6 Natural Remedies for Managing Ulcerative Colitis According to Science and Research

Medically Reviewed by Ian Nathan, MBChB, on 4th January 2026

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that causes continuous inflammation of the colon and rectum. Symptoms may include abdominal pain, persistent diarrhea, rectal bleeding, urgency, fatigue, anemia, and unintended weight loss. The disease follows a relapsing-remitting pattern, meaning patients experience periods of flares and periods of remission.

Understanding Ulcerative Colitis: Causes, Inflammation, and Standard Care

According to the Mayo Clinic, ulcerative colitis is believed to result from an abnormal immune response in genetically susceptible individuals, influenced by environmental factors and gut microbiome alterations. The immune system mistakenly attacks the lining of the colon, leading to chronic inflammation and ulcer formation.

Clinical guidelines from the American College of Gastroenterology (ACG) emphasize that conventional treatments—including 5-aminosalicylic acid (5-ASA) medications, corticosteroids, immunomodulators, and biologic therapies—are the foundation of care. These therapies are essential for inducing remission, preventing complications, and reducing colorectal cancer risk.

While medications remain central to disease control, many individuals seek complementary approaches to help manage inflammation and improve overall gut health. Scientific research suggests that certain natural strategies may provide supportive benefits when used alongside prescribed treatments and under medical supervision.

How Inflammation Develops in Ulcerative Colitis

Ulcerative colitis involves dysregulation of the intestinal immune system. Inflammatory pathways—such as tumor necrosis factor-alpha (TNF-a), interleukins (IL-6, IL-13), and nuclear factor-kappa B (NF-κB)—become overactivated. At the same time, the intestinal barrier may become compromised, allowing increased exposure to luminal antigens and bacteria.

Research also shows that individuals with UC often exhibit reduced microbial diversity and lower levels of beneficial bacteria that produce short-chain fatty acids like butyrate. This combination of immune dysregulation and microbial imbalance contributes to chronic inflammation.

Natural remedies that target inflammation, microbial balance, nutrient deficiencies, and stress regulation may therefore serve as supportive tools within a comprehensive management plan.

1. Probiotics and Gut Microbiome Support

The gut microbiome plays a crucial role in regulating immune responses and maintaining intestinal integrity. Dysbiosis—an imbalance in gut bacteria—has been consistently observed in patients with ulcerative colitis.

Probiotics are live microorganisms that may help restore microbial balance. Certain strains, including Escherichia coli Nissle 1917 and multi-strain formulations containing Lactobacillus and Bifidobacterium species, have been studied in clinical trials.

A review published in Clinical Gastroenterology and Hepatology suggests that specific probiotic formulations may help maintain remission in mild to moderate ulcerative colitis when used as adjunct therapy. In some trials, probiotics demonstrated similar efficacy to mesalamine in maintaining remission, though results vary depending on formulation and patient population.

Probiotics are generally considered safe for most individuals but should be used cautiously in immunocompromised patients. Because strain specificity matters, patients should consult a gastroenterologist before selecting a probiotic supplement.

2. Omega-3 Fatty Acids

Omega-3 fatty acids—particularly EPA and DHA—are known for their anti-inflammatory effects. They alter eicosanoid production, shifting the balance toward less inflammatory mediators, and may reduce cytokine activity.

A Cochrane systematic review examining omega-3 supplementation for ulcerative colitis found mixed evidence. While some small studies reported reduced steroid use and improved symptom scores, overall data were insufficient to recommend omega-3s as a primary treatment.

However, omega-3 fatty acids are endorsed by the American Heart Association for cardiovascular benefits. Including fatty fish such as salmon, sardines, and mackerel in the diet may provide general health advantages while potentially offering mild anti-inflammatory support.

High-dose supplementation should be discussed with a healthcare provider, especially for individuals on anticoagulants or with bleeding risk.

3. Curcumin (Turmeric Extract)

Curcumin, derived from turmeric, has demonstrated anti-inflammatory and antioxidant properties in laboratory and clinical studies. It appears to inhibit NF-κB activation and reduce pro-inflammatory cytokine production.

A randomized, double-blind, placebo-controlled trial by Hanai et al., published in Clinical Gastroenterology and Hepatology (PMID: 17101300), found that curcumin combined with standard mesalamine therapy improved remission maintenance compared to placebo.

Despite promising findings, curcumin has variable bioavailability, and standardized formulations are important. Mild gastrointestinal side effects have been reported in some individuals. Patients should consult their healthcare provider before use, particularly if they are taking blood-thinning medications.

4. Soluble Fiber and Prebiotic Support (During Remission)

Fiber intake requires careful individualization in ulcerative colitis. During active flares, insoluble fiber may worsen symptoms. However, during remission, soluble fiber may provide benefits by promoting short-chain fatty acid production.

Short-chain fatty acids—especially butyrate—serve as a primary fuel source for colon cells and possess anti-inflammatory properties. A study published in Gut demonstrated that germinated barley foodstuff (GBF) supplementation helped maintain remission and reduce inflammatory markers (PMID: 10403733).

Food sources of soluble fiber include oats, psyllium, apples, bananas, and legumes. A gradual increase in fiber under professional guidance may improve tolerance and reduce digestive discomfort.

5. Vitamin D Optimization

Vitamin D is a fat-soluble vitamin that influences immune regulation and intestinal barrier integrity. Vitamin D deficiency is common among individuals with inflammatory bowel disease.

Research published in the World Journal of Gastroenterology indicates that low vitamin D levels are associated with increased disease activity and higher relapse rates. Observational studies suggest that correcting deficiency may reduce inflammatory markers and support disease control.

Vitamin D status can be assessed via blood testing. Supplementation should be individualized and monitored to prevent excessive intake, which can lead to toxicity.

6. Stress Management and Mind-Body Therapies

Psychological stress can influence immune function and gastrointestinal symptoms. While stress does not cause ulcerative colitis, it may exacerbate flares and increase symptom severity.

Clinical research published in Inflammatory Bowel Diseases indicates that mindfulness-based stress reduction (MBSR), cognitive behavioral therapy (CBT), and yoga may improve quality of life and psychological well-being in individuals with IBD.

Mind-body therapies may reduce perceived symptom burden and improve coping skills. Regular sleep, moderate physical activity, and structured relaxation techniques can support overall disease management.

Dietary Patterns and Anti-Inflammatory Eating

In addition to specific nutrients, overall dietary patterns may influence inflammation. The Mediterranean diet—rich in fruits, vegetables, whole grains, legumes, nuts, olive oil, and fish—has been associated with anti-inflammatory effects and improved microbial diversity.

No single diet works for everyone with ulcerative colitis. Personalized nutrition strategies, guided by a registered dietitian, can help identify trigger foods while ensuring adequate nutrient intake.

Safety, Monitoring, and When to Seek Medical Care

Natural remedies should always complement—not replace—medical therapy. Abrupt discontinuation of prescribed medications can increase flare risk and complications.

Immediate medical attention is necessary if symptoms such as severe abdominal pain, persistent rectal bleeding, fever, dehydration, or rapid weight loss occur. Long-standing ulcerative colitis also increases colorectal cancer risk, making regular colonoscopic surveillance essential.

Patients should inform their healthcare provider about any supplements they use to avoid potential interactions with prescribed medications.

Conclusion

Ulcerative colitis is a complex, immune-mediated condition requiring comprehensive medical management. Scientific evidence supports several complementary approaches that may provide additional support when integrated thoughtfully into a treatment plan.

Probiotics may help maintain remission in certain individuals. Omega-3 fatty acids offer anti-inflammatory and cardiovascular benefits. Curcumin has demonstrated promise in adjunctive therapy trials. Soluble fiber during remission may support beneficial gut bacteria. Vitamin D optimization supports immune regulation. Stress-reduction strategies improve quality of life and symptom perception.

These approaches should be personalized, evidence-informed, and supervised by a healthcare professional. A collaborative approach that combines conventional therapy with carefully selected complementary strategies offers the most balanced and safe path toward long-term disease control.

References

1. Mayo Clinic. Ulcerative colitis - Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/ulcerative-colitis/symptoms-causes/syc-20353326
2. American College of Gastroenterology. ACG Clinical Guideline: Ulcerative Colitis in Adults. https://journals.lww.com/ajg/Fulltext/2019/03000/ACG_Clinical_Guideline__Ulcerative_Colitis_in.10.aspx
3. Hanai H, et al. Curcumin maintenance therapy for ulcerative colitis. Clin Gastroenterol Hepatol. https://pubmed.ncbi.nlm.nih.gov/17101300/
4. Fujimori S, et al. Germinated barley foodstuff in ulcerative colitis. Gut. https://pubmed.ncbi.nlm.nih.gov/10403733/
5. Lev-Tzion R, et al. Omega-3 fatty acids for ulcerative colitis. Cochrane Database Syst Rev. https://pubmed.ncbi.nlm.nih.gov/17313082/
6. Ananthakrishnan AN, et al. Vitamin D and inflammatory bowel disease. World J Gastroenterol. https://pubmed.ncbi.nlm.nih.gov/24187478/
7. Berrill JW, et al. Mind-body therapies in inflammatory bowel disease. Inflamm Bowel Dis. https://pubmed.ncbi.nlm.nih.gov/20629105/
8. National Institutes of Health Office of Dietary Supplements. Vitamin D Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/