Updated on January 4, 2023
Ulcerative colitis, the most common inflammatory bowel disease, can significantly interfere with quality of life for patients and families. Because there is no cure, patients are forced to cope with a wide range of symptoms—from chronic diarrhea to fatigue to eye irritation to joint pain. These symptoms typically worsen over time, and even patients who achieve remission are constantly at risk of unexpected flare-ups.
Conventional treatment options for ulcerative colitis include anti-inflammatory medications like aminosalicylates and corticosteroids, as well as other drugs like antibiotics and methotrexate. However, the side effects and questionable efficacy of some of these drugs have driven more patients and families to seek more natural options, such as nutritional support through supplementation. Because of the high demand among patients and families for natural ulcerative colitis therapies, a plethora of recommendations for such treatment methods can be found online. However, only a few of these options are backed by empirical evidence. When considering the possibilities for natural ulcerative colitis therapy, it is helpful to know what researchers have uncovered about some of the more promising options.
The idea of using nutritional supplementation as natural therapies for ulcerative colitis has been discussed within the research community for decades, and some supplements are now backed by limited scientific evidence. In the late 1980s, for example, scientists began examining the potential therapeutic effects of fish oils for ulcerative colitis patients. Because fish oils are high in omega-3 fatty acids, which have well-documented positive effects on inflammatory response, researchers hypothesized they might be able to address inflammation in the GI tracts of patients with ulcerative colitis. However, clinical evidence supporting this hypothesis remains mixed, and scientists are still attempting to clarify the pathophysiological mechanisms through which fish oil supplements address the inflammatory response of patients with ulcerative colitis.
More recently, scientists have been studying how curcumin, another natural compound, can affect patients with ulcerative colitis. Curcumin is best known as the active chemical constituent in turmeric, a common spice, but it also holds potential in therapeutic applications for a wide range of inflammation-related conditions. Although only a few rigorous research studies have been conducted so far, early evidence suggests that curcumin supplements can provide nutritional support in patients with ulcerative colitis. This might be particularly true of highly bioavailable curcumin supplements designed to optimize therapeutic benefits.
Over the last few years, probiotic supplements have become a growing area of interest for researchers studying natural therapies for ulcerative colitis. Understanding the connection between probiotic supplements and the inflammation that characterizes ulcerative colitis has long been a goal for researchers. Currently, it appears that multiple factors play a role. By lining the intestinal tract and promoting the production of intestinal mucus, probiotics can help prevent “bad” bacteria from colonizing the gut microbiome.
Probiotics might also support the production of anti-inflammatory compounds and limit the activities of pro-inflammatory mediators. In a 2017 breakthrough study out of the University of North Carolina, researchers demonstrated a clear link between probiotics and NLRP12, a protein that normally suppresses inflammatory signals. They found that patients with ulcerative colitis had low levels of NLRP2 and microbial gut profiles that included more bacterial strains known to drive inflammation, such as Erysipelotrichaceae. Importantly, when protective bacteria known to produce anti-inflammatory compounds, such as Lachnospiraceae, were added to the gut microbiome, the scientists were able to reverse the effects of the low levels of NLRP2. Based on this success, there are now exciting opportunities for more studies on the effectiveness of probiotic supplementation as a natural therapy for ulcerative colitis.
Although a variety of bacterial strains have been studied, two strains in particular—Escherichia coli Nissle 1917 and VSL #3—have strong evidence from multiple studies supporting their efficacy for the prevention and treatment of mild to moderate cases of ulcerative colitis. In several trials, they have been shown to reduce disease activity and/or lower the risk of remission, although it is not entirely clear why these two bacterial strains stand out among the rest; some researchers suspect it is a lack of rigorous research on other strains. Future randomized, controlled trials might demonstrate that other strains can be just as effective.
As in all gastrointestinal treatments, the efficacy of particular bacterial strains might also depend on the microbial composition of an individual patient’s gut. As such, some researchers are recommending probiotic-based, natural therapies for ulcerative colitis that are tailored to the patient’s microbiome. The idea is that the microbial composition of the patient’s gut will be examined, and the patient’s probiotic supplementation regimen will be determined based on the particular beneficial strains lacking from that microbiome. Ideally, this strategic supplementation would make the patient’s microbiome look like that of a healthy patient.
Among the many botanical supplements that have been proposed for the treatment of ulcerative colitis—most of which remain unsubstantiated by rigorous research—ginseng appears to be one of the most promising. Preliminary research suggests that ginseng has direct anti-inflammatory effects and can also support the gut microbiome. In one study, researchers identified a specific biochemical mechanism through which ginseng can reduce inflammation: by promoting the apoptosis (controlled cell death) of inflammatory cells. Additionally, there is evidence indicating that ginseng supports the growth of beneficial gut bacteria in vitro and in rat models of ulcerative colitis.
Certain fiber supplements—including oat bran, wheat bran, psyllium, and germinated barley—have been associated with declines in disease activity in small-scale studies of ulcerative colitis patients. In addition to the general observation that fiber consumption is associated with a reduction in system-wide inflammatory markers, there is evidence that suggests that fiber supplements directly support “good” gut bacteria. For instance, in one study, an oat bran supplement significantly increased stool concentrations of butyric acid, a compound known to be produced by beneficial bacteria and that can have a beneficial action on inflammatory response in the GI tract through a variety of mechanisms.
Although the supplementation options for patients with ulcerative colitis abound, the possible dietary interventions are even more numerous. With a quick online search, patients can find everything from strict exclusion diets to general guidelines for foods to avoid. And although some patients have found relief from options like low-residue or semi-vegetarian diets, research-based evidence supporting these strategies is limited. With rigorous research lacking that supports specific dietary interventions, many health professionals remain skeptical. Patients can certainly adopt a diet if they find it makes them feel better, but more extensive clinical studies are needed before the research and clinical communities embrace any single ulcerative colitis diet.
The research supporting regular exercise as a natural therapy for ulcerative colitis is more concrete. From a biochemical perspective, exercise causes muscle cells to release myokines, which are small proteins that combat inflammation. Exercise is also a well-known stress reliever, and effective stress management can aid in the prevention and management of ulcerative colitis flare-ups. Plus, exercise can naturally combat some of the most common complications of ulcerative colitis, including low bone density, mental health problems, and weight management challenges. Although some clinical studies indicate the physical activity of some ulcerative colitis patients can be limited by the severity of their symptoms, the results are generally positive for patients who are able to engage in general exercise.
With so many natural therapy options for ulcerative colitis available, it can be a challenge for patients and practitioners to identify the most effective combination for each particular case. Based on the existing research, high-quality nutritional supplements that have beneficial inflammatory response properties and/or support the health of the gut microbiome can be a great place to start. Lifestyle interventions like diet and exercise can also be effective on a case-by-case basis. As future clinical studies provide more evidence for or against specific interventions, it will become easier for patients and practitioners to navigate the many options and create treatment plans that provide meaningful and durable symptom relief.
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Barbalho SM, Goulart RA, Quesada K, Bechara MD, Carbalho ACA. 2016. Annals of Gastroenterology. 29(1):37-43.
Bliski J, Brzozowski B, Mazur-Bialy A, Sliwowski Z, Brzozowski T. 2014. BioMed Research International.
Chen L, Wilson JE, Koenigsknecht MJ, Chou WC, Montgomery SA, et al. 2017. Nature Immunology, 18(5):541-51.
Chibbar R, Dieleman LA. 2015. Journal of Clinical Gastroenterology. 49(1):S50-5.
Fedorak RN. 2010. Gastroenterology & Hepatology. 6(11):688-90.
Guo M, Ding S, Zhao C, Gu X, He X et al. 2015. Journal of Ethnopharmacology. 162:7-13.
Haskey N, Gibson DL. 2017. Nutrients. 9(3):259.
Jin Y, Hofseth AB, Cui X, Windsut AJ, Chumanevich AA et al. 2010. Cancer Prevention Research. 3(3):339-47.
McCall TB, O’Leary D, Bloomfield J, O’Morain CA. 1989. Alimentary Pharmacology & Therapeutics. 3(5):415-24.
Narula N, Fedorak RN. 2008. Canadian Journal of Gastroenterology. 22(5):497-504.
Rios-Covian D., Ruas-Madiedo P, Margolles A, Guiemonde M, et al. 2016. Frontiers in Microbiology. 185.