Probiotics. Probiotics are beneficial bacteria that form the intestinal flora. An alteration of the intestinal flora is observed in people with ulcerative colitis during the active phase of the disease. Scientists have thought to restore the balance of the intestinal flora using probiotics, and to assess their effect on the duration of remissions, the risk of relapse and recurrence of pouchitis (see Surgery). See the Probiotics fact sheet for more information on dosages.

Extend the duration of remissions. The results of several studies have shown the effectiveness of the daily consumption of 100 ml of bifidobacteria fermented milk for 1 year.²⁵, a preparation based on the yeast Saccharomyces boulardii (750 mg per day) combined with the conventional treatment⁴³ and a preparation based on bifidobacteria (Bifico®)⁴⁴.

Prevent the risk of relapse. Three double-blind trials indicate that a probiotic preparation made from a non-toxic strain ofE. coli is as effective as mesalazine in significantly reducing the risk of relapse in patients in remission from ulcerative colitis^26-28 . lactobacillus GG, alone or in combination with mesalamine, has also been shown to be effective in maintaining remission²⁹.

Prevent recurrence in case of pouchitis. The results of several clinical trials with placebo carried out on subjects suffering from recurrent pouchitis indicate that a specific preparation (VSL # 3®) composed of four strains of lactobacilli, three strains of bifidobacteria and one strain of streptococcus can prevent relapses^30-35 . On the other hand, treatments with Lactobacillus GG and fermented milk (Cultura®) were less successful^36,37.

 Turmeric. Turmeric (Curcuma longa) is the main spice in curry powder. Turmeric has been tested in a randomized, double-blind trial including 82 patients with ulcerative colitis. The patients took either 1 g of turmeric twice a day or a placebo in combination with their usual treatment (mesalazine or sulfasalazine) for 2 months. The group receiving the turmeric experienced 6% less relapses than the placebo group (4,7% vs. 20,5%)³⁸. Other clinical trials to confirm these data are underway, especially in children.

 Fish oils. A few randomized and controlled studies carried out on a small number of subjects suggest that fish oils, taken in addition to the usual medication, make it possible to reduce the inflammatory reaction which sits in the intestines during acute attacks of the disease^12-16 . The studies performed included people with ulcerative colitis of mild to moderate severity. In some cases, the dose of anti-inflammatory drugs could be reduced by taking the oils fish¹⁶. This treatment with essential fatty acids, however, has been shown to be ineffective in reducing the number of disease attacks in the long term.^17,18.

 prebiotics. Researchers have evaluated the effect of different dietary fibers (the psyllium^19,20, sound oatmeal²¹ andbarley sprouted²²), whose prebiotic action is known, on the duration of remission of ulcerative colitis as well as on the mild intestinal symptoms that some people experience during these periods. Regarding psyllium, a clinical study shows that it is as effective as mesalazine, a classic anti-inflammatory, in limiting the number of relapses. The study lasted 12 months. The lowest relapse rate was obtained in the group of patients who took both mesalazine and psyllium¹⁹.

A randomized clinical trial in 2005 evaluated the efficacy of a combination of inulin, oligofructose and bifidobacteria in 18 patients suffering from active ulcerative colitis. A reduction ininflammation of the colon and rectum was seen in these patients compared to those taking placebo²³.

 Aloe. A double-blind, placebo-controlled trial evaluated the effectiveness of an aloe gel in 44 patients with mild to moderate ulcerative colitis. The results indicate that ingesting 200 ml of aloe gel per day for 4 weeks was more effective than placebo in improving patients’ condition, possibly due to the anti-inflammatory properties of aloe vera.²⁴.

 Boswellie (Boswellia serrata). Traditional Ayurvedic Medicine (India) attributes to boswellia anti-inflammatory properties useful for the treatment of inflammation of the digestive tract. Two studies have shown that boswellia resin (300 mg⁹ or 350 mg¹⁰, 3 times a day) may be as effective as sulfasalazine in stopping inflammation in the gut without causing the side effects caused by the anti-inflammatory drug. However, these studies were of low methodological quality.¹¹.

 Formule de Bastyr. A preparation composed of several medicinal plants and some other ingredients (cabbage powder, pancreatin, vitamin B3 and duodenal substance) is recommended by naturopath JE Pizzorno in order to relieve the inflammation in the tube digestive⁴⁰. This is an old naturopathic remedy that has not been documented by scientific studies.

The following medicinal plants are part of the recipe: marshmallow (Althea officinalis), slippery elm (red ulmus), wild indigo (Baptisia tinctoria), goldenseal (Hydrastis canadensis), echinacea (Echinacea angustifolia), American plant protection (Phytolacca americana), la consoude (Symphytum officinale) and spotted geranium (Geranium maculatum).

 Stress management. Taking a few deep breaths, learning to use biofeedback or trying hypnotherapy sessions are just a few of the ways you can relax and sometimes even reduce the symptoms of colitis. The D^r Andrew Weil, follower of complementary medicine, recommends these methods specifically for people with inflammatory bowel disease³⁹.