Ulcerative Colitis: Therapy

General measures

  • Nicotine restriction (refraining from tobacco use).
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program or program for the underweight.
    • BMI ≥ 25 → participation in a medically supervised weight loss program.
    • Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
  • Avoidance of psychosocial stress:
    • Psychosomatic maladjustment – lack of interpersonal contact, conflict situations, stress.
    • Stress – it is suspected that stress may play a role in the development of ulcerative colitis. However, the study results are not yet clear

Conventional non-surgical therapy methods

  • Fecal transplantation (microbiome transfer; duodenal infusion of feces/stools from healthy or via colonoscopy or enema) – to rebuild intestinal flora (gut flora); fecal bacterial therapy resulted in steroid-free remission (temporary abatement of disease symptoms without administration of steroids) in 1 in 3 patients with mild-to-moderate ulcerative colitis in a randomized clinical trial (73 patients); after 12 months, 42% of patients were still in remission.

Vaccinations

The following vaccinations are advised:

  • Pneumococcal vaccination
  • Flu vaccination

General note: Patients with inflammatory bowel disease (CEDV; English : inflammatory bowel disease, IBD), who receive therapy with immunosuppressants, respond significantly worse to routine vaccinations. Therefore, post-vaccination titers should be checked regularly.

Regular checkups

  • Regular medical checkups

Nutritional medicine

  • Nutritional counseling based on nutritional analysis for prevention and therapy of malnutrition or undernutrition.
    • Especially in sick children, malnutrition is a major problem. Thus, as a result, the physical development, length growth as well as bone quality may be impaired.
    • In adults, the risk of further complications increases. In addition, they respond worse to therapy due to malnutrition / malnutrition.
  • Dietary recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
  • Observance of the following specific dietary recommendations:
    • In the acute episode: Schonkost – By a Schonkost can relieve the gastrointestinal tract in the acute episode. However, should be started as soon as possible with the diet build-up, since a Schonkost in terms of calories and nutrients is not demand-covering.
    • In the remission phase: replenish nutrient stores and aim for normal weight.
    • High protein diet – meat, milk, soy and soy products, legumes, potatoes, egg.
    • Diet rich in fiber (especially soluble fiber: psyllium (psyllium), pectins (a component of most fruits), vegetable gums (eg, gum arabic)).
    • Diet rich in:
      • Vitamins (A, D, E, K, vitamin B complex, folic acid).
      • Minerals (magnesium)
      • Trace elements (iron, selenium, zinc)
      • Omega-3 fatty acids (marine fish) – anti-inflammatory (anti-inflammatory) effect.
      • Secondary plant compounds (eg beta-carotene).
      • Probiotic foods (if necessary, supplements with probiotic cultures) – they have a positive impact on the microbiome (intestinal flora) and have a beneficial effect on the remission phase
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – Taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

Psychotherapy

Complementary treatment methods

  • Yoga