Ulcerative Colitis

Ulcerative colitis is a fairly common disease, with an incidence of about 1 person per 600 and equal prevalence in men and women. It typically affects people in the age brackets 15-30 and 50-70 years. 

Ulcerative colitis is an inflammatory bowel disease in which the mucous membranes lining the colon become inflamed and develop ulcers. It generally starts towards the end of the bowel, in the rectum or sigmoid colon, and can then spread partially or completely through the large intestine.

The disease is thought to have a genetic basis, but can be triggered by a number of factors which provoke abnormal activation of the immune system.


Symptoms can often occur as flare-ups interspersed with periods of remission.

Ulceration confined to the end portion of the large intestine may cause hard or dry stools, though they may remain normal. Rectal discharge of mucus, pus or blood may accompany bowel movements or occur in between. Systemic symptoms are mild or absent.

Ulceration that has spread thorough the colon causes looser stools and more frequent bowel movements. Stools may be watery and consist almost entirely of blood and pus. Severe cramps and bloating are also common.

An attack of ulcerative colitis may begin with increased urgency to defecate and mild lower abdominal pain. Some attacks can begin suddenly with violent diarrhoea, high fever and abdominal pain.

Symptoms may include:

  • Watery diarrhoea
  • Blood, mucus or pus in the stool
  • Abdominal cramps
  • Pain, spasm, bloating, flatulence
  • Weight loss
  • Loss of appetite
  • Lethargy or malaise
  • High fever
  • Inflammatory symptoms such as redness or pain in the eyes, skin or joints


Contributory factors

Digestive imbalance: research shows clearly that digestive imbalances such as an inability to digest fat and the levels and types of bacteria in the gut can all contribute to IBD. Your ability to absorb nutrients can affect your immune system, which is implicated in diseases such as IBD.

(Many people are now starting to think that Crohn’s disease – another form of IBD may develop as a ‘gut’ reaction to imbalances between friendly and detrimental bacteria.)

Friendly bacteria are very important for ensuring that food is properly digested and to ensure a healthy gut lining. They also prevent pathogen invasion. If our numbers of friendly bacteria drop, these important roles may be compromised, leaving us susceptible to leaky gut, inflammatory flare-ups and infection by pathogens that could trigger the disease.

Research shows that particular types of good bacteria can influence the outcome of the disease in a positive way.

Digestive stool tests check how well you are digesting food and absorbing nutrients, the health of your gut wall and the levels of good and bad bacteria present. The new GI Effects Test uses the latest PCR technology to check the DNA of the good bacteria and assess the diversity of your gut bacteria.  This particular test is also appropriate for those with ulcerative colitis as it also measures the inflammatory marker calprotectin in the gut. calprotectin. Smart Nutrition can use these results to help optimise your gut flora and minimise inflammation.

Leaky gut: also known as intestinal permeability, this can be caused by imbalances in gut flora, stress and or poor digestion.

A normal healthy gut lining allows certain molecules to pass across into the bloodstream, including endotoxins – broken down particles of your gut bacteria that make up your gut microbiome. 

A damaged intestinal lining can open up slightly, allowing larger particles such as incompletely digested foods, yeasts or bacteria to enter the bloodstream. The immune system interprets these as foreign and produces antibodies against them, leading to irritation and  inflammation.

The presence of leaky gut can be confirmed via a simple Leaky Gut Test. Once identified, leaky gut can be effectively treated by Smart Nutrition’s qualified nutritional therapists.

Food allergy or intolerance: immune reactions to food particles may play an important role in the development or severity of ulcerative colitis.

Intolerances often develop due to leaky gut – it allows food particles which would normally remain in the digestive tract to enter the blood stream and interact with the immune system. Whenever you then eat the food containing the protein you’re allergic to, your immune system responds by creating antibodies and other chemicals, including histamine, in an effort to expel the “invader” from your body.

Histamine release in the gastrointestinal tract can lead to stomach pains, cramps, diarrhoea and inflammation.

A simple blood test can identify food allergies and intolerances.

Chronic stress: stress can lead to both leaky gut and compromised gut flora, both of which exacerbate ulcerative colitis symptoms.

Coping with an inflammatory bowel disease is a stressful experience in itself. If you’d like to find out more about your stress levels, consider having an Adrenal Stress Test to pinpoint any imbalances.

Nutrient deficiencies: people with ulcerative colitis may be at risk of malnutrition and nutrient deficiencies, which makes it more difficult for the body to heal and fight infection. Decreased appetite, fear of pain, dietary restrictions, diarrhoea and resultant dehydration all play a role.

The NutrEval Test highlights any nutrient deficiencies that can then be targeted to help your general well being and your ulcerative colitis.

Essential fatty acid imbalances: absorption of fats is often compromised in ulcerative colitis patients.

The most important of these are the essential fatty acids which have many functions in the body, including building new cells and mediating inflammatory processes. The inflammation responsible for ulcerative colitis symptoms may be significantly reduced by ensuring adequate levels of these vital nutrients.

A Fatty Acid Test evaluates the level of red cell membrane fatty acids which are associated with inflammation. Once the levels of the various fatty acids are known, Smart Nutrition can help you establish your fatty acid balance using a combination of diet and supplements.

Amino acid deficiency: amino acids are the building blocks of protein. Low levels affect the body’s ability to control inflammation and intestinal health, and may exacerbate ulcerative colitis symptoms.

An Amino Acid Test measures the levels of all the different amino acids, highlighting any deficiencies. These can then be addressed with the help of a Smart Nutrition’s nutritional therapists.

Poor diet: bad dietary habits often contribute to ulcerative colitis attacks. Following a low reactive diet with all inflammatory triggers removed can help to prevent or calm an ulcerative colitis flare-up.

Smart Nutrition can design for a diet that addresses your dietary needs. Once the ulcerative colitis is in remission, they can also help you to gradually reintroduce appropriate foods.

Useful Links

Please do not return samples to the laboratories that may arrive after Wednesday 27th March and up to and including Monday 2nd April.

The laboratories are closed from the 28th March – 2nd April for the Easter Holiday.