The Ulcerative colitis o rettocolite ulcerosait’s a pathology breaking latest news of type inflammatory which affects the mucosa of the large intestine (colon-rectum).
The causes of ulcerative colitis non they are still well known but among the authors there is a common belief that it is a disorder immunological. The body’s own white blood cells would therefore damage the intestinal mucosa through the release of anti-epithelial antibodies; this theory seems to be supported by the more or less frequent comorbidity of ulcerative colitis with other similar disorders extra-intestinal. Furthermore, the possibility of a transmissible genetic component is not excluded.
Use: it is also quite common to encounter strong emotional stress probably caused by the anxiety-provoking tendency of some subjects suffering from ulcerative colitis. This etiology seems to overlap with that of irritable bowel syndrome.
Ulcerative colitis manifests itself with mucoematic diarrhea, i.e. containing a good quantity of intestinal mucus associated with blood; diarrheal discharges are more frequent at night and after meals, and are associated with crampy abdominal pain and constant feeling of need to defecate even though the rectum is already completely empty (Tenesmo).
If left untreated, ulcerative colitis can lead toextension of the affected mucosal area. with relative worsening of the symptoms. In addition to enteric manifestations, the onset of high fever is frequent.
The therapy of ulcerative colitis focuses above all on the induction of remission, and on the maintenance and management of any complications related to the disease.
Role of diet in ulcerative colitis
The most important precaution in prevention of ulcerative colitis is undoubtedly that of keep intact the intestinal mucosa; however, the diet for ulcerative colitis changes significantly depending on the state of the disease, or rather:
if ulcerative colitis is found in form latent, when it does not present specific symptoms, the objective of the diet is to maintain intestinal balance by avoiding acute flare-ups; if ulcerative colitis manifests any type of symptoms acutethe objective of the diet is to reduce enteric manifestations.
Diet in remission phases
In the latency or remission period, food therapy for ulcerative colitis aims to maintain intestinal efficiency and strengthen the “barrier” effect towards pathogens, acidity, food waste, etc.
Colon peristalsis is favored by the right intake of dietary fiber, which should be introduced in the right doses and as regularly as possible. In this regard, research bodies recommend taking approximately 30g/day (+/- 5g), a portion which, based on subjectivity, can be increased or decreased based on the peristaltic response individual (frequency of bowel movements and consistency of stool). The fibre, adequately divided between soluble (contained mainly in fruit and vegetables) and insoluble (mainly from cereals and derivatives), in addition to maintaining a certain “vitality” of the colonic muscles, nourishes the physiological bacterial flora contributing significantly to the maintenance of the right bacterial trophism.
Since these are molecules also useful for the growth of physiological colonies (function prebiotics), foods containing fiber act synergistically with probiotics (yogurt, fermented milks, supplements, medicines, etc.) for maintaining mucosal defenses; if the patient does not use probiotic foods, by consulting the doctor it is possible to integrate the intake of these bacterial strains using drugs or food supplements containing: L. acidophilus, B. bifidum, L. bulgaricus.
Also the food sources of omega-three (due to the powerful anti-inflammatory action of these essential fatty acids), and those of glutaminedue to the trophic function of this amino acid on the intestinal mucosa, are particularly recommended in the diet of subjects suffering from ulcerative colitis.
Finally, let us remember that all agents irritating for the mucosa must be limited in the diet, therefore, if possible, it is recommended to drastically reduce alcohol, coffee, strongly spiced foods, very fatty foods, etc.
Diet in the acute phases
On the other hand, during the acute period of ulcerative colitis, dietary recommendations change drastically. Having to comply with the increased water requirement (dehydration induced by diarrhea), the first measure is to introduce water frequently; furthermore, remember that muco-blood diarrhea promotes nutritional malabsorption, therefore, vitamin supplementation associated with mineral salts (especially magnesium and potassium). Furthermore, in order to reduce diarrheal discharges as much as possible, in acute ulcerative colitis it is necessary:
Reduce your intake of dietary fiber which, although it is necessary during maintenance, in the acute phase it could favor evacuation, worsening the symptoms;
Discontinue any probiotic supplementation for hygiene reasons; we know that probiotic bacteria are not potential pathogens, however, considering that there are traces of blood in the feces indicating a lesion of the walls, to be on the safe side it is advisable not to encourage the introduction of other bacteria through diet.
Eliminate from the diet the lactose as, due to the flaking of the mucosa, it is possible that the fermentation of lactose by intestinal bacteria is favored; all this would inexorably worsen the frequency and importance of the diarrhea typical of ulcerative colitis. Obviously, more than in the latent phase, it is important eliminate all foods that provide molecules irritating: alcohol, coffee, other nerve agents, irritating spices (especially pepper), foods cooked on the grill or worse on the embers, excessively fatty foods, sources of solanine, etc.
Use: in more serious cases it may be necessary to replace the diet with parenteral nutrition; at the end of the most intense period, the ulcerative colitis patient will have to reintegrate food little by little through an elementary diet (hypoallergenic foods and simple cooking) possibly with low waste residue.
Bibliography
Systemic internal medicine – C. Rugarli – Elsevier Massono – page 701.