Fish Oil's Role in Reducing Symptoms of Inflammatory Bowel Disease (IBD) And Crohn's Disease

With each passing medical and scientific study the benefits of fish oil and fish oil supplements, are finding their way into the spotlight. Many studies have shown a correlation between reducing the possibility of heart failure, heart attack and different vascular diseases, but it has only been recently that a connection between Omega-3 fatty acids and helpful benefits for patients suffering from Irritable Bowl Diseases (IBDs) such as ulcerative colitis and Chrohn's disease.

Many of these studies are double-blind studies that are further validated with cultural studies of Inuit and Eskimo populations that have a diet high in fish that contains Omega-3 fatty acids and a very low occurrence of ulcerative colitis and Chrohn's disease. As the evidence mounts, further studies will be needed to pinpoint with any accuracy how much the dietary intake of Omega-3 fatty acids can help in patients suffering from these gastrointestinal diseases, but on the surface the smaller studies that have been done are very promising.

Ulcerative Colitis and Chrohn's Disease Overview

Ulcerative Colitis and Crohn's disease are two types of inflammatory bowel diseases. These diseases are believed to be caused by several factors. First, genetic and non-genetic causes are believed to be the culprit in many cases. The other possible cause is environmental factors such as infections that cause an immune reaction in the gastrointestinal area. The body then generates a large amount of white blood cells in the intestinal lining. These white blood cells release chemicals in the process of fighting the infection that inflame the intestinal tissue. It should be noted, though, that the exact causes of IBDs, such as ulcerative colitis and Crohn's disease, are currently unknown.

In general, an ulcerative colitis attack or Crohn's disease attack will consist of severe intestinal inflammation, which can cause bloody diarrhea, stomach cramps, fever, loss of appetite, weight loss, anemia, bleeding from the ulcers, rupture of the bowel, obstructions and strictures, fistulae, toxic megacolon and malignant cancer. In the last instance, the risk of colon cancer in patients that have had ulcerative colitis or Crohn's disease rises significantly. Generally, after an attack, the disease will go into a remission stage that can last weeks or even years. If you are suffering from these symptoms you should see your physician immediately for a proper diagnosis.

Until recently, the treatment for ulcerative colitis and Crohn's disease was, first and foremost, a healthy diet. If symptoms require it, physicians will ask their patients to limit their intake of dairy and fiber. While it is true that diet has relatively little to no influence on the actual inflammation process within ulcerative colitis, it could have influence on the different symptoms associated with it. On the other hand, diet does have an impact on the inflammatory activity in Crohn's disease and one of the main ways of treating these symptoms is a diet that consists of predigested food. It should also be noted that in both diseases, stress has been shown to be a factor in causing flare-ups. Because of this, physicians will also emphasize the importance of stress management.

Secondarily, medical treatment for these two diseases involves suppression of the high level of inflammatory response mechanisms of the immune system within the intestinal tract. By suppressing this response, the intestinal tissue can heal and the symptoms of abdominal pain and diarrhea can be relieved. After the symptoms have been controlled, further medicinal treatment helps to decrease flare-ups and lengthen or maintain remission periods.

Conventional methods of medicating these two diseases involve a stepped approach. Initially, the least harmful of medications are given in as low a dosage as possible and are taken for a short time period. If these medications provide little or no relief, the dosages are either increased or the medications are changed.

The lowest levels of medications, or Step I, are aminosalicylates and antibiotics. Corticosteroids make up the set of Step II drugs. Step III drugs involve the use of immune modifying medications or a drug called Infliximab for patients suffering from Crohn's disease. These medications are not used, however, during acute flare-ups due to the length of time that a flare-up can last. Only after Step III medications fail completely are Step IV drugs introduced because at this time, they are experimental.

A final alternative in treating ulcerative colitis is surgery. Because ulcerative colitis is limited to the colon, surgery can completely cure it. Crohn's disease, unfortunately, is not restricted to the colon and can exist anywhere in the digestive tract. Because of this, surgery will often complicate matters more.

Limitations of Medical Treatment

Nearly one-quarter of all patients diagnosed with some form of IBD, either Crohn's disease or ulcerative colitis, will not respond to medical treatment. In about three-quarters of cases of Crohn's disease, surgery (even though it is not curative) will be required. Regardless of current medical treatment, a person suffering from ulcerative colitis will have a 50% chance of having remission end within a two-year period after the last flare-up. Even if the initial diagnosis of ulcerative colitis is limited to the rectum there is a 50% probability of the disease becoming more extensive over a twenty-five year period. If a patient has ulcerative colitis that involves the entire colon, that patient stands a 60% chance of requiring a colectomy and most patients will require surgical intervention within the first year after diagnosis of the disease.

It's obvious that Intestinal Bowel Disease can be debilitating. Continued treatments with progressively harsher medications and surgeries that may help in some cases but not others become the norm for these patients. Further, the complications like strictures and fistulas associated with IBDs, can ultimately lead to colon cancer. Many times, these complications create a feeling of hopelessness among those who suffer from ulcerative colitis or Crohn's disease.

There is hope, though. New studies are presenting strong evidence for the use of Omega-3 fatty acids (fish oil and fish oil supplements) in the prevention and treatment of IBDs. These studies are shedding new light on the multi-faceted health benefits of Omega-3 fatty acids and ultimately may present new methods for the treatment of these painful diseases.

The Case for Omega-3 Fatty Acids

Traditionally, the Inuit populations of Alaska have existed on diets high in fatty fish, specifically, types of fish that are high in Omega-3 fatty acids. Past studies of these cultures have shown that the large majority of these groups do not suffer from heart problems, heart disease or other forms of vascular disease. Less known, however, was the fact that the majority of people within these cultures also do not suffer from any form of Inflammatory Bowel Disease. This has led some scientists to postulate that there is a strong connection between the dietary intake of fish oil or fish oil supplements and the prevention of IBDs.

Take, for instance, one example of a symptom of both Crohn's disease and ulcerative colitis: inflammation. Fish oils high in Omega-3 fatty acids have anti-inflammatory properties, which can help reduce its occurrence in patients suffering from IBDs. The reason for this is that when Omega-3 fatty acids are introduced into the body it suppresses the production of leukotriene B4. Omega-3s have also been shown to inhibit interleukin 1Beta. Both leukotriene B4 and interleukin 1Beta are major players in the inflammation of mucosa lining the gastrointestinal tracts.

With regular dietary intake of fish oil supplements high in DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), inflammation can be reduced by up to 50% in the intestinal tissues of patients who suffer from ulcerative colitis. Fish oils that have anti-inflammatory properties are only effective in reducing inflammation, but not preventing it. Results in patients with Crohn's disease haven't been quite as promising, but this area of research is still in its infancy.

Recent studies show tremendous promise in fish oil's effectiveness in preventing and reducing the effects of IBDs. These studies show that there is an increase in the manufacture of less powerful prostaglandins at the sacrifice of the more potent ones. Patients with active ulcerative colitis who were given fish oil supplements have also shown significant improvement versus patients who were given placebos. Further study with larger control groups is needed, though, in order for more accurate data to be gathered.

As further evidence of the link between Omega-3s and relief from the symptoms and inflammation of IBDs, a 12-week study involving patients who knew they were taking fish oil supplements showed a significant decline in the disease. This study was further bolstered by the results from samples of the intestinal mucosa that were found to have increased amounts of eicosapentaenoic acid. These results increase when the supplement given to the patients is encased with an enteric coating, which allows the fish oil to be released lower into the intestinal tract. This further alleviates side effects such as fishy breath, burping and flatulence related to taking fish oil supplements. Because of the fewer side effects associated with these supplements, treatment over the long-term is more tolerable.

A Worldwide Phenomenon

With more notice being taken of the effects of Omega-3 fatty acids on the health of people who take them on a consistent basis, the worldwide scientific community has opened up more to the idea of this supplement being used for effective treatment of IBDs. For instance, in Italy, a study was conducted using enteric-coated fish oil supplements and a notable reduction in the rate of relapse in Crohn's disease remission was noted. The patients involved in this study showed evidence of inflammation at the beginning of the study and were suffering from the symptoms related to Crohn's. In this study, patients suffering from the disease received either three fish oil capsules three times per day or a placebo three times per day. Those patients receiving fish oil supplements showed a significant reduction in the inflammation.

Among 39 patients in the placebo group, almost 70% of the patients who were in remission, relapsed. Out of the 39 patients supplementing their diet with fish oil capsules, only 28% relapsed. Further, after a year, nearly 60% of the 39 patients being given fish oil supplements were still in remission while only 25% of the patients given the placebo were in remission.

Given the small size of the study group it is only possible to speculate on the efficacy of treatment for Crohn's disease patients, however, the results of this study are promising. If scientists are given the opportunity to produce a study with a much larger group of patients, better and more accurate data could be gathered which could lead to even more positive results. More research would also allow scientists and doctors to understand the ways in which the EPA works to help increase time of remission.

There is strong speculation that patients suffering from IBDs lack a particular enzyme found in Omega-3 pathways and that when this enzyme is present, remission and even prevention of IBDs is possible. In a sense, adding an Omega-3 supplement to the diet of a patient suffering from Crohn's disease or ulcerative colitis appears to be a type of enzyme replacement therapy.

In Japan, medical researchers at Shiga University of Medical Science conducted a study in which the diet of Crohn's disease patients was altered to include a meal of rice, cooked fish and soup. Prior to the establishment of this diet, the occurrence of relapse within one year was 90%. After implementation of the diet the occurrence of relapse dropped to 40% within one year. Results like this are encouraging other countries to do similar studies.

In the United States, research conducted at Boston University Medical Center shows that patients with chronic IBD have unusual fatty acid profiles that were generally lower than control subjects who did not suffer from any type of chronic intestinal disorder. Because of this lack of fatty acids, it is believed that these patients are more prone to these problems. The study also suggests that the addition of Omega-3 fatty acids via a diet that adds fish oil or fish oil supplements can help reduce and correct this shortage.

Another study in San Francisco that involved patients with ulcerative colitis showed that there is an increase in leukotriene B4 in the colonic lining. The hypothesis in this study is that an increase in fish oil supplements in patients suffering from ulcerative colitis could inhibit the synthesis of the leukotrienes. If this is possible, fish oil supplements would be responsible for a reduction or elimination of the symptoms associated with inflammation of the bowels in this disease.

The final results of the study show that the hypothesis was accurate. Patients in the study were randomized and placed into two different groups. The study group received regular daily doses of fish oil containing 2.7 grams of eicosapentaenoic acid and 1.8 grams of docosahexaenoic acid. The second set of patients were placed into a control group and given placebo capsules filled with olive oil. Over a three-month period, patients receiving the fish oil supplements showed marked improvement in the severity of the symptoms of the disease. In fact, 72% of the study group taking the supplements was able to reduce or completely terminate their anti-inflammation and steroid medication schedules. The final outcome of the study was that fish oil supplements were integral to the improvement of patients suffering from ulcerative colitis.

A similar study done at Mount Sinai School of Medicine shows that the regular use of fish oil supplements in patients suffering from ulcerative colitis diminishes the severity of the disease. Fully 70% of the patients involved in the study showed moderate to significant improvement and 80% of the patients in the study were able to reduce their intake of prednisone, an anti-inflammatory used to help alleviate symptoms of the disease, by up to 66%.

Taking the Next Steps

Studies are showing positive results and it's obvious that the Omega-3 fatty acids inherent to fish oil supplements are beneficial to our intestinal health. The obvious thing to do is find out what types of fish oil supplements are the best. Personal research will aid you in finding the correct supplements and additionally, if you suffer from Crohn's disease or ulcerative colitis, you should consult with your physician about the benefits of adding a fish oil supplement to your diet and what dosage you should take. There is, however, some basic information about fish oil supplements that you need to know.

First of all, not all fish oil supplements are created equal. Cod liver oil is, by far, the most inexpensive form of fish oil that contains Omega-3 fatty acids. However, it does not contain the highest amounts and in most cases it cannot be taken in high doses because of impurities such as mercury that are left in it. It also has an extremely powerful taste that most have trouble tolerating.

A much better choice for supplementing your diet with fish oil is a health food grade supplement. These supplements have been purified using a process called molecular distillation. This process eliminates nearly all of the impurities and is very safe when taken in the doses necessary to help alleviate the symptoms associated with IBDs.

The purest form of fish oil supplements is pharmaceutical grade. These supplements have also been processed using molecular distillation, however, at a much higher level. The process used in filtering out the impurities gets rid of all of them down to the particulate level. These supplements, of course, are also the most expensive, but will have the greatest impact on your ulcerative colitis or Crohn's disease.

The benefits of Omega-3 fatty acids are proving to be phenomenal and it is anyone's guess as to the limits of what these supplements can do for our health. With few side effects that are relatively minor, fish oil supplements are a good choice to help you improve your overall health. The fact that they can be used to inhibit the relapse of the symptoms of Crohn's disease and ulcerative colitis is even more exciting. Omega-3 fatty acids are carving out a healthy niche in the diets of individuals worldwide and everyone is all the better for it.

Benefits of Spirulina, One of the World's Most Nutritious Antioxidant Foods

Spirulina is one of the most familiar of the single-celled plants known as blue-green algae. They are usually found in warm and alkaline waters all over the world, predominantly in South America, Africa, and Mexico. The name "spirulina" is derived from the Latin word for "helix" or "spiral"; reflecting the physical configuration of the organism as it forms swirling, microscopic strands.

Blue-green algaes contain significant nutritional content, including polysaccharides, antioxidants, nucleic acids and peptides. Spirulina contains about 70 percent protein, vitamin E, vitamin C, beta carotene and B complex and chlorophyll. Spirulina also contain essential fatty acids, and minerals like calcium, iron, magnesium, manganese, potassium and zinc.

Protein Content. Spirulina is the world's most digestible natural source of high quality protein, far surpassing the protein bioavailability of beef. The protein found in this algae superfood is complete, containing all eight essential amino acids, unlike beans and other plant foods that typically lack some of the essential amino acids.

Spirulina's predigested protein is absorbed almost immediately, without the energy-draining effects of breaking down meat protein, and its simple carbohydrates give you immediate yet sustained energy. Its protein-bonded vitamins and minerals, as in all whole foods, assimilate better than the synthetic variety. Spirulina is a great supplement for those who exercise vigorously, as evidenced by the many world-class athletes who use it.

Spirulina is the ideal food source for people looking to get more protein into their diets:

• people on low-carb, high-protein diets like the Atkins Diet or the South Beach Diet.


• people who workout vigorously or engage in strength training.


• people who are frail, have trouble gaining weight, or who are generally malnourished.

Essential Fatty Acids (EFA). Blue-green algaes--especially spirulina--are some of the best sources of gamma linolenic acid (GLA), an omega-6 fatty acid with many healthful properties that is missing in most people's diet. GLA has been shown to help prevent conditions such as heart disease, arthritis, diabetes, and even cancer.

Health Benefits of Spirulina

Studies reveal some of the most common benefits of spirulina:

• inhibits the infectious power of many viruses--including HIV, flu, mumps, measles, and herpes


• helps diminish allergies such as hay fever


• helps protect the liver from toxins


• helps boost the immune system


• reverses the signs of aging


• helps reduce blood pressure and cholesterol


• helps control symptoms of ulcerative colitis


• exerts strong antioxidant and anti-inflammatory effects


• helps with weight loss

Spirulina has been found to have significant positive effects on people suffering from type 2 diabetes. Studies show that spirulina has the ability to reduce fasting blood sugar levels in the body after 6 to 8 weeks of intake.

Spirulina has long been established to have cancer fighting ingredients.

Spirulina helps support the healthy pH balance of the body. Western diets tend to be highly acidic, due to the heavy reliance on foods like animal proteins. These acidic foods can be effectively countered by the alkaline nature of spirulina.

Cleansing & Detoxification. If you engage in intense physical training, you'll find the chlorophyll in spirulina especially valuable. Anytime you put your body under stress, toxins and free radicals are released from your tissues. The chlorophyll in spirulina helps eliminate these waste products, and cleanses your liver, kidneys and blood. When the liver and kidneys are working more smoothly, everything else in the body works better, too.

This cleansing effect is also important if you're on any sort of low-carb diet (Atkins diet, South Beach diet, etc.) since such diets can place a heavy burden on the liver and kidneys. (Eliminating excess ketones puts your body under additional stress.)

The cleansing effect of spirulina is also of great benefit in protecting you against environmental toxins, air and water pollution, and other contaminants that you're being exposed to every day.

Spirulina is a Whole Food. Think of spirulina as a nutrient-dense green food, rather than a nutritional supplement. The more of it you can get into your diet, the better. You can't eat too much, and one tablespoon has the nutritional value of 5 or 6 servings of common vegetables. This is a great way to ensure that you get enough phytonutrients into your diet, especially if you avoid dark green leafy vegetables.

Blood in Stool - 7 Reasons Found in the Colon

Blood in stool is often discovered with some perplexity, accompanied appropriately by exclamations of 'bloody' (not expletive). Dots of blood, scarlet red, stand out unmistakably on excrement. Maroon red blotches of blood besmirches the toilet tissue. Bright red spots of blood dribble into the toilet bowl or down the legs. Quite naturally, a sudden bout of fear causes our hearts to jump a beat or two.

No undue alarm is warranted yet as the hemorrhaging (technical word for bleeding) could be any one of 7 possible causes arising from the colon. Mindful attention to ensure early diagnosis and correct treatment will reduce any unsettling lifestyle changes as the best part of the 7 causes are treatable. Do not be unconcerned. Commence close monitoring. Without delay, consult your doctor if bleeding and pain lingers for more than a week.

Appropriate treatment following proper diagnosis can often quickly resolve the problem. More critically, blood in stool may be the consequence of some type of cancer.

Melena or Hematochezia

Hematochezia (maroon or bright red colored blood) or melena (black sticky or tarry stools) are two medical categorizations for the less technical term rectal bleeding. Whilst recognised as rectal bleeding as the exit is the rectum, the origins of the blood may be any of 7 causes in the colon (large intestine). Cancer, colon polyps, diverticulosis, Crohn's disease, ulcerative colitis, intestinal ischemia and peptic ulcer are the 7 known causes in the colon.

Colorectal Cancer

This is the third most frequent form of cancer on earth and the third most frequent reason for of cancer-related death with a fatality toll of around 640,000 annually. It is the reason why one should see a medical specialist for continual blood in stool.

Tumours in the colon, appendix and rectum are classified as colorectal cancer. Colonoscopy (visual inspection by micro-camera inserted via the anus) is the chief means of ascertaining colorectal cancer. Treatment focuses on surgical excision and chemotherapy. Timely discovery often leads to a total cure. Those over 50 and those with family history of cancers are classified under the higher risk group. Colorectal cancer is gender blind, affecting both women and men, with no conspicuous bias for either sex.

This next point bears taking note. Quite in contrast to what is reported elsewhere, colorectal cancer commonly produces occult (not visible to the naked eye) blood in feces i.e it is NOT a regular reason for visible blood in stool! According to the University of Michigan Health System, colorectal cancer does cause bleeding but special tests are requisite to confirm the presence of occult blood. Crucial accompanying symptoms to watch out for are diarrhea, constipation, abdominal pain, weight loss, appetite loss and incessant fatigue.

Colon Polyp

Affixing on the walls of the intestines or the rectum, polyps are frequently benign and may be raised or flat. Those above 50 years of age and with a family history of polyps and colorectal cancer are prone to polyps. Contributory factors include lack of exercise, obesity, alcohol and smoking. It would seem that no one knows the real cause.

Whilst benign, polyps are usually excised during colonoscopy as they can become malignant. Polyps do not usually cause noticeable symptoms. But in others, blood in stool is present.

Diverticulosis

Pouches (diverticula) stretching from the colon wall is distinctive of diverticulosis. Diverticula growth is postulated to be a result of abnormal colon pressure, the causes of which are not entirely distinct. Contributory factors include deprivation of dietary fiber. If food gets embedded in diverticula, infection may set in leading to diverticulitis. Complications from diverticulitis can ensue if an infected diverticulum ruptures and disseminates bacteria to the abdominal cavity lining. The possibly deadly peritonitis can materialise.

Diverticulosis do not cause distinct symptoms in most people. Mild cramps, constipation and bloating are some noted symptoms. Yet others suffer more acutely, including nausea, vomiting and rectal bleeding as the most common symptoms. The peril of peritonitis emphasizes the need that blood in stool should first be examined by a doctor. A CT (computed tomography) scan is 98% efficacious in diagnosing diverticulitis.

Ulcerative Colitis

IBD or inflammatory bowel disease, under which colitis is classified, affects the large intestine (colon) and the small intestine. Inflammation by itself is a healthy bodily response to heal damaged tissue. Like a tap that must be turned off, inflammation sets off curing of injured tissue but must terminate thereafter or greater tissue harm may ensue. Ulcerative colitis is caused by ulcers which are erosion of the mucous membrane lining.

Apart from other symptoms, blood in stool is frequent. The risk of peritonitis from colitis is the key reason for diagnosing it as the cause of rectal bleeding.

Crohn's Disease

Crohn's disease is an auto-immune disease whereby the body's immune system provokes harmful inflammation by assailing the gastrointestinal tract. It can develop in any part of of the gastrointestinal tract, from the mouth to the anus. But it usually affects the small and large intestine (colon).

Smoking, genetic makeup and industrial environmental exposure are believed to be contributory causal factors even though definitive causes are unknown. The symptoms are blood in stool, abdominal cramps, severe bloody diarrhea, blood on toilet tissue or in the toilet bowl, fever and weight loss.

Often termed as granulomatous colitis, Crohn's disease can go into abeyance and happen again periodically throughout life. Currently, there is no known surgical or pharmaceutical solution for Crohn's disease. Early detection is important for efficacious control of the symptoms and checking recurrences.

Intestinal Ischemia

Ischemia is a suppression in blood supply to any part of the body. Dysfunctional arteries result in tissue damage due to the deprivation of blood nutrients and oxygen. Intestinal ischemia is the depletion blood supply causing inflammation of the large intestine; a result of blood clots, blood vessel constriction and general high blood pressure.

Symptoms include blood in stool, urgent and violent bowel movements, weight loss, nausea, diarrhea, abdominal pain and cramps, abdominal bloating and fever. Urgent medical attention is needed to rejuvenate intestinal blood supply if there is serious consistent pain. It may be crucial to surgically circumvent blocked blood vessels and remove blood clots and damaged tissue. To arrest clots and infections, respective medication includes anticoagulants and antibiotics.

Peptic Ulcer

An exceedingly painful ulcer, this is located in the gastrointestinal tract. An erosion of the mucosal membrane that is at least 0.5cm in diameter is an ulcer. Commonly mistaken to occur in the stomach, peptic ulcers are actually prevalent in the duodenum (initial part of the small intestine). Peptic ulcers are largely presumed to be caused by a bacterium that inflicts chronic gastritis.

Symptoms include blood in stool (melena), abdominal pain, bloating, nausea, appetite and weight loss, vomiting of blood and at the extreme, perforation of the intestine. This can lead to possibly deadly peritonitis and requires emergency surgery. Antibiotics and antacids can be used to cure milder cases.

Hemorrhoids

The above 7 causes is the rationale why rectal bleeding demands the skills of a medical doctor who can render a precise diagnosis. Appropriate treatment and medication, possibly including surgery, can accelerate the path to recovery.

Lest you be too distressed by the above narrated causes, blood in stool is most usually due to the relatively innocuous internal or external hemorrhoids.

Ulcerative Colitis Diet Recommendations

If you are searching for information about an effective ulcerative colitis diet, you may find yourself very confused. There is no diet for ulcerative colitis that is agreed upon by all healthcare professionals. Most eating plans that are advertised as an ulcerative colitis diet were designed by those who suffer from the disease or those who love them. One man who sells a cookbook for his ulcerative colitis diet plan says that he was told by a doctor of "oriental medicine" (his words, not mine) that he should eat no meat, no fish, no egg yolks, no fruits and no nuts. While another diet for ulcerative colitis control, developed by a doctor and a biochemist recommends meat, fish, eggs, fruits and nuts. It may be wise and most effective to design your own ulcerative colitis diet, taking into account any known food allergies or sensitivities.

A symptoms and food diary may be helpful to use as you are designing your diet for ulcerative colitis control. Try to note not only what you ate, but what you drank. While there is little agreement about what foods should be included in an ulcerative colitis diet, there are certain products (like caffeine, alcohol, high fiber cereals, some fruits and some fruit juices) that are known to have a laxative effect, cause cramping and diarrhea, even in people who do not have an inflammatory bowel disease like ulcerative colitis. Diet is important. A healthy diet is important for overall good health and sense of well being. For those who suffer from ulcerative colitis, diet is particularly important.

Chronic diarrhea may lead to malnutrition, weight loss, weakness and dehydration. For these reasons a diet for ulcerative colitis control should be well-balanced, with adequate amounts of protein, carbohydrates and good fats. Including vitamin supplements, particularly D, B12 and iron is recommended.

Simple sugars and artificial sweeteners cause flare ups in some people. No matter what your food preferences, it is important when designing your ulcerative colitis diet to be honest with yourself. It may be hard to give up sodas, coffee, candy and muffins, but your goal should be to control your symptoms. Ulcerative colitis is considered a chronic disease that has a tendency to go into remission and then flare up again over time. Mild to moderate symptoms may be controlled with an ulcerative colitis diet, supplements, herbs and medications, but severe ulcerative colitis can only be cured with surgery. Since cases rarely begin as severe, keeping your symptoms under control decreases the likelihood that surgery will be necessary.

One thing to consider when designing your ulcerative colitis diet is stress and anxiety. While stress and anxiety are not believed to cause ulcerative colitis, it is believed that they can aggravate the condition. Many people who suffer from ulcerative colitis also suffer from anxiety. It may be that the condition causes people to be more anxious, never knowing when they may have to find a bathroom, always worrying about a flare up, etc. Symptoms of anxiety include rapid pulse, trembling, shaking, sweating and nausea or abdominal distress. If you experience symptoms of anxiety, in addition to symptoms of ulcerative colitis, diet considerations are similar, but there are other suggestions. These include eating smaller meals more frequently, chewing thoroughly and eating slowly.

Salt and preservatives are known to put additional stress on the body. These should be excluded or at least restricted from a healthy ulcerative colitis diet, particularly when symptoms of stress and anxiety are present. When designing your diet for ulcerative colitis control, try to include less pre-packaged foods which are full of salt and preservatives.

One more consideration for an ulcerative colitis diet is meat selection. Most companies that raise poultry, cattle and pigs for human consumption include hormones in the animal's diets. While there is no conclusive evidence that these hormones are harmful to humans, many people believe that they can put additional stress on the human body, because they increase stress on the animal's bodies. When you are selecting meat and fish for your ulcerative colitis diet, try to select products that do not contain hormones. For example, wild salmon, free range chicken and other organic products are better choices for a diet for ulcerative colitis control than pork and beef.

The lack of agreement about an effective ulcerative colitis diet probably stems from the fact that people have different food sensitivities and allergies. For example, a person who is lactose intolerant can not follow a diet that contains numerous milk products. One who is allergic to legumes can not follow a diet that relies heavily on legumes for protein. If you do not know if you are allergic to any foods, it may be wise to visit an allergy specialist. Sometimes food allergies develop over time, so foods that you were able to eat at one time with no adverse reactions may, at a later date, cause symptoms to flare up.

All of this may seem overwhelming and even depressing, but you may be encouraged to know that many people have found an ulcerative colitis diet that works well for them. For other suggestions about diet for ulcerative colitis control, from people just like you, you may want to visit a colitis support group. There are several on the web and your doctor may be able to recommend groups in your area. For more information about ulcerative colitis and other digestive problems, visit www.digestive-disorders-guide.com.

Coping With a Colostomy Bag

I suffered with ulcerative colitis from the age of 23, I had many symptoms that where undetected and mistaken for other things such as piles. My symptoms included loss of weight at a fast rate for no reason, blood in stools or just passing of pure blood. My symptoms went undetected for about six months which left me anemic and very tired all the time.

My worse nightmare was when I found out I had ulcerative colitis was the thought of having a colostomy bag as I hadn't saw one but a user of them had described them to me and carried around a massive holdall bag around with her saying that she had to take it everywhere with her. This really upset me as being only young I thought that I couldn't go out parting with friend's carrying a massive bag around. With this in mind when they told me that I would need a colostomy bag I was devastated and thought that maybe life was not worth living as at the time I was also single. I had lots of issues with having the bag and was upset for a few days until the operation.

The day of the operation came and I went down for the colostomy bag still with terror in mind still not having seen a colostomy bag yet as the operation was an emergency.

Coming round a few days later I was really scared about seeing the bag that was now going tho be part of my life, I remember a nurse coming and changing it for me which was not as strange as I had originally thought. Being inquisitive I asked if I could help so we did it together then after that I started changing it myself with confidence. (Bearing in mind I can now change it even after having a few drinks on a night out it is that easy.)

The surgery took a while to heal but I felt really well and was amazed by the way my life had changed with what felt like just a bag. It is the best thing that I could of had done to make my life become normal again and if people didn't know that I wore a colostomy bag then you would never know as it is really discrete.

If you show any signs of blood in your stools or a fast weight loss than be sure to ask for your doctor for tests as they are sometimes to quick to pass any tummy troubles off with IBS. If your do have to have a colostomy bag then I would advise you to ask your stoma nurse if you could have the number of someone who has had one so you can talk to them about any concerns you have, I have had the pleasure of meeting people who have had to have the surgery or might have to so they can ask questions as who best to ask than someone who as gone through it all and can give you first hand experiences that they have experienced during the surgery and after care.

Mastocytic Enterocolitis or Mastocytic Inflammatory Bowel Disease (MIBD), A New Epidemic?

Mastocytic enterocolitis is a new clinical entity characterized by increase mast cells of 20 or more per high-powered field in the duodenum or colon. Jakate et al. described 47 patients with intractable diarrhea and abdominal pain without other cause who had elevated mast cell numbers in intestinal biopsies and responded to therapy directed at mast cells. The patients generally met criteria for diarrhea predominant irritable bowel syndrome (IBS). Normal subjects had much lower levels of mast cells of an average of 12 per HPF. My experience indicates that this condition may be another hidden epidemic that should be added to the that of celiac disease and non-celiac gluten sensitivity (NCGS). My colleague Dr. Rodney Ford has suggested the term 'gluten syndrome" for the broader problem of non-celiac gluten sensitivity and I agree that this may be a more appropriate term. Now, I am suggesting that mastocytic inflammatory bowel disease (MIBD) be considered as a better term for the newly recognized mastocytic enterocolitis. I review my reasons below.

Until recently the presence of increased mast cells was either missed due to lack of ability to see mast cells on biopsies in the background of normal cells or was only noted in association with inflammatory bowel diseases and celiac disease. A few pediatric studies have noted increase mast cells in the esophagus in association with eosinophilic esophagitis or "allergic esophagus". Systemic mastocytosis has been known for years and has been associated with bowel symptoms such as abdominal pain and diarrhea. Now two new studies are shedding more light on this covert cell and its role in postoperative ileus and association with stress. Mast cells have been linked to diarrhea predominant IBS in a few studies but it wasn't until the Jakate article that a distinct entity defined.

The problem with linking mast cells with IBS and other digestive symptoms has been hampered by the difficulty seeing these cells in intestinal biopsies. However, now commercially available special stains utilizing immunohistochemistry for the enzyme tryptase allows the mucosal mast cells to be seen and counted in intestinal tissue obtained from routine random intestinal biopsies. Over the past year I have been asking the pathologists to perform mast cell stains on intestinal biopsies in my GI patients with diarrhea and abdominal pain. Recently, I began expanding this to include as many patients as possible as well as requesting these stains be done on biopsies performed previously in patients who I suspected might have this condition.

I have now accumulated fifty patients meeting criteria for mastocytic enterocolitis or mastocytic enteritis. These patients are in various stages of evaluation and treatment. I am collecting and analyzing the clinical information with the intent to submit the data for publication. What I have observed on initial review is that appears to be a higher than expected prevalence of the celiac disease risk genes DQ2 and DQ8. In particular, DQ8 appears to be overrepresented compared with the incidence in the general population. There also appears to be an association with celiac disease, non-celiac gluten sensitivity and multiple food intolerance.

The latter finding of multiple food intolerance determined by mediator release testing abnormalities (MRT, Signet Diagnostic Corporation and Alcat) makes sense. The principle of these tests is the detection of changes in cell volumes that occur due to chemical mediator release from cells present in the blood. The tests are not specific for the mediator or mediators released but is assumed that the greater the reaction the greater the number of mediators released and more likely a particular food, chemical or food additive can cause an adverse reaction.

The laboratories that provide mediator release testing report great success in treating a variety of symptoms commonly attributed to food intolerance or chemical/additive sensitivity. It is my belief that mast cells are heavily involved in this process. This would make sense since success with conditions now being associated with mast cells are reported to respond favorably to dietary elimination of foods or substances with abnormal MRT reactions. Classic examples include IBS, headaches, and interstitial cystitis that have been linked to mast cells as well as stress that is now linked to increase mast cells and mast cell degranulation releasing mediators.

Mediator release tests are criticized by some U.S. doctors, in particular quackwatch.com as being unproven or not validated for "food allergy" evaluation. However, they are not food allergy tests. Food allergy is an IgE mediated type I immediate immune response known as allergy. MRT tests for non-immune delayed type reactions resulting from mediator release from immune cells. The point is that mediator release testing is not a form of food allergy testing. MRT is a form of non-immune food intolerance or sensitivity reaction.

New articles published in the January 2008 issue of the journal Gut reveal exciting new associations of mast cell degranulation with postoperative ileus and a link to a stress hormone. The first study may be the first to show that mast cells in human bowel release mediators when the bowel is handled during surgery resulting in temporary bowel paralysis known as postoperative ileus. The minimally invasive surgery technique of laparoscopy results in less mechanical stimuli to the bowel and has a lower incidence of postoperative ileus.

Stress association with IBS and inflammatory bowel diseases (Ulcerative colitis, Crohn's disease) has been long known but a mechanism had not been determined definitely. In the same issue of Gut investigators showed that the stress hormone corticotropin-releasing hormone (CRH) regulates intestinal permeability (leaky gut) through mast cells. The investigators even identified specific receptors on mast cells. This new information sheds new light on the possible link of leaky gut and mast cells with IBS, IBD and celiac disease.

So, how do I believe this new information may help us? Since stress can increase mast cells in the bowel and these cells can release mediators that cause gut injury and symptoms, stress reduction important. These cells can cause abdominal pain, diarrhea, and constipation as well as other symptoms outside the gut so they are important. Yet, the significance of these cells is generally not recognized because most doctors, including gastroenterologists and pathologists are unaware of their presence and importance.

These cells cannot be seen in the intestine without special stains done on intestinal tissue obtained during upper endoscopy or colonoscopy. Those stains are not routinely done but generally require the doctor performing the biopsy to request them. If no biopsy is performed then obviously these cells cannot be found. There may be a genetic predisposition for what I think may be better termed mastocytic inflammatory bowel disease (MIBD) rather than mastocytic enterocolitis. There also may be the same genetically determined white blood cell protein patterns that are associated with Celiac disease playing an important role in MIBD.

As note above, stress reduction and probiotic therapy may be helpful to reduce mast cells and leaky gut but what about once the mast cells are increased in the gut. Once elevated mast cells are present, treatment may include medications and dietary interventions. Antihistamines, both type I (e.g. Claritin, Allegra, Zirtec) and type II (e.g. Zantac, Tagamet, Pepcid) to block histamine effects have been used successful in reducing abdominal pain and diarrhea in people with mastocytic enterocolitis. A very specific mast cell stabilizer, sodium Cromalyn (Gastrocrom), also has reduced symptoms. It is an accepted therapy for the more severe condition of generalized mastocytosis.

Searching for food allergies and food intolerance (by mediator release testing) followed by dietary elimination of problem foods until leaky gut resolves and mast cell numbers in the bowel reduce is also helpful in my experience. Food allergy testing consists of skin testing and IgE RAST antibody tests. These tests do not exclude non-allergic food intolerance and sensitivity. Antibody tests for IgG in blood or IgA in stool or saliva have been used for food sensitivity. In my experience MRT tests are much more helpful as they look for any abnormal mediator release to a variety foods, chemicals, or additives, regardless of the nature.

Stay tuned for new developments about the role of mast cells and look for more interest in mastocytic enterocolitis in the future. I propose that the GI community should adopt the broader term mastocytic inflammatory bowel disease since there is information indicating mast cells have an important role in allergic esophagus and stomach problems.

Selected References:

The, FO et al. "Intestinal handling-induced mast cell activation and inflammation in human postoperative ileus." Gut 2008; 57:33-40

Wallon, C et al. "Corticotropin-releasing hormone (CRH) regulates macromolecular permeability via mast cells in normal human colonic biopsies in vitro." Gut 2008; 57:50-58.

Jakate, S. "Mastocytic Enterocolitis: Increased mucosal mast cells in chronic intractable diarrhea." Arch Pathol Lab Med 2006; 130:362-367.

Copyright 2008 Dr. Scot M. Lewey http://www.thefooddoc.com

Treatment Of Ulcerative Colitis Symptoms Using Medications

Medications for ulcerarive colitis do not cure ulcerative colitis itself. But they can help provide some relief for the pain and discomfort caused by symptoms. One of the other things medications can do for you is help you attain remission - and hold it.

The following medications for ulcerative colitis are used most often by doctors.

Sulfasalazine - Sulfasalazine combines two other drugs, sulfapyridine and 5-aminosalicyclic acid, which is often simply called 5-ASA. The role of sulfapyridine is to transport 5-aminosalicyclic acid to the intestines. But sulfapyridine has a variety of possible effects like headaches, nausea, vomiting, heartburn and diarrhea.

Aminosalicylates - There's also 5-ASA in this medication but no sulfapyridine. Therefore, it has no side effects and can be taken by those who can't take aminosalyicylates.. Aminosalicylates are made from salicylic acid, and there's evidence they have antioxidant properties. Your doctor can suggest several different methods for administering aminosalicylates: by mouth, by suppository, of with an enema. This group of medications is usually first treatment for individuals with colitis. They can also provide some relief when the patient suffers a relapse.

Corticosteroids - These medications include prednisone, methylprednisone, and hydrocortisone. Their primary benefit is that they reduce inflammation. Cortisteroids generally work best with patients who have moderate to severe cases. Delivery methods include enema, suppository, or a pill taken orally. They can also be administered intravenously.. Your doctor will recommend a delivery method based on where the inflammation is located in your colon. Certicosteroids are better when used in the short term. But they have been known to cause side effects in the long term, including weight gain, risk of infection. mood swings, hypertension, facial hair, diabetes, bone mass loss, and acne.

Immunomodulators - These have an effect on the immune system that reduces swelling and inflammation. Corticosteroids are usually recommended when corticosteroids and 5-ASA's haven't worked, or when the patient has become dependent of corticosteroids. They're popular with many patients because they are taken by mouth. However, they take a long time to work compared to other drugs, possibly as long as six months before the patient gets the full benefit.

Cyclosporine A - Patients who are suffering from active, severe cases are often treated with this drug. It may also be administered to those who have not had success with intravenous methods. Cyclosporine is often combined with 6-MP or azathioprine. While treatment with these medications is progressing, the patient may also need other drugs to help relax, get relief from pain,andr combat diarrhea or infection.

Once again, doctors know of no long-lasting cure for ulcerative colitis. However, medications for ulcerative colitis can help prevent flare ups and keep down inflammation. Plus, they can reduce or delay the need for surgery.

Your doctor will evaluate a number of factors in deciding on the appropriate ulcerative colitis medication for you. Among these factors are

* how much discomfort your symptoms are causing
* complications that could arise
* any side effects you may have to face
* other ulcerative colitis medications that have worked - or not worked - previously

Although many similarities exist from one case to another, ulcerative colitis affects different individuals in different ways. So it's possible your physician may have to try a number of therapies before finding one that will be best for you.