Ulcerative colitis, or UC, is a bowel disease characterized by inflammation and ulceration of the colon. Depending on its severity, UC can involve either a small part of the colon, such as the rectum, or it can affect the entire large bowel. Unlike Crohn's disease, which is an inflammatory bowel disorder that can involve any part of the gastrointestinal tract, UC only affects the colon. Although the nutritional problems associated with Crohn's disease are typically more severe, UC can cause nutrient deficiencies, too.
Iron
The hallmark of ulcerative colitis is bloody diarrhea. UC tends to wax and wane, and when it is active patients may have 10 to 20 bowel movements daily. The blood loss that occurs during one of these "flares" can be significant. However, even when it is relatively quiescent, UC can cause occult blood loss. According to "The Merck Manual for Diagnosis and Therapy," it isn't unusual for people with UC to require transfusions during flares, and iron supplementation may be required to compensate for ongoing blood loss.
Vitamin K
The inflammatory changes caused by UC may alter the composition and activity of bacterial organisms that inhabit the colon. Among other functions, these microorganisms produce vitamin K, some of which is absorbed from the gut. Although the vitamin K produced by colonic bacteria is usually not needed to avoid a deficiency of this nutrient, people with UC are often advised to avoid many vitamin K-containing foods, such as dark green leafy vegetables. Reduced bacterial production, decreased dietary intake and impaired colonic absorption could contribute to a deficiency of vitamin K.
Protein
When UC is active, the interior of the colon is ulcerated, bleeding and fragile. Its ability to absorb fluids, electrolytes and nutrients is impaired. In fact, the colon's lining becomes excessively permeable, and water, electrolytes and proteins leak into the gut, where they are lost during bowel movements. UC patients frequently suffer from hypoalbuminemia, a condition characterized by abnormally low levels of protein in their bloodstreams. Therefore, high-protein diets are usually recommended for UC patients.
General Malnutrition
Inflammatory bowel diseases, including UC, are often aggravated by eating certain foods, such as raw fruits and vegetables or milk products. Frequent bowel movements interfere with normal social function, and many people with UC are unable to work or even go shopping. During flares, the consumption of any food whatsoever can trigger a spate of uncomfortable bowel movements. For fear of making their condition worse, many patients severely restrict their eating, which leads to weight loss and malnutrition.
Considerations
Ulcerative colitis is a chronic, recurrent condition. The nutritional deficiencies associated with this disease can be troublesome. Iron, fat-soluble vitamins and protein are often problematic, and generalized malnutrition is not uncommon. If you suffer from UC, ask your doctor if you should see a dietitian or nutritionist.
References
- "The Merck Manual of Diagnosis and Therapy, 18th Edition: Ulcerative Colitis"; Mark H. Beers, M.D., Editor-In-Chief; 2006
- PubMed.gov: Diagnostic guideline of ulcerative colitis
