Understanding Ulcerative Colitis: Causes, Treatment & Natural Remedies

Those tummy problems may not just be your everyday indigestion. Ulcerative colitis is a form of inflammatory bowel disease that affects the large intestine and can have a significant impact on daily life. From unpredictable flare-ups to challenging symptoms, it can be difficult to complete even the simplest of tasks or activities without having to worry about feeling ill or all of the potential “what if’s”.  Unfortunately, there is no known cure for ulcerative colitis but there are a variety of proven treatments and effective natural remedies that can help you manage your symptoms, prolong periods of remissions and reduce flare-ups to improve your quality of life to what it once was.

ulcerative colitis fact sheet

What is Ulcerative Colitis?

Ulcerative colitis is a form of inflammatory bowel disease (IBD that causes inflammation and ulcers to form in the digestive tract. It affects the inner lining of the large intestine, specifically, which also includes the colon, as well as the rectum. The inflammation typically starts in the rectum and can gradually extend and impact either a portion or the entire colon. It’s important to note that when the inflammation is confined to the rectum and the lower part of the colon, it is referred to as ulcerative proctitis. If the inflammation spreads to involve the entire large intestine, it is known as pancolitis. In cases where only the left side of the colon is affected, it is termed limited or distal colitis. However, all variations are forms of ulcerative colitis and can lead to a vast array of uncomfortable, painful and debilitating symptoms, such as:

  • Abdominal pain
  • Frequent bowel movements
  • Diarrhea (often with blood or pus)
  • Rectal bleeding
  • A persistent urge to empty the bowels

These symptoms may come and go, with periods of remission and flare-ups. The severity and frequency of symptoms can vary from person to person as well. In fact, the severity of ulcerative colitis is determined by the extent and intensity of inflammation, and it can vary among individuals. Some individuals may experience severe inflammation limited to a small area in the rectum, while others may have mild inflammation affecting the entire length of the colon. As such, the symptoms experienced and to what degree highly depends on the individual circumstances.

Unfortunately, ulcerative colitis is a chronic condition that requires ongoing management and medical care. While there is no known cure, there are plenty of ways you can effectively manage and reduce your symptoms, so you can get back to living your life to the fullest.

The Common Causes of Ulcerative Colitis

The exact cause of ulcerative colitis is believed to be complex and involves a variety of factors. Researchers suggest that an overactive immune response plays a significant role in the development of this condition. This is because a normal functioning immune system is designed to protect the body against harmful substances and infections. However, in the case of ulcerative colitis, the immune system becomes overactive and mistakenly attacks the body’s own tissues, leading to chronic inflammation and damage.

The specific reasons behind the immune system’s misdirected attack are not yet fully understood, but the following factors are believed to contribute to the development of ulcerative colitis:

  • Genetics: If you Have a close relative with inflammatory bowel disease (IBD), your risk could be up to 30% higher.
  • An overactive immune system.
  • Environment: Exposure to a lot of air pollution can increase your risks.
  • Lifestyle: Exercise, sleep habits, diet, stress and smoking can lead to ulcerative colitis.

Your age may also play a factor, as people are more likely to develop ulcerative colitis between the ages of 15 and 30 years old, or older.

What is the Treatment for Ulcerative Colitis?

Although there is no known cure for ulcerative colitis, there are highly effective treatments available to help manage the condition and reduce your symptoms. Typically, treatment involves either medication or surgical interventions or a combination of the two. Working closely with your doctor can help you determine the best course of action for treating your symptoms and achieving long-term remission. They will be able to recommend treatments or create a plan for you based on your individual circumstances and needs, which may include:

Anti-inflammatory medications: The two main types used for treating inflammation associated with ulcerative colitis are:

  • 5-aminosalicylates: Medications such as sulfasalazine (Azulfidine), mesalamine (Delzicol, Rowasa, etc.), balsalazide (Colazal), and olsalazine (Dipentum) can help calm inflammation. Some can be taken by mouth, as a suppository or enema, offering a better reach to the inflammation down in the colon or rectum.
  • Corticosteroids: Prednisone and budesonide are examples of corticosteroids, which are typically reserved for moderate to severe cases of ulcerative colitis that have not responded to other treatments. These medications work by suppressing the immune system and are generally prescribed for short-term use.

Immune system suppressors: These medications may also be used to suppress the immune system response that is causing the inflammation. Sometimes, a combination of these medications may be used for maximum results. Some immunosuppressant medications include:

  • Azathioprine (Azasan, Imuran) and mercaptopurine (Purinethol, Purixan) are often used for the treatment of inflammatory bowel disease and are often combined with biologic medications (more on those in the next section). 
  • Cyclosporine (Gengraf, Neoral, Sandimmune are typically reserved for people who have not responded well to other medications.
  • “Small molecule” medications, such as tofacitinib (Xeljanz), upadacitinib (Rinvoq), and ozanimod (Zeposia) may be effective when other options aren’t working.

Biologics are advanced treatment medications that target the proteins made by the immune system to help manage your symptoms and control the inflammation associated with ulcerative colitis. They are typically prescribed for individuals with severe or refractory disease, and some common options are:

  • Tumor necrosis factor (TNF) inhibitors, such as Infliximab (Remicade), adalimumab (Humira), and golimumab (Simponi) neutralize a protein produced by the immune system.
  • Vedolizumab (Entyvio) medication works by blocking inflammatory cells from reaching the site of inflammation, and is an approved for the treatment of ulcerative colitis in cases where other treatments have not been effective or well-tolerated.
  • Ustekinumab (Stelara) help block a different protein that causes inflammation.

Other medications may be used to manage specific symptoms, such as diarrhea, pain, and so on and so forth. Many of these are available over-the-counter. However, it is still recommended to speak with your doctor to see if they are the best option for you:

  • Anti-diarrheal medications, such as loperamide (Imodium A-D), are sometimes used in cases of severe diarrhea). However, they can pose risks for individuals with ulcerative colitis, such as an increased risk of toxic megacolon (enlarged colon).
  • Pain relief medications, such as your common acetaminophen (Tylenol, others), can help relieve the pain and discomfort associated with ulcerative colitis. However, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve), may worsen your symptoms and even increase the severity of the disease.
  • Antispasmodics can be used to help manage cramps.
  • Iron supplements are sometimes used for people with chronic intestinal bleeding that have developed an iron deficiency anemia.

Surgeries are also available as a potential treatment for ulcerative colitis when other options have been ineffective or when complications arise. The most common surgical procedure for this condition is a proctocolectomy, which involves the removal of the entire colon and rectum.

Typically, this procedure now involves a surgical technique known as ileoanal anastomosis, or J-pouch surgery, which eliminates the need for an external bag to collect stool. During the surgery, the surgeon creates a pouch using the end of the small intestine. The pouch is then connected to the anus, allowing for the normal passage of waste.

However, if a pouch isn’t able to be made in such a way, the surgeon may create a permanent opening in the abdomen, known as an ileal stoma. Stool passes through this opening and is collected in a bag attached to the stoma.

Natural Remedies and Tips for Managing Ulcerative Colitis

While natural remedies cannot cure ulcerative colitis, they can offer relief from symptoms and help manage flare-ups without all of the potential side effects commonly associated with prescription medications. Whether it’s addressing the blood or pus in the stool, calming a fever, addressing loss of appetite, anemia or a rapid heart rate, there are the natural remedies and tips worth adding into your repertoire.

Avoid Food Triggers

While diet alone does not cause ulcerative colitis, the foods you eat can impact your symptoms and even prolong periods between flare-ups. On the other hand, certain foods can also do quite the opposite and actual encourage symptoms and flare-ups. So, it’s important to take a look at your diet and make changes where necessary.

It’s important to mention that food triggers aren’t always the same for every person, so keeping a food diary can help you identify any trigger foods that affect you personally. All you have to do is track what you eat each day and take note of how you feel afterward. This can help you pinpoint any potential links between specific foods and symptoms.

However, as a general rule of thumb, foods commonly found to exasperate symptoms of ulcerative colitis are:

  • Greasy foods
  • Sugar foods and beverages
  • Carbonated beverages, such as soda
  • High-fiber foods
  • Alcohol
  • Salt
  • Dairy

In addition to avoiding known food triggers, it’s also recommended to improve your overall diet by eating plenty lead protein, fruits and vegetables. And of course, you have to stay hydrated! Aim to drink 8 full cups of water each day.

Get These Supplements In  

There are several nutritional supplements you can take to help manage your symptoms and reduce the effects of ulcerative colitis, such as:

  • Probiotics: promotes the healthy bacteria in your digestive tract, reduce inflammation and suppress your immune responses
  • Calcium: improves bone strength and hormone secretion
  • Vitamin D: improves bone health.
  • Fish oil: helps fight inflammation and blocks chemical reactions
  • Folate: helps the body make new cells.
  • Turmeric: reduces inflammation.
  • Multivitamin: for all of your necessary vitamins and minerals.

Work Out and Reduce Inflammation

Regular exercise can help manage several complications associated with ulcerative colitis, such as bone density, a compromised immune system, emotional health issues, stress, and weight gain. Research has also found that regular exercise can help release protective myokines, such as irisin, from active skeletal muscles to promote healing and reduce inflammation associated with inflammatory bowel disease (IBD.

Now, you don’t have to sign up for an intense spin class or anything like that. Simply aim to enjoy 30 minutes of moderate-intensity exercise, such as swimming or biking, three to four days each week.

Address Your Stress

Stress has been directly linked to the development and exacerbation of inflammatory bowel diseases, including ulcerative colitis. It also contributes to inflammation and changes in your gut, further worsening symptoms of ulcerative colitis.

Incorporating relaxation techniques, such as meditation, deep breathing exercises, yoga, journaling and progressive muscle relaxation into your daily routine can help you properly manage your stress. They can also have a positive effect on your heart rate, blood pressure, and respiration rate, while encouraging blood and nutrients to move towards your core to support optimal digestive function.

Needless to say, it’s time to address that stress!

Essential Oils for Ulcerative Colitis

There are many essential oils that contain anti-inflammatory properties, which can be used to help reduce some of your symptoms, such as peppermint, fennel, and ginger essential oil. You can use these by diluting two to three drops in a carrier oil and applying it to your stomach area twice a day. Some can also be ingested. However, it is highly recommended to do research on the specific essential oil you intend on using before consuming it as not all essential oils can be ingested.

As a general rule of thumb, here are some essential oils you may want to play around with:

  • Peppermint essential oil has a calming effect on the digestive system.
  • Patchouli essential oil can help calm down inflammation.
  • Turmeric essential oil can reduce inflammation.
  • Lavender essential oil can promote relaxation and stress relief, and improve your sleep
  • Fennel essential oil can help soothe inflammation in the digestive tract.
  • Ginger essential oil has anti-inflammatory and antioxidant properties, potentially providing relief from UC symptoms.

As effective as these natural remedies can be, it’s important to note that they should only be used to complement your doctor-recommended treatment plan, and not replace it. Managing ulcerative colitis often requires a comprehensive approach that involves a combination of medical guidance, positive lifestyle changes, and self-care practices. And the more options you have for managing your symptoms and getting back to living your life, the better. So, try various strategies that can be used alongside your treatment plan to find the ultimate approach for you. 

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