Is Coconut Water Helpful For People With Mild To Moderate Ulcerative Colitis?

By Andreu Prados, PhD, BPharm, RDN, and Natasha Haskey PhD, RD

Paying attention to diet may help reduce symptoms, prevent gut inflammation, and improve quality of life in patients with inflammatory bowel disease (IBD). A new small study suggests adding coconut water alongside standard medications may help maintain remission and reduce intestinal inflammation in mild and moderate ulcerative colitis (UC). 

In the study, 49 adult patients with mild and moderate UC drank 200 ml of coconut water twice daily, while 46 received the placebo (coconut flavored water). All participants were on their current medical treatment for UC (stable doses of oral 5-aminosalicyclic acid, azathioprine/6-mercaptopurine and topical therapy). 

Researchers at the All India Institute of Medical Sciences in New Delhi explored the potential of coconut water in alleviating ulcerative colitis (UC). Their investigation was prompted by compelling animal studies demonstrating the anti-inflammatory properties of coconut water and its ability to foster a balance among beneficial gut microorganisms.

After eight weeks, 26 of the 49 patients (53%) consuming coconut water achieved symptom remission, indicating well-controlled symptoms with minimal disease activity. In contrast, only 28% of the 46 patients in the placebo group experienced similar remission. Additionally, 57% of those in the coconut water group exhibited an improvement in the severity of symptoms, as opposed to 28% in the placebo group.

Some patients with UC who received coconut water also showed a decrease in their fecal calprotectin (below 150 mcg/g) and changes in some gut bacteria that are associated with endoscopic and clinical remission. However, endoscopic changes were not different between coconut water and placebo groups.

It is important to note that coconut water should not be consumed if you are taking medications that interact with potassium, such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and potassium-sparing diuretics, as well as in individuals with chronic kidney disease.

While coconut water exhibited positive effects in this clinical trial, these results need to be confirmed through additional research.

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Reference:

^{Kedia S, Virmani S, Bajaj A, et al. (2024) Coconut water induces clinical remission in mild to moderate ulcerative colitis: double-blind placebo controlled trial. Clin Gastroenterol Hepatol (published online ahead of print 24 January). doi: 10.1016/j.cgh.2024.01.013.}

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^‍‍About the writers:

‍Dr. Andreu Prados is a science and medical writer specializing in making reliable evidence of non-prescription therapeutics for gastrointestinal conditions understandable, engaging and ready for use for healthcare professionals and patients. He holds bachelor’s degrees in Pharmacy and Human Nutrition and Dietetics and a PhD in nutrition communication.

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Dr. Natasha Haskey is a clinical scientist and Registered Dietitian with over 20 years of practical experience in nutrition therapy for IBD.  In 2022, she completed her doctorate at the Center for Microbiome and Inflammation Research at the University of British Columbia in Okanagan, Canada, examining how a Mediterranean diet influenced clinical disease activity, inflammation and the microbiome in ulcerative colitis. She co-authored the textbook called "Gut Microbiota: Interactive effects on nutrition and health"

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