I would like to know if drinking Ensure during a flare-up of ulcerative colitis would be helpful, or would it make things worse? I can't seem to find the answer. Eating is really difficult for me during these times.

C.B.

Ulcerative colitis (UC) is an inflammatory disease in which the lining of the large intestine and rectum becomes ulcerated and unable to properly absorb food. As a result, patients develop bloody diarrhea, abdominal pain, weight loss and fevers. The exact cause of UC is unknown. However, it is thought to occur when people who are genetically predisposed to the disease are exposed to an environmental trigger (such as a bacterial infection), setting off an hyperactive immune response and chronic inflammation.

Drugs that act as anti-inflammatory agents are used to treat UC. These medications, which include mesalamine, steroids and cyclosporine, help to ease symptoms in most patients. Many patients also continue to take small doses of these medications to keep UC in remission. However, flares still do occur at unpredictable intervals in certain patients. Most flares tend to be mild and are treated with increased doses of medications at home. More severe flares may require more intense treatment (including intravenous therapy) in the hospital.

Many doctors are afraid to feed patients with a severe flare of UC. However, there are only a few situations in which feeding is a bad idea. These include cases in which the colon becomes very large and dilated (toxic megacolon) and cases in which vomiting is the primary symptom. In other cases, the goal should be to encourage the patient to consume enough calories to prevent malnutrition, build up nutrient stores and nourish the cells that line the colon. Diets low in fiber may be recommended to limit the amount of material entering the patient's inflamed colon. Thus, to answer your question, high-nutrient drinks such as Ensure may be very useful. However, before making any major changes in your diet, be sure to discuss the issue with your gastroenterologist to see if it is right for your particular case.