any recommendations on effective diets for UC?

Curiously, the role of diet therapy for IBD is minimized by the gastroenterology establishment. One authoritative text, after devoting 20 pages to minute details of IBD diagnosis and drug and surgical treatments, notes tersely: "In mild to moderate ulcerative colitis, there is no need to impose general dietary restrictions."

This might sound, at the very least, counterintuitive to an informed layperson, who would question the dissociation between what a person eats and the condition of the selfsame alimentary canal through which food passes. The situation is analogous to that of a hydraulic engineer who makes no allowance for pipe corrosion susceptibility based on the acidity or chemical characteristics of the fluid the pipe conducts.

Ignoring diet in IBD also flies in the face of much evidence linking poor diets, especially those high in sugar and starches like bread and potatoes, to ulcerative colitis and Crohn's disease incidence. Historical documents date back to Greek and Roman times with references to detoxifying protocols that prompted remission in intestinal diseases.

Remission of Crohn's Disease may be maintained for long periods when foods to which patients are intolerant are identified and eliminated from the patient's diet, according to researchers from Cambridge, England, as reported in Drug Therapy (January 1986).

In their controlled study, seven of ten patients with remitted Crohn's Disease who excluded specific foods remained in remission for six months (Lancet 1985;2:177-180). In contrast, none of the ten similar patients who consumed an unrefined carbohydrate, fiber-rich diet were able to stay in remission for this length of time.

In a subsequent uncontrolled trial, the exclusion of certain foods enabled 51 of 77 patients to remain in remission for up to 51 months; the average annual relapse rate in these patients was less that 10%.

The investigators noted that this approach demanded a great deal of cooperation on the part of the patient. However, they added that most of their patients were so pleased with their improvement that they were willing to comply.

In my experience, the most significant breakthroughs for my patients with IBD have taken place with the "Specific Carbohydrate Diet" advocated by Elaine Gottschall in her book Breaking the Vicious Cycle. Ms. Gottschall formulated the diet based on personal experience with her daughter, who at age 8 was stricken with debilitating ulcerative colitis. Faced with the imminent prospect of surgery to remove her daughter's colon, Gottschall, then a young biochemist, sought out the advice of an elderly physician trained in turn-of-the-century Germany. His approach hearkened back to an early naturopathic tradition that recognized "pathogenic fermentation" as the root cause of gastrointestinal ailments. Gottschall's use of diet cured her daughter's colitis and out of this experience was born the Specific Carbohydrate Diet (SCD).

The basic theory underlying the SCD is that disease-producing bacteria and fungus spread their toxic humors in the intestines when a natural balance has been disrupted. This can arise several ways:

inadequate breast-feeding

over-reliance on antacids

use of antibiotics

a diet high in sugar or starch

parasites or harmful bacteria or yeast from food or water

immunosuppression from disease, malnutrition or stress

toxic chemicals in food or water

natural aging of the GI tract

use of aspirin and aspirin-like pain-killer (NSAIDs) that inflame the intestinal lining.

In a "vicious cycle," harmful bugs proliferate, irritate the intestine, disrupt digestion, impair immunity, and foster fermentive degradation of certain hard-to-digest foods. The main dietary culprits: two-sugar and other enzymatically-resistant carbohydrates found in grains, certain starchy vegetables, certain fruits, table sugar, and lactose-rich dairy products.

Gottschall's Specific Carbohydrate Diet is a balanced, varied program consisting of meat, fish, eggs and poultry with most vegetables, nuts, and some fruits and sugars allowed. Lactose-free dairy products are permitted, as are certain ingeniously-formulated grain-free breads, cookies and pastries consisting of nut-meal. Beans are usually able to be reintroduced within three months.

Patients with IBD often note significant improvement in their symptoms within three weeks of starting the Gottschall diet. By twelve weeks, the majority are recovering definitively. One twenty-year-old patient of mine with ulcerative colitis took a full year to become symptom-free. She now maintains her remission with a modified version of the SCD that allows her occasional rice-based grain products. Another patient with ulcerative proctitis affecting the rectum had daily bloody diarrhea despite medications for years until initiating the Gottschall diet. After 18 months, he is completely symptom-free without the aid of medications. Elaine Gottschall herself is a frequent recipient of letters of gratitude from patients relieved of devastating symptoms.

Yes, just because you have UC does not mean you have IBS - though you may have some similar symptoms.  From what I've read, the main argument about diet and UC isn't about a poor diet being the cause of UC but about an incorrect diet aggravating or trigerring an underlying UC condition.

(Though some may say that a prolonged poor diet is what causes UC in the first place and that's why it's more common in the Western world where more processed foods are consumed, than in developing countries, where people eat more freshly cooked meals).

This is a person to person thing, but there seem to be some foods that typically most of us with UC tend to avoid as they aggravate the condition further - for example dairy (lactose), caffeine, spicy, fried, high-starch foods.....

I also think this is a person to person thing as I've always eaten healthy, fresh foods but I used to smoke and a few months after I quit smoking I was diagnosed with UC. I think stopping smoking may have played a role in my underlying UC condition getting triggered - in fact, some studies show that people who smoke show lower incidences of UC and nicotine supplements have helped reduce flare-ups in ex-smokers.

By the way, a few interesting resources I've come across also mention:

- getting an allergy test done to find out what foods you're allergic to as they may be triggering the UC.

- getting a candida test done to check for yeast overgrowth in the intestine (and making sure you avoid high sugar and moldy foods and take some anti-fungal treatment)

There are many sources of information out there, some of which offer a diet-based 'cure' for UC - I think there's an element of truth to some of them and suppose it's a matter of seeing which ones make sense to you and then trying them yourself to find the right balance through trial and error (as I am doing).

Rio