Ulcerative colitis is an inflammatory bowel disease that can cause abdominal pain (often on the lower left side of the abdomen), bloody diarrhea, mucus in stools, fever, weight loss, loss of appetite. It is the result of chronic inflammation, usually in the lining of the large intestine (colon) and rectum.

Probiotics, “friendly” bacteria that reside in the gut, have been found to be effective in managing ulcerative colitis. They help control the number of potentially harmful bacteria, reduce inflammation, and improve the protective mucus lining of the gut.

Probiotics are among the more popular remedies for inflammatory bowel disease because they are without significant side effects and appear to be safe.

A University of Alberta study examined 34 people with mild-to-moderate active ulcerative colitis who were unresponsive to conventional treatment. The researchers gave them a probiotic supplement called VSL#3, which provided 3,600 billion bacteria a day for 6 weeks. At the end of the study, 18 people (53%) demonstrated remission on a sigmoidoscopy and a further eight people (24%) had a favorable response.

Researchers at the University of Dundee analyzed bacteria from rectal biopsies of patients with active ulcerative colitis and healthy control subjects. There were significantly fewer bifidobacterium numbers in the ulcerative colitis biopsies, which suggested that these probiotic bacteria might have a protective role in the disease. In a further study, 18 people with active ulcerative colitis were given a bifidobacterium supplement or a placebo for one month. Sigmoidoscopy, biopsy and blood tests showed significant improvement in the probiotic group compared with the placebo group.

An Italian study examined the probiotic yeast Saccharomyces boulardii, which was previously found to be beneficial in the maintenance of the other inflammatory bowel disease, Crohn’s disease. Researchers gave 25 patients with a mild-to-moderate flare-up of ulcerative colitis a supplement containing 250 mg Saccharomyces boulardii three times a day for 4 weeks during maintenance treatment with the drug mesalazine (these patients were unsuitable for steroid therapy). Of the 24 patients who completed the study, 17 had clinical remission, which was confirmed by endoscopic exam.

Some studies have found that omega-3 fatty acids, found in fish oil capsules, may reduce inflammation in people with ulcerative colitis.

A meta-analysis published in the American Journal of Clinical Nutrition looked at controlled trials published from 1966 to 2003. Although the researchers concluded that more evidence is needed about the efficacy of omega-3 fatty acids, three studies found that omega-3 fatty acids reduced corticosteroid requirements (statistical significance was shown in one of these studies.

Another study looked at the influence of fish oil and an elemental diet on the intestinal tissues of ulcerative colitis, Crohn’s, and control patients and found the most marked anti-inflammatory effect in ulcerative colitis tissues.

Research conducted at the Cleveland Clinic looked at an oral supplement containing fish oil, soluble fiber, and antioxidants (vitamin E, C, and selenium) on disease activity and medication use in adults with mild-to-moderate ulcerative colitis.

In the study, 86 patients with ulcerative colitis consumed 18 ounces of the supplement or a placebo each day for 6 months. Patients taking the oral supplement had a significantly greater rate of decreasing their dose of prednisone over 6 months compared with the placebo group. Both groups showed significant and similar improvement in clinical and histological responses.

More research on omega-3 fatty acids is needed, especially at differing doses, because not all studies have found a positive effect.

Aloe vera gel has been found in studies to have an anti-inflammatory effect.

A double-blind randomized trial examined the effectiveness and safety of aloe vera gel for the treatment of mild-to-moderate active ulcerative colitis. Researchers gave 30 patients 100 mL of oral aloe vera gel and 14 patient’s 100 mL placebo twice daily for 4 weeks. Clinical remission, improvement, and response occurred in nine (30%), 11 (37%) and 14 (47%) respectively, of aloe vera patients, compared with one (7%), one (7%) and two (14%), respectively of patients taking the placebo. It appeared to be safe.

A Japanese study evaluated the role of dietary factors on inflammatory bowel disease. Included in the study were 111 people with ulcerative colitis who were given food questionnaires to complete. The survey found a higher consumption of sweets was positively associated with ulcerative colitis risk. Vitamin C was found to have a protective effect-intake of vitamin C was negatively related to ulcerative colitis risk. Examples of foods rich in vitamin C are red bell peppers, parsley, strawberries, and spinach.

A study in the journal Gut monitored ulcerative colitis patients in remission for one-year using food questionnaires. Consumption of meat, particularly red and processed meat, protein, and alcohol increased the likelihood of relapse. Researchers speculate that the high sulfur or sulfates compound in many of these foods is the culprit since high sulfur or sulfates intakes were also associated with relapse.

Carbohydrates may be a culprit for some people.

Elaine Gottschall popularized the Specific Carbohydrate diet after she used it to help her daughter recover from ulcerative colitis. Gottschall later wrote a book called Breaking the Vicious Cycle describing the “vicious cycle” of injury to the intestinal mucous lining, which then promotes malabsorption and bacterial overgrowth, which is then believed, to bacterial by-products and mucus production, which leads back to injury to the intestinal mucous lining.

Folic Acid

People with chronic ulcerative colitis are at greater risk of colon cancer. A University of Toronto study found that dietary folate supplementation at four times the basic dietary requirement significantly suppressed ulcerative colitis-associated colon cancer. The incidence of high-grade lesions in the folate-supplemented group was 46% lower than that in the control group.

Boswellia is a herb that comes from a tree native to India. The active ingredient is the resin from the tree bark, which has been found to block chemical reactions involved in inflammation. People with ulcerative colitis, rheumatoid arthritis, and other inflammatory conditions use it. Unlike anti-inflammatory medication, Boswellia does not seem to cause gut irritation that can occur with many conventional pain relievers.

According to traditional Chinese medicine, pain results from blocked energy along energy pathways of the body, which are unblocked when acupuncture needles are inserted along these invisible pathways. A scientific explanation is that acupuncture releases natural pain-relieving opioids, sends signals that calm the sympathetic nervous system, and releases neurochemicals and hormones.

An acupuncture treatment generally costs between $60 and $120. Acupuncture is tax-deductible (it is considered a medical expense) and some insurance plans pay for acupuncture. If you want to try acupuncture, plan to go one to three times a week for several weeks initially.

Bromelain, a mixture of protein-digesting enzymes derived from pineapple stem, is believed to reduce inflammation. A Duke University animal study found that daily treatment with oral bromelain decreased the incidence and severity of colitis.

Although stress is no longer believed to be the main cause of ulcerative colitis, chronic stress can worsen symptoms, decrease coping, and increase the chance of remission of the disease.
A small study at the University Clinic of Essen in Germany investigated the effects of mind-body therapy on thirty patients with ulcerative colitis in remission.

Patients were randomly assigned to an intervention group consisting of a structured 6 hour a week training program for 10 weeks that included stress management training, moderate exercise, Mediterranean diet, behavioral techniques and self-care strategies or a usual care waiting for a control group. The study showed improvement in the quality of life assessed by standardized questionnaires. However, there were no differences in clinical or physiological parameters.

These are just some of the natural remedies that are showing promise for ulcerative colitis. All remedies should be used with caution and under the guidance of a qualified practitioner.

There are serious consequences to untreated ulcerative colitis. It is important not to shun complementary therapies but instead to take a complementary approach.