From the Guidelines
Fasting is not a recommended treatment for healing ulcerative colitis, and patients should instead focus on standard nutritional practice and medical therapy. According to the ESPEN guideline on clinical nutrition in inflammatory bowel disease 1, enteral nutrition (EN) appears safe and can be recommended as supportive therapy in patients with severe ulcerative colitis (UC), but there is no mention of fasting as a treatment option. The guideline recommends following standard nutritional practice, giving due attention to nutrition screening and generic nutritional support where needed.
Some key points to consider when managing ulcerative colitis include:
- Enteral nutrition can be nutritionally adequate in patients with severe disease, but its efficacy needs to be tested by additional studies in larger cohorts of patients 1.
- Parenteral nutrition (PN) should not be used in UC unless intestinal failure occurs, and it is recommended in malnourished patients with UC and in those with severe disease, only when they are not able to tolerate enteral feeding, or cannot be fed effectively by either mouth or enteric tube 1.
- Probiotics may be beneficial in induction of remission and maintenance of UC, but omega-3 fatty acid supplementation has not been shown to be effective in maintaining remission 1.
It is essential to work with a gastroenterologist to develop a personalized treatment plan that includes medications, nutritional support, and lifestyle modifications to manage ulcerative colitis symptoms and prevent complications. Standard medical therapy, including medications like aminosalicylates, corticosteroids, immunomodulators, and biologics, should be the primary focus of treatment, and fasting should not be attempted without medical supervision.
From the Research
Healing Ulcerative Colitis with Fasting
- Ulcerative colitis (UC) is a chronic inflammatory disease of the colon, and current treatment options aim to induce and maintain remission, reduce complications, and improve quality of life 2.
- Research has explored the impact of different nutritional plans and dietary supplements on UC, including the potential benefits of fasting 3, 4.
- A study published in 2023 found that intermittent fasting reduced inflammation markers, such as CRP and calprotectin, in a patient with UC, and the patient reported improved symptoms 4.
- However, another study highlighted the risk of unjustified underfeeding in hospitalized patients with UC, particularly those admitted without evidence of objective disease flare, which can lead to nutritional compromise 5.
- The role of fasting in healing UC is not fully understood, and more research is needed to determine its potential benefits and risks.
- Other treatment options, such as aminosalicylates, have been established as effective for acute and maintenance treatment of UC, and may be used in conjunction with dietary changes or fasting 6.
- The Mediterranean diet and the UC Exclusion Diet (UCED) have shown promise in managing UC symptoms, but further research is needed to confirm their effectiveness 3.