed at various times - a long and serious illness.
Colon (Colonic)
The part of the large intestine that extends to the rectum. The colon takes the contents of the small intestine, moving them to the rectum by contracting.
Colonoscope (Colonoscopy)
A thin, flexible 'telescope' that is passed up from the anus in order to examine the bowels.
Constipation (Constipated)
Difficult, incomplete, or infrequent evacuation of dry, hardened feces from the bowels.
Copper
An essential mineral that is a component of several important enzymes in the body and is essential to good health. Copper is found in all body tissues. Copper deficiency leads to a variety of abnormalities, including anemia, skeletal defects, degeneration of the nervous system, reproductive failure, pronounced cardiovascular lesions, elevated blood cholesterol, impaired immunity and defects in the pigmentation and structure of hair. Copper is involved in iron incorporation into hemoglobin. It is also involved with vitamin C in the formation of collagen and the proper functioning in central nervous system. More than a dozen enzymes have been found to contain copper. The best studied are superoxide dismutase (SOD), cytochrome C oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase, lecithinase and other monoamine and diamine oxidases.
Crohn's Disease (Crohn's)
Chronic inflammatory disease of the gastrointestinal tract. The most common symptoms are abdominal pain, often in the lower right area, and diarrhea. Rectal bleeding, weight loss, and fever may also occur. Bleeding may be serious and persistent, leading to anemia.
DHEA (DHEA-S)
Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. DHEA may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEA-S. One form is converted into the other as needed.
Diarrhea
Excessive discharge of contents of bowel.
Distal
Anatomically located further away from a point of reference, such as an origin or a point of attachment.
Enzymes (Enzyme)
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
Fatty Liver
Accumulation of triglycerides in the liver.
Gastrointestinal (GI, GI Tract)
Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.
Gram (gm, gms, Gramme, Grammes, Grams)
A metric unit of weight, there being approximately 28 grams in one ounce.
Hepatitis
Inflammation of the liver usually resulting in jaundice (yellowing of the skin), loss of appetite, stomach discomfort, abnormal liver function, clay-colored stools, and dark urine. May be caused by a bacterial or viral infection, parasitic infestation, alcohol, drugs, toxins or transfusion of incompatible blood. Can be life-threatening. Severe hepatitis may lead to cirrhosis and chronic liver dysfunction.
Hiatal Hernia (Hiatal Hernias)
Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm (a diaphragmatic hiatus). This is a common problem and most people are not bothered by it. A hernia may allow stomach acid to flow back into the esophagus ("food pipe"), where it can cause problems. The most common symptom is burning in your chest (heartburn), especially at night when you are lying down. Other possible signs include burping and trouble swallowing.
Hypochlorhydria (Hypochlorhydric)
The condition of having low hydrochloric acid levels in the stomach, often the cause of digestive disorders.
Immune System (Immune Response, Immunity)
A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation. The process may involve acquired immunity (the ability to learn and remember a specific infectious agent), or innate immunity (the genetically programmed system of responses that attack, digest, remove, and initiate inflammation and tissue healing).
Iron
An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.
Kidney Stone (Kidney Gravel, Kidney Stones)
A stone (concretion) in the kidney. If the stone is large enough to block the tube (ureter) and stop the flow of urine from the kidney, it must be removed by surgery or other methods. Also called Renal Calculus. Symptoms usually begin with intense waves of pain as a stone moves in the urinary tract. Typically, a person feels a sharp, cramping pain in the back and side in the area of the kidney or in the lower abdomen. Sometimes nausea and vomiting occur. Later, pain may spread to the groin. The pain may continue if the stone is too large to pass; blood may appear in the urine and there may be the need to urinate more often or a burning sensation during urination. If fever and chills accompany any of these symptoms, an infection may be present and a doctor should be seen immediately.
Lactobacillus
A genus of gram-positive, acid-resistant bacteria in the Lactobacillaceae family. We know of lactobacillus because of its use in making yogurt and the conventional wisdom of taking it in one form or another after antibiotic therapy, but it is an integral part of the colon and mouth flora, and is the critical acidifying agent in vaginal flora. There is a growing body of rather ignored data showing the value of regular consumption of a lactobacillus-containing food in immunosuppression, slow virus, and candidiasis conditions.
Lesion (Lesions)
Any damage to tissue structure or function; an abnormal change in body tissue caused by disease or injury. A scar is a lesion, as is cancer, a stomach ulcer or a pimple.
Leukocytosis
Having abnormally high numbers of white blood cells, usually the result of a non-viral infection.
Liver (Hepatic)
The largest and one of the most complex organs of the body, the liver is responsible for much of the metabolism of fats, proteins and carbohydrates. It is the site of much of the body's detoxification. It is connected very closely with digestion and the regulation of blood sugar, among many other functions. Found behind the ribs on the right side of the abdomen, it has many important functions such as removing harmful material from the blood, making enzymes and bile that help digest food, and converting food into substances needed for life and growth. Hepatic: Pertaining to the liver.
Mucous Membranes (Mucosa, Mucous Membrane, Mucus Membranes)
The membranes, such as the mouth, nose, anus, and vagina, that line the cavities and canals of the body which communicate with the air.
Mucus (Mucous)
The viscous, slippery substance that consists chiefly of mucin, water, cells, and inorganic salts and is secreted as a protective lubricant coating by cells and glands of the mucous membranes.
Nausea
Symptoms resulting from an inclination to vomit.
Occult Blood
Usually detected through an occult blood test: A test used in screening for blood found in the stool, sputum or urine. The most common test is for hidden blood in the stool, also known as a stool guaiac or hemoccult test, which usually indicates the presence of ulceration or cancer.
Osteoporosis
A disease in which bone tissue becomes porous and brittle. The disease primarily affects postmenopausal women.
Pancreas (Pancreatic)
Opposite the liver and behind the stomach, the pancreas has two main functions - to manufacture various enzymes for digestion, and to release hormones to help control the body's use of carbohydrates. It releases insulin to help each cell absorb glucose to burn as energy. In this way, insulin controls the amount of sugar (glucose) in the blood. Proper pancreatic function is very important: too much, too little, or no insulin production can be life-threatening. Some of the chemicals released by the pancreas are not hormones, but stimulate other glands to make hormones. Once again, balance is necessary. Nutritional requirements for the pancreas are many. Research indicates that chromium vitamins C, E, B-complex, calcium, magnesium and potassium are especially important.
Placebo (Placebos)
A pharmacologically inactive substance. Often used to compare clinical responses against the effects of pharmacologically active substances in experiments.
Protein (Proteins)
Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.
Pus
White cells that the body sends to fight an infection.
Serum
The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.
SGOT (SGPT)
SGOT and SGPT: Liver enzymes that are normally only present in minute quantities in the blood, but become elevated under a variety of circumstances, particularly hepatitis.
Spondylitis
Inflammation of one or more vertebrae.
Steroid (Steroids)
Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.
Stomach
A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.
Ulcer (Ulceration, Ulcers)
Lesion on the skin or mucous membrane.
Ulcerative Colitis (Colitis Ulcerosa)
Ulceration of the colon and rectum, usually long-term and characterized by rectal bleeding or blood in the stool, frequent urgent diarrhea/bowel movements each day, abdominal pain.
Vitamin C (Ascorbic Acid)
A water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.
White Blood Cell (WBC, White Blood Cells)
A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. White blood cells are composed primarily of neutrophils, monocytes and lymphocytes. Lymphocytes are either T-cells or B-cells. T-cells (CD3 cells) are divided into T-helper (CD4 cells) and T-suppressor/cytotoxic (CD8 cells) cells.
X-rays (X-ray)
High-energy radiation used to take pictures of areas inside the body.
Zinc
An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.
Last updated: May 11, 2008
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