Colitis

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Colitis

If you have been diagnosed with chronic colitis, you are already familiar with some of its unpleasant symptoms--diarrhea, abdominal pain and rectal bleeding.

Colitis is one of a group of conditions known collectively as inflammatory bowel disease. Ulcerative colitis causes open sores in the large intestine and almost always results in bloody, watery stools. Plain colitis, which is less severe, doesn't involve ulcers and tends to be confined to the upper part of the large intestine.

Although having a chronic inflammatory condition like colitis is no picnic, there is encouraging light on your health horizon. With good care, proper diet and a less stressful approach to life, you may be able to ease some of the discomfort of colitis and keep it under control. But flare-ups do happen. And when the symptoms start up again, the first thing you'll be looking for is some fast-track roads to relief.

Here are some routes top doctors recommend--and some detours around future problems.

Supernourish yourself. "During colitis flare-ups, you may feel too rotten to eat well, so it's important to eat a high-quality diet the rest of the time," says Joel Mason, M.D., a nutritionist and gastroenterologist with the U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University in Boston. "You want to build an adequate store of nutrients in your body."

Be your own diet detective. Since each individual case of colitis is so different, you need to be on the lookout for specific foods that your body may not tolerate well, says Stephen McClave, M.D., a gastroenterologist and associate professor of medicine at the University of Louisville School of Medicine in Louisville, Kentucky. If a specific food causes trouble on multiple occasions, avoid it. But if it happens only once, retest. If you find that cabbage makes your symptoms worse, for example, don't avoid all leafy vegetables.

Tell it to Dear Diary. Recording your foods, moods and flare-ups can help, says James Scala, Ph.D., a nutritional biochemist and lecturer at Georgetown University School of Medicine in Washington, D.C. "Keep track not just of what you ate or drank but also where, when, why and how you felt at the time. If you can relate the onset of a flare-up to a food or an emotional experience, you'll be able to manage your illness more effectively in the future."

Try pectin protection. Fiber may be an important dietary help for colitis sufferers, says Danny Jacobs, M.D., a surgeon at Brigham and Women's Hospital and assistant professor of surgery at Harvard Medical School, both in Boston. And pectin, the soluble fiber found in apples and other fruits and vegetables, is particularly pleasing to the colon. "Apples are a marvelous source of pectin," he says, "and as long as you don't eat the seeds (or peels), there's no limit to how many you can consume."

But phase out fiber during flare-ups. "If you're having a flare-up, use a very low-fiber diet," says Dr. Mason. "You want to pass as little undigested residue through the bowel as possible. But as soon as the flare-up is over, return to a normal or high-fiber diet."

When to See the Doctor The fact is, colitis can get out of control. That's why you need to see your doctor during an acute flare-up, says Joel Mason, M.D., a nutritionist and gastroenterologist with the U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University in Boston. "Self-medicating is not a good idea. The antidiarrheal medications Imodium and Lomotil can be very harmful if used inappropriately," he says. Dr. Mason also recommends a regular screening for colon cancer if you've had chronic ulcerative colitis for more than seven years, because the disease does increase your risk. "If a cancer is detected very early, it increases the likelihood that you can be adequately treated and even cured," he says.

Fix friendly fruits. Dr. Scala offers these suggestions for taking the trouble out of fruit by reducing the amount of fiber. Be sure to peel all fruits (even grapes!), he advises. And if you're eating a citrus fruit, cut it into sections, removing all white, fibrous material. Dr. Scala also recommends eating canned fruit that's preserved in juice rather than sugar syrup. And be sure to avoid dried fruit.

Supplement your strategy. Since colitis can attack your nutritional status, multivitamin/mineral supplements are important, says Dr. Scala. "Take a multivitamin/mineral supplement that provides twice the Recommended Dietary Allowance of key nutrients," he recommends. "For about seven cents a day, it's worth it."

Fuel yourself with folate. People with ulcerative colitis should consider taking a daily multivitamin/mineral supplement that contains at least 400 micrograms of folate, recommends Dr. Mason. This is particularly true for those individuals who use sulfasalazine (Azulfidine), the most commonly prescribed drug for controlling colitis. The drug tends to inhibit your body's ability to use this B vitamin, he says. If more than 400 micrograms of folate is taken per day, however, it should be done under the supervision of a physician.

De-stress for less distress. After food intolerance, emotional stress is the biggest challenge for colitis sufferers, says Dr. Scala. To reduce stress, he calls for "a regular exercise program. Exercise will dissipate the effects of stress better than anything." In addition, Dr. Scala recommends stress counseling.

Lighten up on lactose. Inability to digest lactose, the sugar in milk, can be a factor in colitis, says Dr. McClave. "A lot of us teeter on the edge of milk intolerance, and a bowel disease like colitis can tip the balance." By avoiding all milk products, you may be able to reduce your symptoms.

Avoid crunchy veggies. You need to take the crunch out of carrots, asparagus, zucchini, squash and other popular vegetables, says Dr. Scala. The best way is to cook them until they are very tender, he says. Pressure cooking is especially effective.

Check your medicine chest. Ulcerative colitis patients need to be cautious about using nonsteroidal anti-inflammatory drugs, warns Gary R. Gibson, M.D., assistant professor of medicine at Northeastern Ohio University College of Medicine in Warren. Over-the-counter ibuprofen (Advil), aspirin and a dozen prescription drugs (including Naprosyn, Voltaren and Feldene) can erode the lining of the small intestine and colon. Be sure to check with your doctor before taking any of these medications.