Indian Diet Plan for Ulcerative Colitis

Table Of Content

Living with any kind of gut issues damages more than one's physical health. Quality of life is drastically affected for those struggling with IBS.

Even the simple task of going out to enjoy a meal or catch up with friends can be challenging and come with anxiety. Having worked with clients globally for IBS/ IBD management, I have come to realise that it is both mental and physical health that needs working on.

In India, ulcerative colitis (UC) is becoming increasingly prevalent, affecting a significant proportion of the population.

According to a study published in the Indian Journal of Gastroenterology, the incidence of UC in India has steadily increased over the past few years, with a prevalence rate of 19.2 per 100,000 individuals.

Ulcerative colitis is a chronic inflammatory disease primarily affecting the large intestine (colon) and the rectum. It is a type of inflammatory bowel disease (IBD) that causes inflammation and ulceration in the lining of the colon and rectum. This can lead to various symptoms, such as:

• abdominal pain,
• bouts diarrhoea and/ or constipation,
• irritability to certain food groups
• fever, and,
• rectal bleeding.

IBD is a group of chronic inflammatory disorders that affect the digestive tract. The two most common types of IBD are Crohn's disease and ulcerative colitis. Watch this video I created to understand more:

While Crohn's disease can affect any part of the digestive tract (however, commonly the upper part of the small intestine) , UC affects only the colon and the rectum.

UC can cause weight loss, anaemia, nutritional deficiencies, and fever in severe cases. It can also increase the risk of developing colorectal cancer.

Before we dive into the right protocol for treatment for UC, lets understand the disease from its root cause.

What is Ulcerative Colitis?

Ulcerative colitis is a chronic inflammatory bowel disease that primarily affects the colon and rectum. It is characterized by inflammation and ulceration of the inner lining of the large intestine, leading to various gastrointestinal symptoms.

The inflammation typically starts in the rectum and spreads continuously to other parts of the colon. The severity and extent of the disease can vary widely among individuals, ranging from mild to severe cases. Read this article if you are struggling with IBS symptoms:

• Indian Diet Plan for IBS Management.

The exact cause of ulcerative colitis is unknown, but it is believed to be related to eating habits, lifestyle, environmental, and immune factors. The immune system mistakenly attacks the colon's lining, causing inflammation and ulcers.

There is no known cure for ulcerative colitis, but various treatments and a change in lifestyle can help reach remission and improve quality of life. Medications such as anti-inflammatory drugs, immunosuppressants, and biologics can help reduce inflammation, but do come with side- effects of their own. In severe cases, surgery to remove the colon may be necessary.

With regard to nutritional interventions,

• A plant forward diet low in sulphur containing amino acids is the best treatment backed by science.
• Conversely, a diet high in animal products such as eggs, meat and dairy may exacerbate inflammation and worsen symptoms.

Therefore, a plant-based diet may be beneficial for those with ulcerative colitis.

What Are The Potential Causes of Ulcerative Colitis?

Some evidence suggests that dietary factors may contribute to developing or worsening ulcerative colitis. Specifically, a diet high in sulfur-containing amino acids, primarily found in animal products such as dairy, meat and eggs, may increase the risk of developing the condition.

Sulfur- containing amino acids are a group of amino acids that contain sulfur atoms in their chemical structure. The three main sulfur- containing amino acids are methionine, cysteine, and homocysteine.

One interesting study followed 60,000 people over time and showed a very strong correlation between animal protein intake and IBS. Meaning, the more meat you consume, the higher your risk of IBS/ IBD.

Sulfur- containing amino acids are converted to hydrogen sulfide in our gut by our gut microbiome. Hydrogen sulfide has strongly been related to disrupting gut health and causing inflammation.

Additionally, studies have suggested that consumption of cow's milk may be associated with an increased risk of ulcerative colitis.

Other factors, such as genetics, environmental factors, and immune system dysfunction, may also play a role in the development of the condition.

Besides this, lifestyle factors such as a bad circadian health, alcohol consumption, stress etc can also play a role in making symptoms worse.

Nevertheless, a plant-based diet high in fibre and anti- inflammatory foods may be beneficial in managing symptoms and promoting overall health for those with ulcerative colitis. Therefore, promoting a plant-based diet and avoiding consuming animal products such as meat and dairy is recommended for individuals with ulcerative colitis.

What Are The Early Symptoms Of Ulcerative Colitis?

Ulcerative colitis is an inflammatory bowel disease primarily affecting the large intestine and rectum lining. The symptoms of ulcerative colitis can vary from person to person, but some common early symptoms include the following:

• Abdominal pain: Pain in the abdomen is a common symptom of ulcerative colitis. It can range from mild to severe and can be crampy or constant.
  
  
• Diarrhoea: Frequent and urgent bowel movements, often with blood or mucus, are common symptoms of ulcerative colitis. It can also cause dehydration and fatigue.
  
  
• Rectal bleeding: Blood in the stool is a common symptom of ulcerative colitis and can range from mild to severe.
  
  
• Weight loss: Ulcerative colitis can cause a loss of appetite and weight loss, which can be a sign of malnutrition.
  
  
• Fatigue: Feeling tired or weak is a common symptom of ulcerative colitis, often due to the body's efforts to fight inflammation.
  
  
• Fever: Ulcerative colitis can cause a low-grade fever or high fever, which may indicate an infection or inflammation in the body.
  
  
• Joint pain: Some people with ulcerative colitis may experience joint pain or swelling, particularly in the larger joints such as the knees or ankles.
  
  
• Skin rashes: Ulcerative colitis can cause skin rashes or lesions, which may be a sign of inflammation in the skin.
  
  
• Eye inflammation: Ulcerative colitis can cause eye inflammation, resulting in redness, pain, and blurred vision.
  
  
• Anaemia: Chronic bleeding from ulcerative colitis can lead to anaemia, which can cause fatigue, weakness, and shortness of breath.

If you are experiencing any of these symptoms, it is essential to consult with a healthcare professional for proper diagnosis and treatment. A healthy, plant-based diet can help alleviate symptoms and promote digestive health.

What Are The Treatment Options For Ulcerative Colitis?

There are several treatment options for ulcerative colitis, including:

Nutritional and Lifestyle Changes:

Ideally, nutritional and lifestyle changes should be your first approach to treating UC. All other treatment forms are really symptom management, rather than getting to the root- cause of the problem.

A well planned low- sulfur containing amino acid nutritional approach helps best with ulcerative colitis. You will be eating fruits, vegetables, whole grains, legumes, and nuts.

It is recommended to limit artificial sweeteners, processed foods, dairy, sugar, and alcohol. Depending on the severity of your inflammation and gut tolerance, I would help my clients also go on a low- FODMAP diet or even try the elimination protocol. Most importantly, inclusion of anti- inflammatory and alkalising foods and spices is a must.

Physical activity:

Regular exercise can help reduce inflammation and improve overall health. Low-impact exercises like walking, yoga, or swimming can benefit people with ulcerative colitis.

It is essential to understand that exercise itself causes a lot- grade inflammation. This is known as a hormonic stress and very important for the body. However, exercising too intense can do more harm than good for people with UC.

That being said, low to moderate grade exercise is a necessary intervention as it helps improve peristalsis movement of the gut, thus, making ti easier to pass stools. Low grade exercise also helps release a series of hormones that heal the body from inflammation.

Medications:

There are several types of medicines used to treat ulcerative colitis, including anti-inflammatory drugs, immunosuppressants, and biologics. These medications work to reduce inflammation and help manage symptoms.

Long term use of medication will impact liver and kidney health. Besides this, quality of life and energy levels might also dip with the intake of daily medication. Medications like PPI's are also habit- forming, meaning, they will keep you dependent on them.

Use medication as a temporary resort if you must, but work on sustainable lifestyle and nutritional changes to completely reverse your symptoms.

Dairy elimination:

Some studies have suggested that dairy elimination may help alleviate symptoms in certain individuals with UC. Not only is the quality of dairy we drink today highly adulterated, dairy itself is very carcinogenic and inflammation causing even if it is not adulterated.

But what about Ghee? Here you go:

Dairy products contain lactose, a type of sugar that most people have difficulty digesting due to lactose intolerance. Lactose intolerance is common among 80% of the global population.

In individuals who are lactose intolerant, consuming dairy products can lead to gastrointestinal symptoms such as bloating, gas, and diarrhea. These symptoms can be particularly problematic for individuals with UC, as they already experience inflammation and sensitivity in the gastrointestinal tract.

Additionally, some research has indicated that certain proteins found in dairy, such as casein, may stimulate an immune response and contribute to inflammation in the gut. By eliminating dairy, these proteins are removed from the diet, potentially reducing inflammation and improving symptoms in some individuals with UC.

Make a list of all dairy products you are consuming in a day. Now swap the same with non- dairy alternatives, one item at a time. For example,

• Switch to using almond milk for your morning cup of chai instead of cow's milk.
• Skip the paneer for tofu.
• Try using homemade cashew or coconut milk in curries instead of cream or milk.
• Stop using Ghee on chappati and for Tadka. Try going oil- free too as oil's are inflammatory too.
• Opt for a plant- based meal when you go out and skip the cheese laden pizza's.

Can Ulcerative Colitis Be Cured Or Reversed?

Ulcerative colitis is a chronic condition, but with proper changes, you can reach a state of remission. Additionally, several ways exist to manage symptoms and improve quality of life.

A plant-based, alkalising diet can be particularly effective in managing symptoms of ulcerative colitis, reducing inflammation in the gut, and improving overall gut health.

A study published in the Archives of Rheumatology and Immunology suggests that a vegetarian diet can help reduce the risk of developing ulcerative colitis and even help manage the symptoms.

Fiber, found only in plant, acts as a prebiotic, providing nourishment to beneficial gut bacteria, which may contribute to a more balanced gut microbiome.

Additionally, plant-based diets are typically low in saturated fats and rich in anti-inflammatory compounds, such as antioxidants and phytochemicals. These components have been associated with reducing inflammation in the body, including the gastrointestinal tract. People on a plant- forward diet also show lower inflammatory markers.

Personally, when working with clients, we bring the inflammatory markers on blood test reports in as little as 6 weeks of making nutritional changes!

One study published in the journal Nutrients in 2019 investigated the effects of a plant-based diet on individuals with inflammatory bowel disease (IBD), including UC. The study found that participants who adhered to a plant-based diet reported a reduction in symptoms, improved quality of life, and reduced medication use compared to those following a standard diet.

Foods To Include When Suffering From Ulcerative Colitis?

Your gut microbiome is as unique as your thumb- print. Thus, foods can cause a different degree of sensitivity to different people with UC. A meal plan has to be customised and there is no one- diet- fits- all when it comes to UC. However, here is a list of foods that words with most people:

Fruits and vegetables: They are rich in fibre, vitamins, and minerals. Cooked vegetables are generally easier to digest than raw ones. Cruciferous vegetables are the best when it comes to inflammation management, but they need to be introduced slowly to the diet. besides this, amla and other berries are the most anti- inflammatory and must be part of your daily diet.

Whole grains: Whole grains like brown rice, quinoa, and oats are high in fibre and nutrients. However, people with ulcerative colitis should be careful with gluten-containing grains, which can sometimes trigger symptoms.

Aim to consume 2-3 servings of whole grains daily as part of your healthy nutrition plan. Whole grains are also a very rich source of B- vitamins, which help boost the bodies natural energy levels and maintain a healthy immune function.

Legumes: Legumes like lentils, chickpeas, and beans are high in protein, fibre, and other vital nutrients. They are literally a power- house of vitamins and minerals.

Legumes in the gut are food for the good gut- microbiome, the type that reduce inflammation. The good gut microbiome feed on legumes are release byutrate, a type of post- biotic fiber that heals the gut.

If legumes cause symptoms of gut distress for you, reduce the serving size and introduce them slowly to your diet. Soaking them before cooking, sprouting them and using canned beans is another great way to build tolerance as you introduce them.

Turmeric: Turmeric has anti-inflammatory properties and can help manage symptoms of ulcerative colitis.

One pilot study showed an improvement in all subjects that participated on taking a curcumin supplement (the active ingredient found in turmeric associated with its anti- inflammatory properties) for a short period of time. All but one participant even reported a drop in medication and improvement in bowel quality.

Another placebo controlled trial also showed an positive association between turmeric intake and UC symptoms. Relapse rates also decreased in the turmeric group. This is reason enough to add upto a 1/2 tsp of turmeric to your diet daily.

Foods To Avoid When Suffering From Ulcerative Colitis?

As important as it is to include anti- inflammatory and alkalising foods to your diet, it becomes even more important to specifically avoid foods that lead to inflammation. Here is a list of things you must watch out for:

Dairy products: Dairy products can be challenging to digest and can worsen inflammation in the gut. Repeated consumption of dairy has also been linked to a leaky gut and increased markers for inflammation.

For various reasons mentioned in this blog, it is best to avoid the consumption of dairy products altogether.

Processed foods: Processed foods are often high in sugar, salt, and other additives that can trigger inflammation and worsen symptoms.

Processed foods are also often hyper- palatable, designed to keep you addicted to eating them. Thus, the more you consume them, the more you will want of. If you are eating anything that comes in packets or is heavily processed, such as breads, white rice, pastries, cookies, chai- time snacks etc, you want to avoid the consumption of the same.

Nutritional yeast: Nutritional yeast can sometimes trigger symptoms in people with inflammatory bowel disease, including ulcerative colitis. In fact people with inflammatory bowel syndrome do show higher levels to anti- yeast anti- bodies. Meaning, when yeast is consumed by people with IBS, their gut produces antibodies that triggers the immune system when not needed.

Lifestyle Changes For Ulcerative Colitis.

In addition to medical treatments and dietary changes, lifestyle changes can help manage ulcerative colitis. Here are some lifestyle changes that may be helpful:

1. Stress management: Stress can trigger flare-ups of ulcerative colitis, so finding ways to manage stress is essential. Some effective stress-management techniques include deep breathing, yoga, meditation, and regular exercise.
   
   
2. Regular physical activity: Exercise can help manage stress, improve overall health, and may also help to reduce inflammation in the gut. Choosing activities that are not too strenuous and talking to a healthcare provider before starting a new exercise program are essential.
   
   
3. Avoid smoking: Smoking can worsen symptoms of ulcerative colitis and increase the risk of complications. Smoking is inflammatory not only to the lungs, but blood vessels all across the body.
   
   
4. Get enough sleep: Lack of sleep can increase stress levels and trigger symptoms of ulcerative colitis. Aim for 7-9 hours of sleep each night and establish a consistent sleep routine. Quality of sleep is just as important as quantity, so aim on improving sleep quality.
   
   
5. Stay hydrated: Dehydration can worsen ulcerative colitis symptoms, so drinking enough fluids is essential. Water, herbal teas, and coconut water are good options.
   
   
6. Avoid alcohol and caffeine: Alcohol and caffeine can irritate the gut and trigger symptoms of ulcerative colitis. Limit or avoid these substances.
   
   
7. Maintain a healthy weight: Obesity can increase the risk of developing ulcerative colitis and can worsen symptoms. Eating a healthy diet and engaging in regular physical activity can help maintain a healthy weight.

It is essential to work with a healthcare provider to develop a personalised plan for managing ulcerative colitis, including lifestyle changes, medication, and dietary changes. Do not keep fixing the symptoms temporarily every time they flare up, but work on a long- term solution to get rid of the same.

Recipes My Clients Enjoy

A dietary approach to healing an inflamed gut is very subjective and requires constant monitoring and changes accordingly. While the principles of a whole- food plant- based diet work to heal everyone with UC, different versions of the diet might become necessary based on each case.

I often will do a full case history to understand if the client is struggling with any other additional problems such as:

• yeast infection,
• parasitic or bacterial infection,
• histamine intolerance,
• FODMAP intolerance,
• celiacs etc

before curating a meal plan. However, below are some recipes that work with most clients. For a customised meal and lifestyle modification plan, fill up the free consultation form below and my team will be glad to see up a call for you with me.