Keep in mind that the best source for nutrients is the food you eat, and that actual deficiencies vary from person to person. So before taking supplements, discuss your nutritional status with your doctor.
Whenever Serena Ehrlich goes someplace new, she scouts out the location of the bathroom. That's because Ehrlich, 38, a Los Angeles-based salesperson for a commercial wire service, has ulcerative colitis. She developed the disease 12 years ago and has been in remission for the past three. Still, the old habit lingers. "Everyone who has ulcerative colitis will tell you that when you walk into a bookstore, a shop, or a restaurant, that's the one thing you want to know first. It's our rule of thumb."
One of the primary risk factors for malnourishment with ulcerative colitis is a decreased intake of food. When UC flares, there is inflammation of the large intestine, or colon, and small sores form on the lining of the intestine and rectum. This causes persistent cramping pain. It can also cause severe diarrhea, sometimes alternating with the formation of hard stool and prolonged constipation.
Diet doesn't cause ulcerative colitis. But certain foods may make symptoms worse. So in addition to the normal loss of appetite that accompanies a flare-up, some people purposely reduce how much they eat in an attempt to ease the symptoms or out of fear of symptoms getting worse.
At the same time, the body has an increased need for additional calories, protein, vitamins, and minerals to aid the healing process. Also, the inflammation and diarrhea interfere with the reabsorption of water and minerals that normally occurs in the large intestine, and there is a danger of becoming dehydrated if the fluid is not replaced.
Finally, some of the medications that are used to treat ulcerative colitis interfere with the body's ability to absorb and maintain the minerals it needs. For instance, corticosteroids such as prednisone can deplete the body's calcium. Drugs like sulfasalazine deplete the level of folate, an important B vitamin.
Food Supplements for Ulcerative Colitis
While ulcerative colitis can interfere with getting all the nutrients you need from the food you eat, a well-balanced diet is the first step in guarding against malnutrition. You need to eat a variety of foods from the various food groups and make sure you are getting adequate protein and calories. Working with a dietitian will make it easier to plan meals that address your nutritional needs.
But even with a well-designed meal plan, you may still need some of the following supplements:
Vitamin D. Your body needs vitamin D to maintain strong bones. It also plays a role in how your immune system functions. Low levels of vitamin D are common among the general adult population.
If you have ulcerative colitis, especially if you take steroids, your risk of a vitamin D deficiency -- along with the accompanying risk of osteoporosis -- is very high. This risk is compounded by the fact that many people with ulcerative colitis restrict the amount of dairy products they consume to help reduce diarrhea, yet dairy foods are good sources for vitamin D.