Ph Levels and Colitis

pH levels and Colitis

Over the past few weeks in some IBD forums I noticed a few questions concerning body pH levels and colitis. I hadn't really thought about pH levels until a friend who suffers from Ulcerative Colitis spoke about the acidity that causes his flare-ups.

pH Levels

So first of all it's worth giving a brief explanation of what pH is. Various measurements make up an overall balanced state of the body called homeostasis. One of the measurements is the pH level, which is basically the balance of acidity to alkalinity within the body fluids - the ideal pH balance is between 7.35 and 7.45

By the way, although not particularly important, apparently the actual meaning of the letters 'pH' is disputed, but the most popular belief is that it means 'power of hydrogen'.

For UCers, the pH levels of the digestive system are particularly interesting. I have to admit that although I'd heard of the term 'pH level', I wasn't too sure how it effected my digestive system. Now, after reading about it for a while, I believe that for some it could well play a role in flare-ups and symptoms of Ulcerative Colitis.

pH levels in the digestive system

After looking into pH levels of the digestive system it was interesting to find out how much they change. I had assumed, incorrectly, that there's just one pH level! Actually there are various levels across the different processes that occur to food travelling from the mouth to the exit.

The pic to the right shows average pH levels throughout the digestive system.

The list below shows how much the levels can differ between a number of healthy digestive systems.

  1. Mouth saliva 6.5 to 7.5
  2. Stomach 1.0 to 2.4
  3. Small intestine 5.2 to 8.5
  4. Large colon 4.5 to 7.3

The difference across the pH levels in the large colon are something that may interest colitis sufferers - the prospect of having over acidic levels here would make one suspect that it's an area where changing to a more alkaline level might result in improvement of some symptoms.

pH Levels Digestive System

pH levels and oral meds for ulcerative colitis

Colitis Meds

Here's something that I hadn't realised until looking into pH levels - certain colitis meds are designed to release depending on the pH level of the small intestine.

Asacol, a pill widely used for Ulcerative Colitis works by releasing mesalazine (also called 5ASA, mesalamine etc.) into the large colon. It's prescribed as an enteric (relating to the intestine) pill which releases as it gets closer to the large colon so that it benefits colitis sufferers.

The release time of the pill is actually dependent on the pH level at the end of the small intestine - it's designed to release when the pH level is equal to or greater than 7.0

It's just a thought, but I've read posts by colitis sufferers saying that the mesalazine pills they took weren't working and some even said the pills were appearing in the toilet undissolved. Could it be worth looking at pH levels in order to see if it affects how the meds work?

pH Level and Diet

Supporters of the alkaline diet believe that a diet high in acid-producing foods disrupts the body's pH balance and promotes the loss of essential minerals such as potassium, magnesium, calcium, and sodium as the body tries to restore equilibrium. This imbalance is thought to make people prone to illness.

As I mentioned at the top of the page, a link between Colitis and pH was only bought to my attention when a friend who has Colitis spoke about his diet.

It was interesting to hear how he manages his colitis by avoiding certain foods and sticking to others. He's lucky that he has managed to find a reason behind his flare-ups - this discovery came about because he suffered from bad acid indigestion which he had medical advice for. As part of the treatment he was told to avoid certain types of food which he noticed improved the indigestion (he also takes oral meds for this).

For UCers, the most interesting part is that he noticed his flare-ups stopped when sticking to a mostly alkaline diet and only return if he eats acidic foods over a period of time. This more or less replicates the problems he had with stomach ulcers e.g. they were caused by excess acid and when he follows a mostly alkaline diet they don't return.

I've read various posts by UCers that have altered their pH and seen improvements, as ever, there are replies by others saying it made no difference. But it's encouraging that this is another aspect of colitis that may be worth looking at for some.

It's not too susprising that the lists of alkaline food correspond to the lists of healthy foods that nutritionists advise us to eat. A good example being green leafy vegetables which are spread across the alkaline pH levels e.g. raw spinach with a pH level of 10.

Alkaline pH food chart

pH imbalance

The perfect pH balance is between 7.35 and 7.45 e.g. slightly more alkaline than acidic. It's worth noting that acidity is also important in the body and problems can occur if the level is too alkaline (called alkalosis) as well as if the level is too acidic (acidosis).

It appears that a pH imbalance can lead to many different diseases if left unchecked, although if a healthy diet is followed it should be fairly easy to maintain a good balance. As an example, lack of fresh fruit and vegetables coupled with too much processed food is a recipe for an acidic imbalance. On the other hand, taking too much sodium bicarbonate could lead to an excess alkaline imbalance.

It's interesting to see how a list of symptoms linked to pH imbalance crosses over with Colitis symptoms:

  • Acne
  • Bloating
  • Cold sores
  • Decreased immunity
  • Dry hard foul smelling stools or foul smelling diarrhea
  • Dry skin
  • Fatigue
  • Food allergies
  • Frequent colds and flu or feeling rundown
  • Inflammation
  • Insomnia
  • Irregular heartbeats
  • Irritable bowel syndrome
  • Joint pain
  • Lack of concentration
  • Muscle cramps
  • Muscular pain
  • Rheumatoid arthritis
  • Thinning hair
  • Weakness
  • Weight problems

Alkaline pH Food Chart

I've put together a chart showing alkaline foods down to a pH level of 6.5, below this the levels start to become acidic. I left out some alkaline foods that Colitis sufferers probably wouldn't eat (potato with skins etc.) and hopefully what remains is a cross-section of the foods that UCers could try to include in their diet.

What's fairly obvious from the chart is how many fresh fruits and vegetables are in the alkaline section. We are always being told to eat more fresh organic fruit and veg and it appears that pH levels are another example of why it's a good thing - interesting that there are no meats in the alkaline chart!

Please note: unless otherwise stated, pH levels are taken from fresh, organic fruit and veg.

pH Levels Chart - Alkaline Foods

Acidic pH Food Chart

The chart below shows many of the foods (and some other things) that contribute to an acidic pH level.

As a complete contrast to the alkaline chart, the fresh fruit and veg tails off while the sugars, grains and meat ramp up!

pH Levels Chart - Acidic Foods