Fish oil to soothe bowel inflammation

ULCERATIVE colitis, an inflammatory disease of ulcers in the lining of the large intestine, is most common among people of European descent and uncommon among Asians. A study (YM Lee et al 2000) among the ethnic races in Singapore indicated that Indians have the highest prevalence of the disease - (16.2 per 100,000) compared with seven per 100,000 for Malays and six per 100,000 for Chinese.

Classified as an inflammatory bowel disease (IBD), ulcerative colitis is commonly mistaken for Crohn's Disease due to their similar symptoms. The difference is where the ulcers are found along the digestive gut.

Ulcerative colitis usually affects the colon and rectum whereas Crohn's Disease usually occurs in the small intestines. The ulceration of the gut lining leads to blood and pus and frequent diarrhoea. This causes loss of body fluids and nutrients, loss of appetite and consequently fatigue and weight loss. Ulcerative colitis affects men and women alike and can develop between the age of 15 and 30 years. The cause of the disease is not fully understood but is believed to be an overreaction of the immune system that produces inflammatory substances against foreign invaders in the lining of the gut.

Stress, poor dietary habits and food allergies or sensitivities are triggering factors that aggravate the condition. Diagnosis of this condition calls for a thorough physical exam and a series of tests that include blood tests to check for anaemia and high white blood cell count for confirmation of inflammation within the body.

Treatment depends on the severity of the disease. Symptoms can range from relatively mild to severe. If symptoms are triggered by food (usually spicy foods, raw fruits and vegetables), the obvious thing to do is to avoid them. However, food sensitivities may be difficult to identify and doing a food sensitivity test may be advisable. The majority of ulcerative colitis patients are given anti-inflammatory medications such as aminosalicylates and corticosteroid preparations. Side-effects of corticosteroids include weight gain, facial hair, acne, raised blood pressure, inclination to infections and mood swings which deter their use on a long-term basis. Some patients may experience remission during which the symptoms disappear for months or even years, but in most cases the symptoms eventually reappear.

Sadly, statistics indicate that about 25 to 40 per cent of patients must eventually have their colons removed because of debilitating symptoms, heavy bleeding, rupture of the colon or risk of cancer. Researchers are always looking for new treatments that encourage and maintain remission, with minimal side-effects and to improve the quality of life for people with ulcerative colitis. Therapies that are being tested include the use of omega-3 fatty acids found naturally in fish oils. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the omega-3 fatty acids that possess anti-inflammatory and immune modifying properties.

Aslan and Triadafilopoulos (1992) looked at fish oil supplementation in active ulcerative colitis and, compared with the placebo therapy using olive oil, concluded that fish oil supplementation results in clinical improvement of active mild to moderate ulcerative colitis. Among the studied patients, 72 per cent of them could reduce or eliminate their need for anti-inflammatory medications. There have been a number of clinical trials assessing the benefits of dietary supplementation with fish oils in other types of inflammatory and autoimmune diseases in humans.

These include rheumatoid arthritis, Crohn's Disease, psoriasis, lupus erythematosus, multiple sclerosis and migraine headaches. Many of the fish oil supplementation studies in chronic inflammatory diseases show significant benefit and a lowered need for anti-inflammatory drugs