THE VALUE OF AN ELIMINATION DIET IN THE MANAGEMENT OF PATIENTS WITH ULCERATIVE-COLITIS

Debate exists about the role of diet in both the aetiology and the man agement of ulcerative colitis, To examine the latter, a group of patie nts with documented ulcerative colitis was studied at the Groote Schuu r Hospital Gastrointestinal Clinic. A total of 18 subjects, 9 female a nd 9 male, were randomised into active or control groups and followed up weekly for 6 weeks, Subjects in the control group were asked to doc ument but not alter their intake of food and drink, Those in the exper imental group had their diets systematically manipulated to exclude fo ods that appeared to provoke symptoms, The symptoms, sigmoidoscopy and biopsy findings of all subjects were compared before and after, 'Remi ssion' was defined as the passage of normal stools with absence of rec tal bleeding, 'Improvement' was defined as a decrease in the number of diarrhoeal stools and/or a diminution of rectal bleeding. At the end of the trial the diet group displayed significantly fewer symptoms tha n did the controls (p = 0,009; Fisher's exact test), Sigmoidoscopic fi ndings improved in 8 subjects in the diet group compared with 2 of the controls, Histological findings improved in 3 of the diet group as we ll as in 3 of the controls. There were no foods that provoked symptoms in all patients, though spiced and curried foods and fruits, especial ly grapes, melon and the citruses, commonly caused diarrhoea. In only 2 patients were symptoms reproduced consistently on reintroduction of a particular food, pork in 1 case and yellow cheese in another.