It is relatively common that in practice we see patients with some form of gastrointestinal disease or disorder. With the growing body of research into the gut microbiome and how we can improve the health of pets with gastrointestinal illnesses, today’s blog looks into what we can do for IBD and colitis patients with diet.

But first, what is IBD and colitis, and how are they different?

Inflammatory Bowel Disease

Inflammatory Bowel Disease is characterized by chronic inflammation of the small and large intestines which disrupts the contractions of the intestinal muscles. The contractions become irregular and cause mucus and toxins to collect in the intestines, trapping gas and faeces. This results in bloating, distension and constipation but also sometimes alternates with diarrhea. The cause is unknown, but can be related to food allergies or bacterial, viral or parasitic infections and can come in a variety of different forms affecting different parts of the gastrointestinal tract. In the small intestine, there are three forms being lymphocytic-plasmacytic enteritis (LPE), eosinophilic enteritis and eosinophilic gastro-enteritis (EGE). While these are generally considered a true IBD, patients may have combinations of both and any part of the GI tract can be affected, including the stomach.

Colitis

Colitis on the other hand, is more specifically describing the inflammation of the colon but does share some characteristics of IBD. The biggest difference is colitis can be triggered by stress and anxiety, much like humans suffering from IBS and is most often associated with blood and mucous in stool. Affecting mainly the large intestine, there are four main forms of colitis; lymphocytic-plasmacytic colitis, eosinophilic colitis, histiocytic ulcerative colitis (HUC), and regional granulomatous colitis. Another important chronic enteritis, that may fall under the umbrella of colitis, is the so-called food-responsive diarrhoea (FRD). This disease is especially important because it is often included in the differential diagnosis of IBD, and can be used to distinguish between the two based on how the patient responds to dietary management.

What is the cause?

Both IBD and colitis share similar causes, with the main difference being stress – this is a significant contributor to colitis and can trigger flare ups of the condition, whereas IBD isn’t usually affected by stress and is more physiological, autoimmune or genetic in cause. Some causes of IBD and colitis are;

• Intestinal parasites such as roundworms, whipworms, hookworms, and Giardia 
• Stress
• Pancreatitis
• Dietary intolerance or allergy
• Dietary indiscretion, such as eating grass, garbage, or people food
• Bacterial infection
• Viral infection 
• Genetics

What are the Key Nutritional Factors?

When looking at how we can manage these conditions with diet, we must consider the Key Nutritional Factors. While the KNFs are very similar between the two conditions, the main difference is for colitis the inclusion of electrolytes; this is due to the fact that both the large intestine’s ability to absorb electrolytes is impaired, and the diarrhea that is generally associated with colitis can cause significant losses of electrolytes. For IBD, there’s a greater focus on hydrolysed foods and novel proteins, as we discussed above, allergies can be a trigger of IBD episodes.

How do we manage IBD and colitis in pets?

Nutritional management forms a huge part of the management of these conditions in pets. Following the above Key Nutritional Factors, there’s a few diets that we can look at using to provide symptomatic and functional relief of the conditions.

Hydrolysed diets: These diets help in two ways. First, some pets with IBD or colitis may have allergies that can trigger their symptoms and have shown promising results in managing IBD in pets. Second, hydrolysed diets are broken down through enzymatic digestion, which means they may be easier to digest and process for pets with gastrointestinal disorders – reducing the energy they need to expend on digesting the food and maximising the nutrition that is absorbed by the dysfunctional gut. Examples of these diets include Hills Z/d, Royal Canin Hypoallergenic, Royal Canin Anallergenic, or ProPlan HA.

Gastrointestinal diets: These diets are different from hydrolysed diets in that they aren’t designed to manage allergies. Instead they are aimed at restoring the gut’s normal function, providing an enriched level of nutrients to replenish what is lost through diarrhea, vomiting or constipation and providing symptomatic relief of gastrointestinal issues. Examples of gastrointestinal diets; Hills I/d, Royal Canin Gastrointestinal, or ProPlan EN.

Prebiotics and Probiotics: I’ve written about these supplements before but I’ll briefly explain how these supplements work to help pets with IBD and colitis; with prebiotics, this is usually a fibre source that provides nourishment to the good bacteria and intestinal cells that line the gut. With probiotics, these are strains of good bacteria that are introduced to repopulate the gut microbiome. Recent studies have shown that the gut microbiome in dogs with IBD and colitis have altered gut microbiomes, and do not have the same microbial strains that are present in healthy pets (Xenoulis, 2008) which is why adding supportive gut microbiota into the GI tract can help reboot the digestive system, and the prebiotic fibre can keep the bacteria sustained and prevent future flare ups of symptoms. Probiotic supplements include products such as ProN8Ture, FortiFlora, SynBiotic, Digesticare and Visbiome. With prebiotics, some probiotic supplements already include a prebiotic, or you can use human fibre supplements such as Metamucil, or using psyllium husk powders. The other option is using enriched diets that contain prebiotics, such as Hills Gastrointestinal Biome.

Medications in conjuction with nutritional management: sometimes the use of steroids, antacids and gastroprotectants may be necessary to support the digestive system’s normal function so that it’s able to respond effectively to nutritional management. It’s also important to ensure these pets are free from parasites, as they can contribute to the condition, so make sure they are on a regular prevention protocol for intestinal worms and ectoparasites such as fleas and ticks. Ask your vet for the right combination of medications and preventatives for your pet.

While we cannot cure Inflammatory Bowel Disease or Colitis, we can manage it and improve the quality of life of pets that are suffering with the conditions. It takes quite abit of commitment to get to a place of management, as any pet parent of these patients will tell you, but it is achievable and we can get there. If you have a pet suffering from these conditions, please know there is a light at the end of the tunnel!

References

Xenoulis, P.G., Palculict, B., Allenspach, K., Steiner, J.M., Van House, A.M. and Suchodolski, J.S., 2008. Molecular-phylogenetic characterization of microbial communities imbalances in the small intestine of dogs with inflammatory bowel disease. FEMS microbiology ecology, 66(3), pp.579-589.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2835779/