Ulcerative Colitis

Aloe vera juice has anti-inflammatory activity and been used by some doctors for people with UC. In a double-blind study of people with mildly to moderately active ulcerative colitis, supplementation with aloe resulted in a complete remission or an improvement in symptoms in 47% of cases, compared with 14% of those given a placebo (a statistically significant difference).¹ No significant side effects were seen. The amount of aloe used was 100 ml (approximately 3.5 ounces) twice a day for four weeks. Other traditional anti-inflammatory and soothing herbs, including calendula, flaxseed, licorice, marshmallow, myrrh, and yarrow. Many of these herbs are most effective, according to clinical experience, if taken internally as well as in enema form.² Enemas should be avoided during acute flare-ups but are useful for mild and chronic inflammation. It is best to consult with a doctor experienced with botanical medicine to learn more about herbal enemas before using them. More research needs to be done to determine the effectiveness of these herbs.

A small clinical study found that people with UC taking 550 mg of boswellia gum resin three times daily for six weeks had similar improvement in symptoms and the severity of their disease as people with UC taking the drug sulfasalazine.³ Overall, 82% of patients receiving boswellia, along with 75% of patients taking sulfasalazine, went into remission.

A fatty acid called butyrate, which is synthesized by intestinal bacteria, serves as fuel for the cells that line the small intestine. Administration of butyrate by enema has produced marked improvement in people with UC in most,^4,5,6,7but not all, preliminary trials. Butyrate taken by mouth is not likely to be beneficial, as sufficient quantities do not reach the colon by this route. Although butyrate enemas are not widely available, they can be obtained by prescription through a compounding pharmacy, which prepares customized prescription medications to meet individual patient needs.

In a preliminary trial, 6 of 13 people with ulcerative colitis went into remission after taking 200 mg per day of DHEA for eight weeks.⁸ This large amount of DHEA has the potential to cause adverse side effects and should only be used under the supervision of a doctor.

Preliminary⁹ and double-blind trials^10,11,12 have found that fish oil supplementation reduces inflammation, decreases the need for anti-inflammatory drugs, and promotes normal weight gain in people with UC. However, fish oil has not always been effective in clinical trials for UC.¹³ Amounts used in successful clinical trials provided 3.2 grams of EPA and 2.2 grams of DHA per day—the two important fatty acids found in fish oil.

In a preliminary trial, people with UC significantly improved on a sugar-free, low-allergen diet with additional nutritional supplementation that included a multivitamin-mineral supplement (2–6 tablets per day); a fish oil supplement (400 mg per day); borage oil (400 mg per day); flaxseed oil (400 mg per day); and a probiotic formula containing Lactobacillus acidophilus and other species of beneficial bacteria.¹⁴ Some participants received slight variations of this regimen. Since so many different supplements were given and since the trial was not controlled, it is not possible to say which, if any, of the nutrients was responsible for the improvement observed by the researchers.

UC is linked to an increased risk of colon cancer. Studies have found that people with UC who take folic acid supplements or who have high blood levels of folic acid have a reduced risk of colon cancer compared with people who have UC and do not take folic acid supplements.^15,16,17 Although these associations do not prove that folic acid was responsible for the reduction in risk, this vitamin has been shown to prevent experimentally induced colon cancer in animals.¹⁸ Moreover, low blood folic acid levels have been found in more than half of all people with UC.¹⁹ People with UC who are taking the drug sulfasalazine, which inhibits the absorption of folic acid,²⁰ are at a particularly high risk of developing folic acid deficiency. Folic acid supplementation may therefore be important for many people with UC. Since taking folic acid may mask a vitamin B12 deficiency, however, people with UC who wish to take folic acid over the long term should have their vitamin B12 status assessed by a physician.

Alcohol consumption is known to promote folic acid deficiency and has also been linked to an increased risk of colon cancer.²¹ People with UC should, therefore, keep alcohol intake to a minimum.

In preliminary and double-blind trials,^22,23 a probiotic supplement (in this case, a non-disease-causing strain of Escherichia coli) was effective at maintaining remission in people with UC. In a double-blind trial, a combination probiotic supplement containing Lactobacilli, Bifidobacteria, and a beneficial strain of Streptococcus has been shown to prevent pouchitis, a common complication of surgery for UC.²⁴ People with chronic relapsing pouchitis received either 3 grams per day of the supplement or placebo for nine months. Eighty-five percent of those who took the supplement had no further episodes of pouchitis during the nine-month trial, whereas 100% of those receiving placebo had relapses within four months. Preliminary and double-blind research suggests that combination probiotic supplements may be effective at promoting recovery and preventing UC relapses as well.^25,26,27

In a preliminary trial, people with UC significantly improved on a sugar-free, low-allergen diet with additional nutritional supplementation that included a multivitamin-mineral supplement (2–6 tablets per day); a fish oil supplement (400 mg per day); borage oil (400 mg per day); flaxseed oil (400 mg per day); and a probiotic formula containing Lactobacillus acidophilus and other species of beneficial bacteria.²⁸ Some participants received slight variations of this regimen. Since so many different supplements were given and since the trial was not controlled, it is not possible to say which, if any, of the nutrients was responsible for the improvement observed by the researchers.

Aloe vera juice has anti-inflammatory activity and been used by some doctors for people with UC. In a double-blind study of people with mildly to moderately active ulcerative colitis, supplementation with aloe resulted in a complete remission or an improvement in symptoms in 47% of cases, compared with 14% of those given a placebo (a statistically significant difference).³⁰ No significant side effects were seen. The amount of aloe used was 100 ml (approximately 3.5 ounces) twice a day for four weeks. Other traditional anti-inflammatory and soothing herbs, including calendula, flaxseed, licorice, marshmallow, myrrh, and yarrow. Many of these herbs are most effective, according to clinical experience, if taken internally as well as in enema form.³¹ Enemas should be avoided during acute flare-ups but are useful for mild and chronic inflammation. It is best to consult with a doctor experienced with botanical medicine to learn more about herbal enemas before using them. More research needs to be done to determine the effectiveness of these herbs.

German doctors practicing herbal medicine often recommend chamomile for people with colitis.³² A cup of strong tea drunk three times per day is standard, along with enemas using the tea when it reaches body temperature.

Aloe vera juice has anti-inflammatory activity and been used by some doctors for people with UC. In a double-blind study of people with mildly to moderately active ulcerative colitis, supplementation with aloe resulted in a complete remission or an improvement in symptoms in 47% of cases, compared with 14% of those given a placebo (a statistically significant difference).³³ No significant side effects were seen. The amount of aloe used was 100 ml (approximately 3.5 ounces) twice a day for four weeks. Other traditional anti-inflammatory and soothing herbs, including calendula, flaxseed, licorice, marshmallow, myrrh, and yarrow. Many of these herbs are most effective, according to clinical experience, if taken internally as well as in enema form.³⁴ Enemas should be avoided during acute flare-ups but are useful for mild and chronic inflammation. It is best to consult with a doctor experienced with botanical medicine to learn more about herbal enemas before using them. More research needs to be done to determine the effectiveness of these herbs.

In a preliminary trial, people with UC significantly improved on a sugar-free, low-allergen diet with additional nutritional supplementation that included a multivitamin-mineral supplement (2–6 tablets per day); a fish oil supplement (400 mg per day); borage oil (400 mg per day); flaxseed oil (400 mg per day); and a probiotic formula containing Lactobacillus acidophilus and other species of beneficial bacteria.³⁵ Some participants received slight variations of this regimen. Since so many different supplements were given and since the trial was not controlled, it is not possible to say which, if any, of the nutrients was responsible for the improvement observed by the researchers.

Aloe vera juice has anti-inflammatory activity and been used by some doctors for people with UC. In a double-blind study of people with mildly to moderately active ulcerative colitis, supplementation with aloe resulted in a complete remission or an improvement in symptoms in 47% of cases, compared with 14% of those given a placebo (a statistically significant difference).³⁶ No significant side effects were seen. The amount of aloe used was 100 ml (approximately 3.5 ounces) twice a day for four weeks. Other traditional anti-inflammatory and soothing herbs, including calendula, flaxseed, licorice, marshmallow, myrrh, and yarrow. Many of these herbs are most effective, according to clinical experience, if taken internally as well as in enema form.³⁷ Enemas should be avoided during acute flare-ups but are useful for mild and chronic inflammation. It is best to consult with a doctor experienced with botanical medicine to learn more about herbal enemas before using them. More research needs to be done to determine the effectiveness of these herbs.

Aloe vera juice has anti-inflammatory activity and been used by some doctors for people with UC. In a double-blind study of people with mildly to moderately active ulcerative colitis, supplementation with aloe resulted in a complete remission or an improvement in symptoms in 47% of cases, compared with 14% of those given a placebo (a statistically significant difference).³⁸ No significant side effects were seen. The amount of aloe used was 100 ml (approximately 3.5 ounces) twice a day for four weeks. Other traditional anti-inflammatory and soothing herbs, including calendula, flaxseed, licorice, marshmallow, myrrh, and yarrow. Many of these herbs are most effective, according to clinical experience, if taken internally as well as in enema form.³⁹ Enemas should be avoided during acute flare-ups but are useful for mild and chronic inflammation. It is best to consult with a doctor experienced with botanical medicine to learn more about herbal enemas before using them. More research needs to be done to determine the effectiveness of these herbs.

Aloe vera juice has anti-inflammatory activity and been used by some doctors for people with UC. In a double-blind study of people with mildly to moderately active ulcerative colitis, supplementation with aloe resulted in a complete remission or an improvement in symptoms in 47% of cases, compared with 14% of those given a placebo (a statistically significant difference).⁴⁰ No significant side effects were seen. The amount of aloe used was 100 ml (approximately 3.5 ounces) twice a day for four weeks. Other traditional anti-inflammatory and soothing herbs, including calendula, flaxseed, licorice, marshmallow, myrrh, and yarrow. Many of these herbs are most effective, according to clinical experience, if taken internally as well as in enema form.⁴¹ Enemas should be avoided during acute flare-ups but are useful for mild and chronic inflammation. It is best to consult with a doctor experienced with botanical medicine to learn more about herbal enemas before using them. More research needs to be done to determine the effectiveness of these herbs.

Caution: It is likely that there are many drug interactions with St. John's wort that have not yet been identified. St. John's wort stimulates a drug-metabolizing enzyme (cytochrome P450 3A4) that metabolizes at least 50% of the drugs on the market.⁴² Therefore, it could potentially cause a number of drug interactions that have not yet been reported. People taking any medication should consult with a doctor or pharmacist before taking St. John's wort.

Curcumin is a compound in turmeric (Curcuma longa) that has been reported to have anti-inflammatory activity. In a preliminary trial, five of five people with chronic ulcerative proctitis (a condition similar to ulcerative colitis) had an improvement in their disease after supplementing with curcumin. The amount of curcumin used was 550 mg twice a day for one month, followed by 550 mg three times a day for one month.⁴⁴ In a double-blind trial, supplementation with curcumin in the amount of 1 gram twice a day for six months decreased the relapse rate in patients with ulcerative colitis in remission. The relapse rate was 4.7% among people receiving curcumin and 20.5% in the placebo group, a statistically significant difference. All patients in the study also received conventional therapy.⁴⁵

Aloe vera juice has anti-inflammatory activity and been used by some doctors for people with UC. In a double-blind study of people with mildly to moderately active ulcerative colitis, supplementation with aloe resulted in a complete remission or an improvement in symptoms in 47% of cases, compared with 14% of those given a placebo (a statistically significant difference).⁴⁶ No significant side effects were seen. The amount of aloe used was 100 ml (approximately 3.5 ounces) twice a day for four weeks. Other traditional anti-inflammatory and soothing herbs, including calendula, flaxseed, licorice, marshmallow, myrrh, and yarrow. Many of these herbs are most effective, according to clinical experience, if taken internally as well as in enema form.⁴⁷ Enemas should be avoided during acute flare-ups but are useful for mild and chronic inflammation. It is best to consult with a doctor experienced with botanical medicine to learn more about herbal enemas before using them. More research needs to be done to determine the effectiveness of these herbs.