Root causes and treatments of ulcerative colitis

Ulcerative Colitis (UC) is an autoimmune disease that occurs when an adaptive immune response acts against self-antigens instead of fighting the foreign invader. In other words, when the immune system goes nuts and starts fighting you instead of those who are attacking you. When this happens in the gut, it attacks our healthy cells and causes an inflammatory response and undesired reactions like flare-ups and ulceration.

Aside from surgery (and more recently, Fecal Transplantation), there doesn’t seem to be an effective cure for the disease. However there are treatments that stop the disease from causing more damage and lessening the symptoms. The root causes of the disease are not completely known yet but conditions appear to relate to nature (genetic) and nurture (life style). It’s like cycles of contributory factors that feed into each other keeping the disease alive and making the patient suffer.

We have to know the root cause or the trigger to treat it in an efficient way. Having UC in the family and inheriting the gene is only one contributing factor but the real reason for the manifestation of the gene starts when we were in our mothers womb, until when we got diagnosed, and how healthy or not did we live our lives.

Below is a more detailed summary of the root causes, key processes of UC, conventional and natural treatments for ulcerative colitis.

NATURE OR NURTURE?

NATURE all starts with mother’s diet during pregnancy (especially in first 3 months); if she was eating healthy or not plays a role in our future health. Then the delivery, if it was C section it diminishes the chance of the baby getting a healthy bacteria from the mother. Breastfeeding tho will introduce some healthy bacteria, but without natural delivery and breastfeeding the microbiome imbalance and manifestation of the gene inherited could start from here..

Environmental factors also contribute massively to our wellbeing. Toxins in the air, people around us and their effect on us (psychological or physiological), types of bacteria around us and the water we drink(s) – whether clean or filled with toxins such as fluoride, glyphosate or arsenic could damage our health and cause problems.

A spike or a low in oestrogen or any dramatic hormonal imbalance could also be a trigger for the gene to be activated. A lot of women get diagnosed with ulcerative colitis upon their pregnancy and others get their flare-ups during menstruation.

Nurture always starts with diet! An Unhealthy Diet - A diet that is high in carbs (sugar) or grains could cause serious damage to the gut health for multiple reasons, harmful bacteria feed on sugars and grows in the stomach causing all sorts of problems and weakening our immune system. Also consuming grains helps increase intestinal permeability (gaps in the intestinal lining) causing a leaky gut or damage to the intestinal lining. In addition, eating processed food and unhealthy fats (e.g. trans-fats) could cause oxidative stress and possible cell damage which could lead to cancer.

Excessive use of alcohol, antibiotics, antacids, and analgesics contribute to damaging a healthy gut bacteria and the immune system. Damage to the cilia happens with UC. This damage causes poor bile production and metabolism. Poor bile metabolism and production weakens nutritional absorption in the gut, leading to deficiencies in vitamins including A, E, D and K. Deficiencies in these vitamins cause all sorts of problems from skin, sinuses, heart, joints and even vision-related problems. Treating these problems tho usually involves using medications like NSAIDs that are harmful to the gut.

A research by Ashwin N et al., in (2012) concluded that frequent use of NSAIDs is associated with increased absolute incidence of Chron’s Disease and UC. This turns it into a vicious cycle of complications that is extremely challenging to treat.

SOMETHING DOCTORS USUALLY MISS

Something else, a deficiency in Vitamin C is a major cause of scurvy in the colon, leading to food allergies that trigger an immune reaction of inflammation, scarred tissues and poor food absorption. Vitamin C deficiency could result from consuming little amounts of fruits and vegetables (which are sometimes troubling for people with UC), or other factors like smoking. This means that it’s crucial to check vitamin C levels with UC patients and all this indicates that diet plays a key role in either forming or healing the disease.

One more vitamin that plays a key role here is vitamin D. Since people with UC usually suffer from a Low nutrients absorption they sometimes have very low vitamin count. A deficiency in vitamin D alone could cause the inherited gene to be activated?

The Gut flora or our microbiome plays a key role in our immune system and overall health. A major cause of most autoimmune disease, especially Irritable Bowel Disease, is poor gut health. Bad diet and excessive use of foods mentioned earlier could causes dysbiosis (imbalance of the gut flora) , reducing the good and much needed bacteria and replacing it with harmful bacteria.

Another factor not to be missed is the relationship between a healthy brain and a healthy gut. The gut constantly sends and receives information from the brain through the vagus nerve (GUT brain axes). With a healthy microbiome, the bacteria in the gut is able to send signals to the brain triggering a release of mood stability hormones like dopamine and serotonin. On the other hand, if the gut status is out of balance, it triggers a fight or flight immune response that then sends signals to the brain, secreting hormones like adrenalin, cortisol and causes our digestive system to be disturbed and work under stress.

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HOW ABOUT STRESS?

Stress is a major trigger for UC flare-ups. It is not yet however established whether or not it could be a primary cause. My personal opinion is that denying our gut feelings, traumas and negative feelings if not processed correctly, could hide in the gut, and if left not dealt with, it starts to harm our inner balance.

HOW IS IT TREATED?

Conventional treatments for UC have relied mainly on 5-aminosalicylates, corticosteroids, and immunosuppressants, including purine antimetabolites and cyclosporine.

Research shows however that while conventional treatment could be effective in maintaining remission and decreasing the length of active disease periods, it causes harmful side effects if used on long periods of time and very often patients stop responding to the drugs. Unconventional treatments on the other hand, are more holistic and they include, dietary changes, essential fatty acids, transdermal nicotine, heparin, melatonin, prebiotics, probiotics, herbal medicine, fibers and other supplements and nutrients.

In my opinion, since the symptoms of the disease vary from a person to another, a lot of factors have to be considered. Also, a lot of tests and trial and error are required to determine the root causes in play and what needs to be changed. Knowing the current status of the patient and learning about their symptoms, the severity of the damage caused by the disease, as well as their sensitivities, their background and their diet, would give a better picture of their status in order to tailor a treatment plan for them. Last but not least, always remember that there is no one treatment fits all with ulcerative colitis.

REFRENCES

1. Ashwin N et al. (2012), Nonsteroidal Anti-inflammatory Drug Use, and Risk for Crohn Disease and Ulcerative Colitis: A Cohort Study. Ann Intern Med[e-journal] 156, pp. 350–359. https://10.7326/0003-4819-156-5-201203060-00007. [Accessed 10 July 2019].

2. Berg E (2017), Intestinal Damage & Vitamin Deficiencies. YouTube https://www.youtube.com/watch?v=n_TZbz16C-U. [Accessed 29 June 2019].

3. Berg E (2017), What's Really Behind Leaky Gut. YouTube https://www.youtube.com/watch?v=3pjaXjmZWpU. [Accessed 27 June 2019].

4. Facebook group (chrons and UC internation support group).[Accessed 16 June 2019].

5. Head KA and Jurenka JS (2003), Inflammatory bowel disease Part 1: ulcerative colitis--pathophysiology and conventional and alternative treatment options. PubMed [e-journal] 8(3), pp. 247-83. https://www.ncbi.nlm.nih.gov/pubmed/12946238. [Accessed 10 July 2019].