Question:

I suffer from chronic ulcerative colitis, and I am on pharmaceutical drugs, which cause side effects that outweigh the benefits. How can I control it?

Answer:

Ulcerative colitis is characterised by an inflamed colon, which may also have numerous ulcers. This condition is caused by the lining of the colon being attacked by the body's own antibodies. A bacterial invasion or some other unknown cause can change the nature of the proteins of the lining. When this happens, the white blood cells reclassify the altered proteins as enemies. They then instruct their special defence units (the lymphocytes) to produce antibodies to fight the altered proteins and the body starts to destroy its own tissue.

Ulceration occurs as the lining of the colon becomes damaged. The ulcers can bleed and cause abdominal pain -the two most common symptoms of ulcerative colitis. Colitis also causes swelling of the gut lining, and loss of functions such as absorption of water and essential minerals and vitamins, formation of stools and storage of waste materials. The ulcers are particularly painful before a motion is passed. Because they bleed, there is frequently fresh blood in the motion.

Diarrhoea is also common. Normally there are folds of mucus-rich tissue lining the inner layer of the colon. When big stools are passing down the colon, the mucus lining expands to ease their passage. Due to the inflammation, these folds disappear and the colon cannot hold stool masses. This results in diarrhoea.

Other symptoms of ulcerative colitis are anaemia (due to the bleeding), fatigue (due to anaemia and the malabsorption of magnesium and calcium), cramps in the legs at night (due to calcium deficiency) and weight loss (due to malabsorption and bleeding). Sufferers get nervous because of the constant fear of 'accidents' due to diarrhoea And the stress of this makes everything worse. Because of this anxiety, physicians sometimes treat ulcerative colitis as a psychological disorder without realising that the mental symptoms are secondary.

My approach is to help the loose stools to firm up, so the fear of accidents is removed. Hopefully you will be able to come off the drugs, but this should be done in consultation with your doctor.

These are my recommendations:

* For four months, eat a diet that helps absorption of nutrients but is fibre-free and devoid of substances that may irritate the bowels. Ear nothing but mushy rice; mashed potatoes with olive oil and salt: jacket potatoes with butter and salt, but not the skin; minced lamb/turkey/chicken cooked in olive oil with garlic, ginger, salt and perhaps a pinch of black pepper; mashed root vegetables; boiled eggs; pasta with olive oil; cottage cheese; live yoghurt manuka honey; carrot and/or pomegranate juice. After four weeks, include oatmeal porridge made with water, as long as it does not cause diarrhea.

* Take a multivitamin and mineral tablet daily because of the lack of fresh vegetables.

* Drink pure, still water; add Dioralyte (available from chemists) or a pinch of salt if you have diarrhea. Avoid tea, coffee and other caffeinated drinks.

* After four months of this diet, if the diarrhoea has settle down, introduce heads of cauliflower and broccoli; asparagus; peeled apples, pears and plums; grapes; bananas, Ryvita and rice cakes. Stay on this regime for three to six months until the abdomen settles down.

* It is essential to do one to two hours a day of vigorous exercise such as power walking, running, lifting light weights, swimming, tennis or strenuous dancing. This will create a demand for more energy so the body is forced to absorb more food by changing the lining of the gut (which is what we want). The muscle-building hormones created by intensive exercise act like steroids, which help to cure the inflammation of the bowels and can replace the steroid drugs which are prescribed for ulcerative colitis.

* Take kadu to help detoxify the body: soak two twigs in a cup of hot water at night, strain and drink the infusion first thing in the morning for two months.

* Ayurvedic remedies to aid digestion are also useful, such as Stomach Formula: take one daily for two months.

* Pomegranate infusion: boil a 5cm square piece of pomegranate peel in two cups of water for l0- 15 minutes, and let it infuse for l5 minutes. Strain and drink half the liquid in the morning and the other half in the evening, before meals. Do this twice a week for a month; it will calm the intestines and help stop diarrhea.

* Relaxation and good sleep are essential, so play a relaxation tape at bedtime to help you unwind.

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