Description
- Ulcerative colits is an inflammatory, often chronic disease that affects the
mucosa of the colon. It usually begins in the rectum and sigmoid colon and may
extend upward into the entire colon, though it rarely affects the small intestine. 1
Causes
- The causes of colitis are not known. Dietary and genetic factors are suspected
of playing a role. 2
P>Types
- Patients experience periods of remission and exacerbation of symptoms. During
an exacerbation, the patient generally reports mild cramping, lower abdominal pain,
and recurrent bloody diarrhea. During these periods, they may complain of fatigue,
weakness, anorexia, weight loss, nausea, and vomiting. 3
- Complications include malnutrition and increased incidence of cancer. 4
At Risk
- There is some indication that colitis may be genetically linked; however, since
only 20% of patients have a family history of colitis, the relationship does not
seem to be uniquely genetic.
- One study indicated an increased occurrence of colitis in people who eat margarine. 5
Prevention and Management
General:
- Stress reduction may decrease the severity of this disease. 6
Role of Nutrition:
- Gastrointestinal diseases commonly result in malnutrition because absorption
is impaired. The malnourished bodys ability to function optimally is impaired and
it is less able to repair itself. 7 This cycle may be broken with a
combination of diet, supplements, and therapy. 8
- Formulas that contain oligosaccharides, fish oil, gum arabic and antioxidants
may be beneficial for patients with ulcerative colitis. 9
- Colitis patients may need to avoid certain foods. Trying different foods and
eliminating the ones that are irritants is the best approach.
Additional Information
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Abstracts
Meier R. [Chronic inflammatory bowel diseases and nutrition]. Schweiz Med Wochenschr
Suppl 1996;79:14S-24S. The etiology of inflammatory bowel disease is still
unknown. Several potential mechanisms are discussed. The etiological and therapeutic
importance of nutrition is controversial. Though changes in dietary habits and
incidence of inflammatory bowel disease during the last century were in parallel,
no specific nutritional factor has been isolated. No dietary prophylaxis of inflammatory
bowel disease is yet known; all dietary therapies in inflammatory bowel disease
aim to improve nutritional support and to diminish inflammation by bowel rest.
Children and adolescents gain in weight and height. Total parenteral nutrition
will not substantially reduce disease activity and operation rates. Total parenteral
nutrition can only be recommended in ulcerative colitis patients with severe disease
in the initial phase and in Crohn's patients with severe malnutrition and intestinal
complications. Enteral nutrition support is less effective in ulcerative colitis
than in Crohn's disease. Reported remission rates on enteral nutrition are 25%
for ulcerative colitis and up to 80% for Crohns. However, in active Crohn's disease enteral nutrition is less effective than standard therapy with methylprednisolone
and sulfasalizine. It is generally believed that nutrition therapy in combination
with drugs is the best treatment modality. There is no evidence to support the
importance of any combination of the formula diets such as elemental, oligopeptide, or polymeric formulations. Administration of formula diets by nasogastric tubes
all show similar remission rates. Whether newer diets supplemented with arginine,
glutamine, omega-3-fatty acids or short chain fatty acids increase remission rates
is not known. Further studies in this field are warranted.
References
1 Diseases. 2nd ed. Springhouse (PA): Springhouse Corporation; 1997. p 25.
2 Meier R. [Chronic inflammatory bowel diseases and nutrition]. Schweiz
Med Wochenschr Suppl 1996;79:14S-24S.
3 Diseases. 2nd ed. Springhouse (PA):Springhouse Corporation; 1993. p 893.
4 The Epidemiology Group of the Research Committee of Inflammatory Bowel
Disease in Japan. A case-control study of ulcerative colitis in relation to dietary
and other factors in Japan. J Gastroenterol 1995 Nov;30 Suppl 8:9-12.
5 Diseases. 2nd ed. Springhouse (PA):Springhouse Corporation; 1993. p 882.
6 OKeefe SJ, Nutrition and gastrointestinal disease. Scand J Gastroentrerol
Suppl 1996;220:52-9.
7 Campbell JM, Fahey GC Jr, Lichtensteiger CA, Demichele SJ, Garleb KA.
An enteral formula containing fish oil, indigestible oligosaccharides, gum arabic and
antioxidants affects plasma and colonic phospholipid fatty acid and prostaglandin profiles
in pigs. J Nutr 1997 Jan;127(1):137-45.
