Chronic ulcerative colitis is a severe prolonged inflammation of the colon or large bowel in which ulcers form on the walls of the colon. In severe cases, ulceration leads to bleeding and the patient passes bloody stools with pus and mucus. The disease results from prolonged irritation of the delicate membrane which lines the walls of the colon. It affects all age groups from very young children to the elderly.
Normally, it is the function of the colon to store waste material until most of the fluids have been removed to enable well-formed soft stools, consisting of non -absorbable food materials to be passed. Persons who suffer from an irritable colon have irregular and erratic contractions which are specially noticeable on the left side.
Chronic ulcerative colitis usually begins in the lower part of the bowels and spreads upwards. The first symptom is an increased urgency to move the bowel, followed by cramping pains in the abdomen and blood mucus in the stools. As the disease spreads upwards, the stools become watery and more frequent and are characterised by rectal straining. All this loss of blood and fluid from the bowels results in weakness, fever, nausea, vomiting, loss of appetite and anaemia.
The patient may develop a bloated feeling because the gas is not absorbed or expelled normally. Some patients suffer from constipation alternating with periods of loose bowel movements. Still others may suffer from persistent diarrhoea for years together. The patient is usually malnourished and may be severely underweight. He may suffer from frequent insomnia.
Ulcerative colitis in its severe form may also lead to nutritional problems. The improper assimilation of food due to inflammatory conditions may cause deficiency diseases. This may gradually result in nervous irritability, exhaustion and depression. IN very severe cases, the patient may even develop suicidal tendencies.
The main cause of colitis is chronic constipation and the use of purgatives. Constipation causes an accumulation of the hard faecal matter which is never properly evacuated. The use of purgatives only increases irritation. Often, colitis is caused by poorly-digested rough-age, especially of cereals and carbohydrates, which causes bowel irritation. It may also result from an allergic sensitivity to certain foods, especially milk, wheat and eggs. Often, the intake of antibiotics may upset the bacterial flora in the intestines and interfere with proper digestion.
Severe stress may also produce ulcerative colitis. During any form of severe stress, outpouring of adrenal hormones causes such destruction of body protein that at times parts of the walls, lining the intestines, are literally eaten away. Such stress also depletes the body of pantothenic acid. Experiments on animals have shown that they can develop ulcerative colitis when they are kept on diets deficient in pantothenic acid.
Diet plays an important part in the treatment of colitis. It is advisable to observe a juice fast for five days or so in most cases of colitis. The juices may be diluted with a little boiled water. Papaya juice and raw cabbage or carrot juice is especially beneficial. Citrus juices should be avoided. The bowels should be cleansed daily with a warm water enema.
After the juice fast, the patient should gradualy adopt a diet of small, frequent meals of soft cooked or steamed vegetables, rice, dalia (coarsely broken wheat) and well- ripened fruits like banana and papaya, yogurt and home-made cottage cheese. Sprouted seeds and grains, whole meal bread and raw vegetables may be added gradually to this diet after about 10 days. Tender coconut water is highly beneficial as it soothing to the soft mucosa of the colon. Cooked apples also aid the healing of ulcerative conditions because of its ample concentration of iron and phosphorus. All food must be eaten slowly and chewed thoroughly.
Foods which should be excluded from the diet are white sugar, white bread and white flour products, highly seasoned foods, highly salted foods, strong tea, coffee and alcoholic beverages and foods cooked in aluminum pans. The following menu may serve as the guideline and should be adopted for at least three months :
Breakfast : Ripe babanas or papaya and milk. Butter-milk may be taken if milk is not tolerated.
Mid-morning : Carrot or raw cabbage juice.
Lunch : Steamed or highly cooked vegetables, rice or dalia, butter and butter-milk.
Mid-afternoon : Coconut water or fruit juice.
Dinner : Salad of raw vegetables, sprouts like alfalfa and mung beans, home-made cottage cheese and nuts. Instead of raw vegetables cooked ones like carrot, beetroot, tomatoes, lettuce, cabbage may be used.
Before retiring : A glass of milk or a baked apple.
The patient should have a bowel movement at the same time each day and spend 10 to 15 minutes in the endeavour. Straining at stools should be avoided. Drinking two glasses of water first thing in the morning will stimulate a normal bowel movement. An enema may be used if no bowel movement occurs. Butter-milk enema twice a week is also soothing and helps in re-installing a healthy bacterial flora in the colon. Complete bed rest and plenty of liquids are very important. The patient should eliminate all causes of tension, adjust to disability and face his discomfort with patience.