Can diet alone control IBD without the need for medication?

Hello M,

I am glad to know that your ulcerative colitis (UC) is in remission. This is likely the result of many factors at play including the use of Pentasa which helps to reduce the level of inflammation in your colon. Besides controlling the inflammation, Pentasa is known to help reduce the risk of colon cancer development in patients with UC.

There are numerous dietary information and recommendations you can find online regarding UC. These diet plans aim to reduce symptoms but none has proven conclusively to prevent, treat or change the natural course of UC. Dietary plan containing Omega-3 for instance, may aid in reducing inflammation although the overall benefit is still debatable.

Keeping a food diary and avoiding certain food which aggravates your symptoms is the right thing to do. Having said that, I would like to advise against an overtly restricting diet. This is because proper and adequate nutrient is important for the colon to heal well. In general, a regular intake of calcium with vitamin D may help to maintain a healthy set of bones. At times, certain probiotics may also help with reducing your symptoms.

May I suggest you have an in-depth discussion with your specialist to decide if you should switch your treatment to one that may help to control your joint pain as well. Personally, I will advise my patients to continue their treatment to avoid any nasty flare of colitis which may subject them to a higher risk of developing colon cancer in the long run.

-Dr Quan

Thanks for the very interesting question. IBD is certainly a disease that is becoming more common in Singapore and Asia, even though it was once more known to be a disease of the "West".

No specific diet has been shown by studies to prevent, treat, or cure IBD. However, some diet strategies can indeed help you to control symptoms better, especially when you are experiencing flare-ups.

A dietitian can best advice you on a diet plan to meet your nutritional needs, which will be specific to:

• Your age
• Your disease stage
• Your weight

Whether you can be taken off Pentasa or not is a conversation best had with your doctor. It's known to be safe for long term use when supervised by a doctor, as it's been in use since 1987, so there is good data on the long-term effects. Adverse effects from Pentasa are uncommon.

I wouldn't stop taking it if I were you however, since it's been so effective at controlling your flare-ups.

Stop taking your medication and you increase your risk of a flare — and the longer you're off the drug, the higher your risk of suffering a relapse.

There is also no need to avoid foods unless they worsen your symptoms. In fact, I'd prefer that you restrict as few foods as possible so that you are more likely to get a balanced diet.