Hemorrhagic Rectocolitis and Intestinal Dysbiosis: Insights and Prevention Tips

Heather Campbell
 min read

Hemorrhagic rectocolitis and intestinal dysbiosis and their relevant links are being looked into with researchers seeking to find cures for related illnesses.

Hemorrhagic Rectocolitis and Intestinal Dysbiosis: Insights and Prevention TipsHemorrhagic rectocolitis is a chronic inflammatory bowel disease. The latter always affects the rectum and the colon to a greater or lesser extent.

Hemorrhagic rectocolitis is also known as ulcerative colitis and is a chronic inflammation of the intestinal mucosa. It is common in the more industrialized countries, and involves genetic, immune, and environmental factors. Sufferers have a strong depletion of microbiota density and diversity.

Read on to understand more about hemorrhagic rectocolitis and intestinal dysbiosis, and how it is favored by genetic predisposition, environmental factors, and immune system dysfunction.

Hemorrhagic rectocolitis and intestinal dysbiosis: Introduction

Also called ulcerative colitis, it is a large intestine and rectum disease.

It is part of chronic inflammatory bowel diseases like, for example, Crohn’s disease.

This disease evolves in unpredictable flare-ups, but ulcerative colitis is not serious when medically managed.

However, flare-ups can be a nuisance when occurring daily.

In this article, we will try to learn more about hemorrhagic rectocolitis and intestinal dysbiosis.

What is ulcerative colitis?

By definition, ulcerative colitis is a chronic inflammation of the intestinal mucosa (specifically the inner lining of the intestine):

  • It is always present in the rectum
  • And it frequently extends continuously over part or all of the colon.

Regardless of the extent of the inflammation, the anus and small intestine are never affected by ulcerative colitis.

This condition is characterized by alternating phases of activity (commonly known as “flare-ups”) of varying intensity and duration and symptom-free phases known as remissions.

At the time of diagnosis of ulcerative colitis:

  • In 50% of cases, only the rectum is affected
  • In 30% of cases, it is an intermediate form of ulcerative colitis with lesions extending to the left colon
  • In 20% of cases, it extends from the rectum to the entire colon.

Hemorrhagic rectocolitis belongs to the group of pathologies, i.e., chronic inflammatory bowel diseases.

Hemorrhagic rectocolitis can present with non-digestive inflammatory symptoms such as:

  • Rheumatic fever, which affects the joints of the limbs such as the ankles, knees, wrists or the spine
  • Inflammation of the bile ducts
  • Mouth ulcers
  • Erythema nodosum which corresponds to hard, red, and painful blisters the size of a walnut and which will be found on the legs and forearms
  • And uveitis is an inflammation of the central part of the eyes.

Hemorrhagic rectocolitis is a chronic inflammatory disease of the rectum and colon

This disease manifests itself by bloody diarrhea, evolving in bouts interspersed with remissions.

The frequency of ulcerative colitis is increasing with the industrialization of countries.

As with Crohn’s disease, in immigrant populations from countries with a low incidence of the disease, ulcerative colitis increases the risk in the host country.

Therefore, this highlights the importance of environmental factors in developing the disease.

Typically, ulcerative colitis begins between the ages of 20 and 40. Sometimes, the digestive involvement is associated with extra digestive involvement (joints, skin, eyes, biliary…), which are of immunological origin.

The disease is also characterized by disturbances of intestinal permeability, leading to hyperstimulation of innate and adaptive immunity, with an abnormally strong reaction of T lymphocytes against the constituents of the intestinal microbiota.

What explains the development of ulcerative colitis?

The mechanisms of the onset of ulcerative colitis are still poorly understood. In fact, they involve genetic, immune and environmental factors.

Genes for predisposition to ulcerative colitis have been identified. However, their presence only modestly increases the risk of disease occurrence.

An imbalance between the intestinal immune system and the gut microbiota may also be a factor in the development of ulcerative colitis.

Indeed, the immune system will react abnormally against the bacteria usually present in the digestive tract. This is followed by an inflammation of the intestinal mucosa.

The rapid increase in the number of new cases of ulcerative colitis in industrializing countries leads us to believe that the environment also plays a role in the onset of the disease.

Other factors are also being studied, such as pollution, diet and psychological stress.

Paradoxically, active smoking would protect against ulcerative colitis, whereas it is a trigger and aggravating factor for Crohn’s disease.

Appendectomy, which is performed before the age of 20 for true appendicitis, is also a protective factor for ulcerative colitis.

Hemorrhagic rectocolitis is an increasingly common disease

Hemorrhagic rectocolitis is increasingly common in industrialized and developing countries, particularly Asia and the Middle East.

Hemorrhagic rectocolitis is most often diagnosed in young people aged 20 to 30 years. A second, smaller peak in frequency occurs between 50 and 70.

Men are slightly more frequently affected by this condition.

The link between ulcerative colitis and intestinal dysbiosis

The same type of dysbiosis seen in Crohn’s disease is present in ulcerative colitis.

Indeed, we find a depletion of the density and diversity of the microbiota with a decrease of Bacteroidetes and Firmicutes, in particular Clostridiae.

Taking probiotics and ulcerative colitis

Studies have been conducted to prove the effectiveness of probiotics in patients with ulcerative colitis during relapses or in preventing recurrences.

The results confirmed the effectiveness of probiotics in the treatment of this disease.

Source: Derikx, et al., Probiotics and prebiotics in ulcerative colitis, Best Practice & Research Clinical Gastroenterology, 2016

Fecal transplantation and ulcerative colitis

Research has shown that fecal transplantation resulted in complete remission of the disease in nearly 30% of cases compared to less than 10% of subjects in patients who received a placebo.

In almost half of the patients, fecal transplantation improved the symptoms of ulcerative colitis.

The effectiveness of the graft would depend on the richness and diversity of the donor flora. For example, it would be more critical in patients who received a graft from several donors than in patients who received the donation from a single donor.

Source: Fang, et al., Protocol for Fecal Microbiota Transplantation in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis, BioMed Research International, 2018

Preventive measures to prevent this condition

There are three types of measures:

Measures to prevent the disease

Since the precise causes of ulcerative colitis are still unclear, it is difficult to prevent its occurrence.

Measures to prevent complications

People who have had inflammatory bowel disease for at least 5 years (or more) are advised to make an appointment with a gastroenterologist every year.

A variety of tests are available for early detection of possible abnormalities in the digestive tract, including colorectal cancer.

Everyday prevention measures

In case of disease flare-ups

To date, dietary advice has no scientific validation. Therefore, this disease is not food-borne, and there is no need to restrict yourself.

However, the dietary advice is common sense:

  • Do not eat or drink foods and beverages that make your symptoms worse.
  • Avoid spicy foods, alcohol, certain vegetables (such as cabbage, broccoli and beans), and caffeinated foods and drinks. These tend to cause bloating.
  • Pay special attention to milk and some dairy products, which can trigger diarrhea, pain and flatulence in some people with lactose intolerance.
  • Limit dietary fiber intake. Although dietary fiber is an integral part of a healthy diet, it can often worsen ulcerative colitis symptoms. Eat fruits and vegetables cooked rather than raw.
  • Eat several small meals throughout the day rather than three large meals.
  • Drink plenty of fluids and choose water. Avoid carbonated drinks, alcoholic beverages and those containing caffeine.

In a severe attack, doctors may also institute a “no residue” diet, which will exclude all sources of plant fiber, animal and fatty residues, to rest the colon for a few days during the attack.

Between the periods of symptoms

Eating foods rich in dietary fiber helps regulate bowel movements.

Dietary fiber also has the advantage of facilitating the growth of bacteria usually present in the intestines.

We choose proteins from lean meats, poultry, fish and eggs. Therefore, it is essential to adopt a healthy diet that contains good fats.

Practice relaxation and/or meditation techniques and exercise to better manage your stress.

Although stress does not cause ulcerative colitis, it can worsen symptoms by interfering with normal digestive functions.

Physical activity also helps regulate bowel movements. Relaxation methods can also help control pain during times of symptoms.

Hemorrhagic rectocolitis: complementary approaches

Probiotics

Probiotics are defined as beneficial bacteria that form the intestinal flora.

Altered intestinal flora can be observed in people with ulcerative colitis during the active phase of the disease.

Prebiotics

Studies have evaluated the effect of different dietary fibers such as psyllium, oat bran and sprouted barley.

These are known to have a prebiotic action on the duration of remission of ulcerative colitis and on the mild intestinal symptoms that some people experience during these periods.

One study shows that psyllium is as effective as mesalazine, a traditional anti-inflammatory drug, in reducing the number of relapses.

Extending the duration of remissions

The results of several research studies have shown the effectiveness of daily consumption for one year of:

  • 3.38 oz of fermented milk with bifidobacteria
  • As well as a preparation based on Saccharomyces boulardii yeast combined with the classic treatment and preparation based on bifidobacteria.

Preventing the risk of relapse

Other research indicates that a probiotic preparation based on a non-toxic strain of E. coli is as effective as mesalazine in significantly reducing the risk of relapse in patients in remission from ulcerative colitis.

Lactobacillus GG, alone or combined with mesalamine, has also been effective in maintaining remission.

Preventing recurrence in case of pouchitis

Some clinical trials conducted on people suffering from recurrent pouchitis indicate that a specific preparation composed of four strains of lactobacilli, three strains of bifidobacteria, and one strain of streptococci could prevent relapses.

On the other hand, treatments with Lactobacillus GG and fermented milk were less successful.

Pouchitis is the inflammation of the ileal reservoir obtained after the doctor has performed an anastomosis (joining) between two parts of the intestines: the ileum and the anus.

Aloe vera

Other studies have been conducted in patients with mild to moderate ulcerative colitis to evaluate the effectiveness of an aloe vera-based gel.

The results show that ingesting 6.7 oz of aloe gel per day for one month effectively improved the patients’ condition, probably due to the anti-inflammatory properties of aloe.

Turmeric

Turmeric is the main spice in curry powder. A study was conducted on patients with ulcerative colitis. They were asked to take 0.03 oz of turmeric twice a day for 6 months.

The results showed that these individuals experienced fewer relapses after consuming turmeric.

Fish oils

Other research suggests that fish oils, taken in addition to regular medication, may help reduce the inflammatory response in the intestines during acute attacks of the disease.

The studies were conducted on people with mild to moderate ulcerative colitis. In some cases, the dose of anti-inflammatory drugs could be reduced by taking fish oil supplements.

However, this treatment with essential fatty acids proved ineffective in reducing the number of attacks of the disease in the long term.

Boswellia

Traditional Ayurvedic medicine attributes to boswellia anti-inflammatory properties that are useful for the treatment of inflammation of the digestive tract.

Studies have found that boswellia resin can be as effective as sulfasalazine in controlling intestinal inflammation without the side effects caused by the anti-inflammatory drug.

The Bastyr formula

A preparation composed of several medicinal plants and some other ingredients (such as cabbage powder, pancreatin, vitamin B3 and duodenal substance) is recommended by naturopaths to relieve inflammation in the digestive tract.

This is an old naturopathic remedy, and the following medicinal plants are part of the recipe:

  • Slippery elm (Ulmus rubra)
  • Marshmallow (Althea officinalis)
  • Echinacea (Echinacea angustifolia)
  • Goldenseal (Hydrastis canadensis)
  • The American Phytolacca (Phytolacca americana)
  • Wild indigo (Baptisia tinctoria)
  • Comfrey (Symphytum officinale)
  • And the spotted geranium (Geranium maculatum).

Stress management

Learning to use biofeedback, trying hypnotherapy sessions, or simply taking a few deep breaths are just a few ways to relax and sometimes even reduce colitis symptoms.

Hemorrhagic rectocolitis and intestinal dysbiosis: Conclusion

Hemorrhagic rectocolitis is a disease that is part of chronic inflammatory bowel diseases.

Also called ulcerative colitis, this condition is a disease of the large intestine and rectum.

Although the cause of this disease is still unclear, it is possible to adopt some healthy lifestyle tips to keep your body healthy.

Having a balanced microbiota also seems to be an excellent way to prevent chronic inflammatory bowel disease.

In addition, it is essential to know how to manage stress, which seems to be a trigger for all these diseases.

About Heather Campbell

As a nutritionist, my field of specialization is science-based nutritional advice but more importantly, it is my goal to share capturing and inspiring stories, examples and solutions which can help plus-size individuals overcome their specific difficulties. Read More