The Impact of Ulcerative Colitis on Your Physical and Mental Health
A type of inflammatory bowel disease that affects the lining of the colon and rectum, ulcerative colitis (UC) can be a challenging condition that flares when a trigger food is consumed or when you are under stress. It causes various symptoms, such as abdominal pain, weight loss, and fatigue. But ulcerative colitis also has lesser-known effects on the body and mind. Many times people with UC have gut dysbiosis, which may affect immunity and digestion. It can also increase the risk of mental health issues — such as depression and anxiety — due to chronic inflammation and stress. Other possible complications include arthritis and kidney stones, which require proper management and treatment.
Microbiome Dysbiosis, Depression, & Anxiety
When compared to healthy people, those with ulcerative colitis tend to have lower microbiome diversity in the gut. Scientists have found that not only do they have lower populations of beneficial bacteria, but also higher levels of pathogenic bacteria, including Escherichia coli. What’s more, their microbiomes are less stable.1 This means those with UC have lower levels of beneficial metabolites that are produced by friendly bacteria — such as butyrate. Researchers aren’t sure whether these changes contribute to the condition or result from the disease itself and the treatments used for it.
How do depression and anxiety play into ulcerative colitis? It all comes down to the gut-brain connection. Recent research has established that the gut microbiome impacts brain signals associated with regions of the brain that regulate emotions.2 This in turn can trigger anxiety and depression when gut dysbiosis is present. Those with UC are particularly prone to mental health challenges with one-third of patients experiencing anxiety, while a quarter report symptoms of depression.6
However, researchers point out that concerns about the condition and the timing of symptoms is often a source of anxiety and stress, both of which are known to aggravate ulcerative colitis.3 Individuals with UC are also more likely to feel overwhelmed, experience denial about their health status, have lower self-esteem, and display dependent behaviors. Moreover, a 2012 review found anxiety and/or depression in ulcerative colitis patients worsened symptoms that lead to flares.4
While this research may be sobering for those with the condition, it can also motivate UC patients to seek out effective methods for managing stress, anxiety, and depression, as well as ways to improve the gut microbiome and digestive health for a better outcome. We will explore how to do just that below.
The Importance of Diet in Managing Symptoms
Needless to say, what you eat will have an enormous impact on the severity of ulcerative colitis and the accompanying depression, anxiety, and feelings of overwhelm/stress. Consuming a diet filled with processed foods and refined sugar is a sure-fire way to create gut dysbiosis, inflammation, and worsening of symptoms. Instead, focus on a largely plant-based diet with moderate amounts of protein and minimal to no saturated fat. This is because a high saturated fat, protein-heavy diet can worsen UC by disrupting the microbiome and causing inflammation in the gut.
Prebiotic and probiotic foods are also helpful, although I recommend consuming probiotic-rich foods for some time before introducing those that have prebiotic properties. Why? Because the abnormal bacteria present in gut dysbiosis tend to rapidly ferment prebiotics, which can lead to bloating and digestive upset. For a full list of prebiotic and probiotic foods, see this post.
It is also crucial to identify possible food triggers/sensitivities through a 28-day elimination-and-challenge process. You can learn precisely how to do this in my Holistic Guide to Wellness, which contains a full daily protocol for addressing inflammatory bowel diseases — including specific supplements, herbal remedies, dietary recommendations, and lifestyle habits. It also explores conventional methods and potential side effects of this approach.
Herbal Support for Optimizing Gut Health & Overall Well-Being
Along with dietary measures, herbal medicines are an exceedingly helpful aspect of managing symptoms and establishing a foundation of health. Here are my top recommendations for lowering inflammation and encouraging a robust microbiome, along with herbs that ease stress, anxiety, and depression.
Medicinal mushrooms — namely, dual-extracted reishi, lion’s mane, and turkey tail — are outstanding for cooling the inflammatory response, helping heal leaky gut, and feeding the “good ” bacteria in the microbiome. Additional anti-inflammatory and soothing herbs include marshmallow root, aloe vera, deglycyrrhizinated licorice, and plantain.
Our Balanced Gut Blend contains several of these beneficial botanicals in a concentrated extract that helps to calm the symptoms of ulcerative colitis by forming a protective layer in the gut, reducing inflammation, promoting a healthy microbiome, and addressing leaky gut.
If you find you struggle with anxiety, depression, and chronic stress, adaptogens and supporting your adrenals should be a top priority to lessen the risk of a UC flare. Here again, medicinal mushrooms can help.
Cordyceps, lion’s mane, and reishi are potent adaptogens that strengthen the body against the negative effects of stress, including: hormonal imbalances, high cortisol, fatigue, and low energy. Research shows that cordyceps in particular has beneficial effects in the prevention and treatment of inflammatory bowel disease.5
Ashwagandha is another herbal medicine that helps to protect you against the harmful impacts of stress. What’s more, it calms inflammation, soothes anxiety and depression, and improves cognitive function — including attention, processing speed, and memory. Lastly, lemon balm quiets the stress response by calming the body and mind. It too reduces inflammation and can help to relieve insomnia when spinning thoughts are keeping you awake.
For a convenient, all-in-one blend, see our Anxiety & Stress formulation in the apothecary. It contains potent extracts of lion’s mane, reishi, ashwagandha, and lemon balm. For cordyceps, we offer an exceptional stand-alone tincture.
A GODSEND AND A BLESSING
“I’ve had severe gut issues since I had my appendix out. Almost died due to it rupturing. I developed IBS-D, which altered my going places and eating foods I loved. I changed my eating habits. It helped a little, but not enough. I couldn’t go out to eat too far in fear of not making it home. So, I ordered out. I did a lot of research and tried many things to no avail, until I stumbled onto Nicole’s website. I ordered her book and now have ordered her tinctures [Balanced Gut Blend].
This is the first I have tried and I immediately felt something going on in my gut that was unusual, so I went along with it. … To this day I haven’t had one episode, not one.
Thank You Nicole for helping so many of us. You are a Godsend and a blessing. May God bless you in your journey to heal many.” -Robertine M.
Nicole’s Apothecary Products in this Post
- 1. Astó, E., Méndez, I., Audivert, S., Farran-Codina, A., & Espadaler, J. (2019). The Efficacy of Probiotics, Prebiotic Inulin-Type Fructans, and Synbiotics in Human Ulcerative Colitis: A Systematic Review and Meta-Analysis. Nutrients, 11(2), 293. https://doi.org/10.3390/nu11020293
Margolis, K. G., Cryan, J. F., & Mayer, E. A. (2021). The Microbiota-Gut-Brain Axis: From Motility to Mood. Gastroenterology, 160(5), 1486–1501. https://doi.org/10.1053/j.gastro.2020.10.066
Bannaga, A. S., & Selinger, C. P. (2015). Inflammatory bowel disease and anxiety: links, risks, and challenges faced. Clinical and experimental gastroenterology, 8, 111–117. https://doi.org/10.2147/CEG.S57982
Sajadinejad, M. S., Asgari, K., Molavi, H., Kalantari, M., & Adibi, P. (2012). Psychological issues in inflammatory bowel disease: an overview. Gastroenterology research and practice, 2012, 106502. https://doi.org/10.1155/2012/106502
Han, E. S., Oh, J. Y., & Park, H. J. (2011). Cordyceps militaris extract suppresses dextran sodium sulfate-induced acute colitis in mice and production of inflammatory mediators from macrophages and mast cells. Journal of ethnopharmacology, 134(3), 703–710. https://doi.org/10.1016/j.jep.2011.01.022
Barberio, B., Zamani, M., Black, C. J., Savarino, E. V., & Ford, A. C. (2021). Prevalence of symptoms of anxiety and depression in patients with inflammatory bowel disease: a systematic review and meta-analysis. The lancet. Gastroenterology & hepatology, 6(5), 359–370. https://doi.org/10.1016/S2468-1253(21)00014-5