DIETETARY MODULATION IN THE MANAGEMENT OF ULCERATIVE COLITIS: AN EVIDENCE-BASED REVIEW

Keywords: Ulcerative Colitis, Fibre, Curcumin, Zinc, Omega-3 Fatty Acids, Vitamin D3

Abstract

Ulcerative colitis is a chronic, idiopathic inflammatory disease of the large intestine, limited to the mucous membrane. The manifestation of the condition is characterised by periods of exacerbation and remission. The onset of Ulcerative Colitis (UC) is most often due to a combination of genetic susceptibility, immune system hyperactivity, microbiota disorders, epithelial barrier defects and environmental factors, including diet. In addition to conventional pharmacological interventions, there is an increasing focus on the importance of a nutritionally balanced diet as a supportive component of the treatment process. A review of the extant preclinical and clinical studies indicates the beneficial effects of fibre, especially the soluble fraction, vitamin D3, curcumin and zinc. These substances have been demonstrated to alleviate the symptoms of the disease and promote remission by supporting the gut microbiota and inhibiting inflammatory processes. The effectiveness of omega-3 fatty acids remains to be fully confirmed, necessitating further research, but the preliminary results are encouraging. A balanced diet is an integral component of the therapeutic management of patients diagnosed with UC. However, further research is required to standardise clinical recommendations.

References

O'Grady, J., O'Connor, E. M., & Shanahan, F. (2019). Review article: dietary fibre in the era of microbiome science. Alimentary pharmacology & therapeutics, 49(5), 506–515. https://doi.org/10.1111/apt.15129

Nie, Y., & Luo, F. (2021). Dietary Fiber: An Opportunity for a Global Control of Hyperlipidemia. Oxidative medicine and cellular longevity, 2021, 5542342. https://doi.org/10.1155/2021/5542342

Soliman G. A. (2019). Dietary Fiber, Atherosclerosis, and Cardiovascular Disease. Nutrients, 11(5), 1155. https://doi.org/10.3390/nu11051155

Dai, F. J., & Chau, C. F. (2017). Classification and regulatory perspectives of dietary fiber. Journal of food and drug analysis, 25(1), 37–42. https://doi.org/10.1016/j.jfda.2016.09.006

P, N. P. V., & Joye, I. J. (2020). Dietary Fibre from Whole Grains and Their Benefits on Metabolic Health. Nutrients, 12(10), 3045. https://doi.org/10.3390/nu12103045

Faghfoori, Z., Shakerhosseini, R., Navai, L., Somi, M. H., Nikniaz, Z., & Abadi, A. (2014). Effects of an Oral Supplementation of Germinated Barley Foodstuff on Serum CRP Level and Clinical Signs in Patients with Ulcerative Colitis. Health promotion perspectives, 4(1), 116–121. https://doi.org/10.5681/hpp.2014.015

Zhou, Z., Cao, J., Liu, X., & Li, M. (2021). Evidence for the butyrate metabolism as key pathway improving ulcerative colitis in both pediatric and adult patients. Bioengineered, 12(1), 8309–8324. https://doi.org/10.1080/21655979.2021.1985815

Spagnuolo, R., Cosco, C., Mancina, R. M., Ruggiero, G., Garieri, P., Cosco, V., & Doldo, P. (2017). Beta-glucan, inositol and digestive enzymes improve quality of life of patients with inflammatory bowel disease and irritable bowel syndrome. European review for medical and pharmacological sciences, 21(2 Suppl), 102–107.

Beukema, M., Faas, M. M., & de Vos, P. (2020). The effects of different dietary fiber pectin structures on the gastrointestinal immune barrier: impact via gut microbiota and direct effects on immune cells. Experimental & molecular medicine, 52(9), 1364–1376. https://doi.org/10.1038/s12276-020-0449-2

Ishisono, K., Mano, T., Yabe, T., & Kitaguchi, K. (2019). Dietary Fiber Pectin Ameliorates Experimental Colitis in a Neutral Sugar Side Chain-Dependent Manner. Frontiers in immunology, 10, 2979. https://doi.org/10.3389/fimmu.2019.02979

Sun, R., Chao, C., Yu, J., Copeland, L., & Wang, S. (2025). Type 5 Resistant Starch Can Effectively Alleviate Experimentally Induced Colitis in Mice by Modulating Gut Microbiota. Journal of agricultural and food chemistry, 73(3), 2103–2113. https://doi.org/10.1021/acs.jafc.4c07046

Montroy, J., Berjawi, R., Lalu, M. M., Podolsky, E., Peixoto, C., Sahin, L., Stintzi, A., Mack, D., & Fergusson, D. A. (2020). The effects of resistant starches on inflammatory bowel disease in preclinical and clinical settings: a systematic review and meta-analysis. BMC gastroenterology, 20(1), 372. https://doi.org/10.1186/s12876-020-01516-4

Wan, J., Zhang, J., Chen, D., Yu, B., Mao, X., Zheng, P., Yu, J., Luo, J., & He, J. (2018). Alginate oligosaccharide-induced intestinal morphology, barrier function and epithelium apoptosis modifications have beneficial effects on the growth performance of weaned pigs. Journal of animal science and biotechnology, 9, 58. https://doi.org/10.1186/s40104-018-0273-x

Niu, B., Li, F., Lv, X., Xiao, Y., Zhu, J., Zhao, J., Lu, W., & Chen, W. (2024). Unveiling the therapeutic potential and mechanism of inulin in DSS-induced colitis mice. International journal of biological macromolecules, 280(Pt 2), 135861. https://doi.org/10.1016/j.ijbiomac.2024.135861

Du, Y., Kusama, K., Hama, K., Chen, X., Tahara, Y., Kajiwara, S., Shibata, S., & Orihara, K. (2024). Protective Effects of Inulin on Stress-Recurrent Inflammatory Bowel Disease. International journal of molecular sciences, 25(5), 2494. https://doi.org/10.3390/ijms25052494

Casellas, F., Borruel, N., Torrejón, A., Varela, E., Antolin, M., Guarner, F., & Malagelada, J. R. (2007). Oral oligofructose-enriched inulin supplementation in acute ulcerative colitis is well tolerated and associated with lowered faecal calprotectin. Alimentary pharmacology & therapeutics, 25(9), 1061–1067. https://doi.org/10.1111/j.1365-2036.2007.03288.x

Valcheva, R., Koleva, P., Martínez, I., Walter, J., Gänzle, M. G., & Dieleman, L. A. (2019). Inulin-type fructans improve active ulcerative colitis associated with microbiota changes and increased short-chain fatty acids levels. Gut microbes, 10(3), 334–357. https://doi.org/10.1080/19490976.2018.1526583

Shoaib, M., Shehzad, A., Omar, M., Rakha, A., Raza, H., Sharif, H. R., Shakeel, A., Ansari, A., & Niazi, S. (2016). Inulin: Properties, health benefits and food applications. Carbohydrate polymers, 147, 444–454. https://doi.org/10.1016/j.carbpol.2016.04.020

Ferenc, K., Jarmakiewicz-Czaja, S., & Filip, R. (2022). Components of the Fiber Diet in the Prevention and Treatment of IBD-An Update. Nutrients, 15(1), 162. https://doi.org/10.3390/nu15010162

Yusuf, K., Saha, S., & Umar, S. (2022). Health Benefits of Dietary Fiber for the Management of Inflammatory Bowel Disease. Biomedicines, 10(6), 1242. https://doi.org/10.3390/biomedicines10061242

Samoilă, I., Dinescu, S., & Costache, M. (2020). Interplay between Cellular and Molecular Mechanisms Underlying Inflammatory Bowel Diseases Development-A Focus on Ulcerative Colitis. Cells, 9(7), 1647. https://doi.org/10.3390/cells9071647

Kanauchi, O., Suga, T., Tochihara, M., Hibi, T., Naganuma, M., Homma, T., Asakura, H., Nakano, H., Takahama, K., Fujiyama, Y., Andoh, A., Shimoyama, T., Hida, N., Haruma, K., Koga, H., Mitsuyama, K., Sata, M., Fukuda, M., Kojima, A., & Bamba, T. (2002). Treatment of ulcerative colitis by feeding with germinated barley foodstuff: first report of a multicenter open control trial. Journal of gastroenterology, 37 Suppl 14, 67–72. https://doi.org/10.1007/BF03326417

Jarmakiewicz-Czaja, S., Piątek, D., & Filip, R. (2020). The Influence of Nutrients on Inflammatory Bowel Diseases. Journal of nutrition and metabolism, 2020, 2894169. https://doi.org/10.1155/2020/2894169

Gao, H., Zhou, H., Zhang, Z., Gao, J., Li, J., & Li, X. (2023). Vitamin D3 alleviates inflammation in ulcerative colitis by activating the VDR-NLRP6 signaling pathway. Frontiers in immunology, 14, 1135930. https://doi.org/10.3389/fimmu.2023.1135930

Abraham, B. P., Fan, C., Thurston, T., Moskow, J., & Malaty, H. M. (2023). The Role of Vitamin D in Patients with Inflammatory Bowel Disease Treated with Vedolizumab. Nutrients, 15(22), 4847. https://doi.org/10.3390/nu15224847

Radziszewska, M., Smarkusz-Zarzecka, J., Ostrowska, L., & Pogodziński, D. (2022). Nutrition and Supplementation in Ulcerative Colitis. Nutrients, 14(12), 2469. https://doi.org/10.3390/nu14122469

Erol Doğan, Ö., Karaca Çelik, K. E., Baş, M., Alan, E. H., & Çağın, Y. F. (2024). Effects of Mediterranean Diet, Curcumin, and Resveratrol on Mild-to-Moderate Active Ulcerative Colitis: A Multicenter Randomized Clinical Trial. Nutrients, 16(10), 1504. https://doi.org/10.3390/nu16101504

Saha, S., & Patel, N. (2023). What Should I Eat? Dietary Recommendations for Patients with Inflammatory Bowel Disease. Nutrients, 15(4), 896. https://doi.org/10.3390/nu15040896

Dragasevic, S., Stankovic, B., Kotur, N., Milutinovic, A. S., Milovanovic, T., Stojkovic Lalosevic, M., Stojanovic, M., Pavlovic, S., & Popovic, D. (2022). Genetic Aspects of Micronutrients Important for Inflammatory Bowel Disease. Life (Basel, Switzerland), 12(10), 1623. https://doi.org/10.3390/life12101623

Abou Zaid, E. S., Mansour, S. Z., El-Sonbaty, S. M., Moawed, F. S., Kandil, E. I., & Haroun, R. A. (2023). Boswellic acid coated zinc nanoparticles attenuate NF-κB-mediated inflammation in DSS-induced ulcerative colitis in rats. International journal of immunopathology and pharmacology, 37, 3946320221150720. https://doi.org/10.1177/03946320221150720

Miyaguchi, K., Tsuzuki, Y., Ichikawa, Y., Shiomi, R., Ohgo, H., Nakamoto, H., & Imaeda, H. (2023). Positive zinc intake and a Japanese diet rich in n-3 fatty acids induces clinical remission in patients with mild active ulcerative colitis: a randomized interventional pilot study. Journal of clinical biochemistry and nutrition, 72(1), 82–88. https://doi.org/10.3164/jcbn.22-72

Kikut, J., Konecka, N., Ziętek, M., Kulpa, D., & Szczuko, M. (2021). Diet supporting therapy for inflammatory bowel diseases. European journal of nutrition, 60(5), 2275–2291. https://doi.org/10.1007/s00394-021-02489-0

Herrador-López, M., Martín-Masot, R., & Navas-López, V. M. (2023). Dietary Interventions in Ulcerative Colitis: A Systematic Review of the Evidence with Meta-Analysis. Nutrients, 15(19), 4194. https://doi.org/10.3390/nu15194194

Ungaro, R., Mehandru, S., Allen, P. B., Peyrin-Biroulet, L., & Colombel, J. F. (2017). Ulcerative colitis. Lancet (London, England), 389(10080), 1756–1770. https://doi.org/10.1016/S0140-6736(16)32126-2

Wan, J., Zhou, J., Wang, Z., Liu, D., Zhang, H., Xie, S., & Wu, K. (2025). Epidemiology, pathogenesis, diagnosis, and treatment of inflammatory bowel disease: Insights from the past two years. Chinese medical journal, 138(7), 763–776. https://doi.org/10.1097/CM9.0000000000003542

Guo, M., & Wang, X. (2023). Pathological mechanism and targeted drugs of ulcerative colitis: A review. Medicine, 102(37), e35020. https://doi.org/10.1097/MD.0000000000035020

Views:

61

Downloads:

21

Published
2025-08-28
Citations
How to Cite
Patryk Kowalczyk, Bartłomiej Trzciński, Wiktoria Socha, Igor Winogrodzki, Alicja Stryczek-Schlusche, Aleksandra Magdalena Furczyńska, Filip Bracichowicz, Aleksandra Gęsińska, Hanna Paszkiewicz, Kamil Nowak, & Oliwia Gugała. (2025). DIETETARY MODULATION IN THE MANAGEMENT OF ULCERATIVE COLITIS: AN EVIDENCE-BASED REVIEW. International Journal of Innovative Technologies in Social Science, 2(3(47). https://doi.org/10.31435/ijitss.3(47).2025.3584

Most read articles by the same author(s)