Ulcerative Colitis Treatment

Ulcerative Colitis Diet

While food doesn't appear to play a role in causing ulcerative colitis, certain foods may cause more symptoms when your disease is active. Your doctor may suggest the following diet changes depending on your symptoms:

Avoid dairy. Dairy products such as milk, yogurt, cheese, and ice cream could make diarrhea, stomach pain, and gas worse. Try avoiding them to see if it helps.

Avoid fiber. High-fiber foods, such as raw fruits and vegetables and whole grains, are rich in nutrition but can worsen ulcerative colitis symptoms. Avoid nuts, seeds, corn, and popcorn. Instead, cook fruits and vegetables by steaming, baking, or grilling to see if it makes a difference.

Eat smaller meals. Instead of three large meals, try eating five or six small meals a day. Make sure these meals are healthy and balanced rather than just snacking throughout the day.

Choose drinks carefully. Drink lots of water every day. Avoid alcohol, caffeine, and carbonated drinks because they can add to your diarrhea and produce gas.

Add vitamins and minerals. Certain vitamins and minerals can help to supplement nutrients lost due to UC or medicines you take to treat the condition. Your doctor may suggest adding foods or supplements with:

• Calcium
• Folic acid
• Iron
• Vitamins B12, D, A, E, and K

Ulcerative Colitis Surgery

Colectomy

Some people get surgery to remove part or all of the colon. Your doctor may suggest this if your medicine isn't working, your symptoms get worse, or your ulcerative colitis leads to further serious health problems.

When you have an operation to remove your entire colon, a surgeon can either do it through a large incision or use a minimally invasive approach with small cuts and cameras — which typically offer quicker recovery. The surgeon most often creates an opening, or stoma, in your belly wall. They attach a bag there and bring the tip of your lower small intestine through the opening. Waste passes through it and collects in a pouch attached to the stoma. You'd need to wear the pouch all the time.

Before surgery, you’ll undergo health screenings, follow a special diet, and receive counseling about the procedure, risks, and life with a possible ileostomy. After surgery, you’ll stay in the hospital for a few days. Full recovery can take up to six weeks, and though complications are uncommon, it’s important to contact your doctor if you notice signs of infection or other concerning symptoms.

In the long term, you may have changes to your bowel health, such as diarrhea, dehydration, gas, and constipation.

Ileal pouch-anal anastomosis

A newer surgery, known as a pelvic pouch or ileal pouch-anal anastomosis (IPAA), doesn't create a permanent opening. Instead, a surgeon removes your colon and rectum and uses your small intestine to form an internal pouch or reservoir that serves as a new rectum. This pouch is connected to the anus.

There are three types of pouches: the J-pouch (the most common), the S-pouch, and the less common Kock pouch. Recovery involves a hospital stay of about a week, and you may need a temporary external pouch until healing occurs. While J-pouches and S-pouches enable normal waste storage and passage, K-pouches allow for controlled bowel emptying.

Risks include pouchitis (inflammation), leakage, and other health problems. You should fully heal in about four to eight weeks and will need to watch for changes.

Continent ileostomy

Doctors perform a procedure called a continent ileostomy (Kock pouch) if you want your external pouch converted to an internal one or if you can't get the IPAA operation.

Alternative Treatments for Ulcerative Colitis

You may consider these approaches in addition to what your doctor prescribes. But it’s important to talk to your medical team about them because some, such as supplements, can interfere with treatments from your doctor. Let’s take a look at a few:

Mind-body therapies

Stress and anxiety are well-known triggers for many people with ulcerative colitis, so it is not surprising that mind-body relaxation techniques could help. These techniques help nurture a healthy connection between your mind and body as well as between you and the outside world. In some cases, they encourage behavior changes in your everyday life. They may be worthwhile if only to lessen anxiety and depression linked to UC and improve quality of life. In addition, there is some evidence that yoga, meditation, and gut-centered hypnotherapy could help with some physical symptoms or UC flare-ups. Some of the techniques, such as cognitive behavioral therapy (a type of psychotherapy) and patient support groups, have been so successful that they have slowly become a part of mainstream treatment for IBD.

Vitamins and supplements for ulcerative colitis

Turmeric. This spice, commonly used in Indian and South Asian cooking, has a chemical called curcumin that may help lessen inflammation in some people. Some small studies show that it could help with UC flare-ups in capsule form, but scientists need to do more research to confirm these results. Also, many of the studies used very pure curcumin compounds that may not be available in retail brands. Curcumin can also have side effects such as bloating, nausea, and diarrhea. Also, it thins the blood and has not been tested for safety in pregnant women.

Probiotics. These are “good” bacteria found in many foods that add to the healthy balance of bacteria in your gut. In supplement form, some studies suggest they could help bring a UC flare-up to an end and keep it there, especially if you have a pouch (from J-pouch surgery) that is inflamed. Still, it’s important to take care. There is a wide variety of probiotic products on the market, and much more study is needed.

The FDA doesn't regulate supplements, so claims on packaging may not be accurate. That’s yet another reason why it’s important to talk to your doctor before you start taking any supplements for your UC.

When Should I Call My Doctor About Ulcerative Colitis?

Call your doctor right away if you have:

• Heavy, persistent diarrhea
• Rectal bleeding with clots of blood in your stool
• Constant pain and a high fever

Takeaways

Doctors treat ulcerative colitis with a combination of medicines, diet changes, and sometimes surgery. While medicines, such as 5-aminosalicylic acids, corticosteroids, immunosuppressants, and newer biologics, can help manage symptoms and lower inflammation, they don’t cure the disease unless doctors surgically remove your colon and rectum.

You and your doctor may consider surgery for severe UC cases or when medications fail. Diet changes may help ease symptoms during flare-ups, and complementary therapies, such as mind-body techniques and certain supplements, could offer relief. But it’s essential to talk to your doctor before trying new treatments or supplements to avoid possible further health problems.