Colitis

Colitis is inflammation of your colon – that’s the main part of your large intestine where undigested food turns into stools, remnants of water are absorbed and there’s normally a rich bacterial population. Inflammation in your colon can affect what happens there and may cause a number of health issues.

Common symptoms include tummy ache, bloated stomach, urgent diarrhoea, mucus or blood in your stools, loss of appetite and weight loss.

In acute cases, it may also cause fever, nausea and vomiting. If, on the other hand, it’s chronic colitis, it may cause fatigue (tiredness for no apparent reason), anaemia, dehydration and malnutrition.

Different types of colitis

There are different types of colitis, depending on what causes it. Some are only temporary, such as those caused by a bacterial, viral or parasitic infection and are treatable. However, chronic colitis is a type of inflammatory bowel disease (IBD) and is much more difficult to treat.

Inflammatory bowel diseases are a group of conditions that cause chronic inflammation in your colon and include ulcerative colitis, microscopic colitis and Crohn’s disease. It is thought they are a type of autoimmune disease, where your immune system malfunctions and attacks your body’s own tissues. The cause is probably a combination of your genetic make-up and environmental factors, such as an infection that triggers the autoimmune reaction.

There is also allergic colitis, which affects babies and may be caused by food intolerances or allergies to something in the mother’s diet that is passed to the baby in breastmilk or it can be caused by infant formula (cow’s milk is the most common culprit).

Ulcerative colitis

Ulcerative colitis is the main type of IBD and can significantly alter your quality of life but most people can manage the condition and lead an active lifestyle.

The inflammation affects the inner lining of your colon and rectum, damaging and weakening it, creating open sores called ulcers. Depending on the size of the affected area and degree of damage, symptoms usually come in waves and may include stools with blood or mucus (caused by ulcers), the urgent need to have a bowel movement, belly cramping accompanying bowel movements, weight loss, fatigue and fever. Most people with ulcerative colitis have periods when they experience these symptoms (flare-ups) alternating with longer periods of no symptoms (remission).

In severe cases, where damage to the colon is serious, life-threatening complications may occur and will require immediate medical care. These include severe dehydration caused by the colon’s reduced ability to absorb water and from fluid loss through diarrhoea; severe bleeding from the rectum caused by extensive colon damage; colon perforation caused by ulcers; and toxic megacolon, which is a condition that arises when inflammation spreads to the deeper tissues of the intestine, causing such complications that the colon stops working.

The cause of ulcerative colitis is unknown but it is thought to be a combination of genes and an immune system dysfunction.

Certain foods and stress can trigger flare-ups but it’s highly individual, so it’s important to track the triggers and adjust your lifestyle accordingly. Common culprits are dairy products and some high-fibre foods, however that’s not a reason to avoid plant wholefoods. In fact, a plant-based diet can be very beneficial for ulcerative colitis sufferers.

There are also medications that can be used to calm the inflammation in your colon – reducing the swelling and irritation allows the tissue heal and can relieve your symptoms.

Colitis and diet

In general, it’s best to have smaller meals more often rather than three big meals a day. Smaller portions mean a lesser burden on your digestive system allowing it to deal with them better.

When it comes to specific foods, it’s highly individual but there are a few guidelines.

Refined carbohydrates, such as white flour and sugar – and products made from them – increase inflammation and should be avoided. Wholegrains are encouraged but you may find that not all of them agree with you.

Vegetables are mostly well-tolerated but you may find that you can digest them better if they are cooked. They are important for your gut bacteria that help to tone down inflammation.

On the other hand, protein from meat, cheese, milk, fish and eggs may negatively affect gut bacteria because it produces hydrogen sulphide during digestion. This also happens with protein from nuts but as we generally eat small amounts, it’s not a major concern. However, you may find that eating whole nuts doesn’t agree with you and in that case, try nut butters instead as they may be easier to digest.

Interestingly, zinc levels are often too low in ulcerative colitis patients so it’s best to have that checked and, if needed, normalised as that, in itself can help improve symptoms.

Inflammation in the gut can interfere with absorption of important vitamins and minerals, so it’s often recommended to take a multivitamin/mineral supplement.

Experts agree that food additives may also be contributing to inflammation so it’s best to avoid them, even those with a natural origin.

Living with colitis requires a lot of experimenting with diet to find what suits you but a plant-based diet is certainly healthy and can help improve your gut health. There are various diets aimed at helping colitis sufferers but there isn’t one that’s best for everyone so you’ll need to find what’s right for you, if possible with the guidance of a dietitian or nutritionist who has experience with colitis and plant-based diets.