Effects of Pomegranate Juice on Ulcerative Colitis

Inclusion criteria

• • Adults ≥ 18 yo
• Following a low-polyphenol and fiber diet (\< 3 servings of fruits/vegetables per day)
• Mild-to-moderate UC at the time of screening (2 ≤ partial Mayo scores ≤ 5)
• Supportive evidence of active inflammation (hsCRP \>1 mg/L, fecal calprotectin \>50 µg/g stool, or abnormal lower endoscopy) in individuals with biopsy-proven UC
• Patients on 5-aminosalicylates must be on a stable dose for ≥ 4 weeks prior to screening
• Patients on treatment with immunosuppressive therapy (e.g., azathioprine/6-mercaptopurine, methotrexate) must be on stable dose for 8 weeks prior to baseline visit
• At the time of baseline visit, patients may be on no more than 20 mg/day of prednisone and 9 mg/day of budesonide MMX
• Subjects must read and sign the Institutional Review Board-approved written informed consent prior to the initiation of any study specific procedures or enrollment. A subject will be excluded for any condition that might compromise the ability to give truly informed consent.

Exclusion criteria

• • Non-English speaker
• Vegetarian/vegan
• Known pomegranate allergy
• Documented chronic disease besides UC, including diabetes, renal or liver diseases, metabolic syndrome, active cancer, MI or stroke, history of gastric bypass
• Patients with CD, indeterminate/severe to fulminant colitis
• History of colectomy or colonic dysplasia
• Presence of ileal pouch or ostomy
• Evidence of active bacterial or viral gastroenteritis as indicated by positive stool studies for ova \& parasites, Clostridium difficile, and stool culture
• Recent hospitalizations (within 2 weeks of screening) for UC requiring IV steroids
• Presence of the following labs indicative of severe colitis: a. Hemoglobin \< 8.0 g/dl b. Albumin \< 3.0 g/dl
• Recent systemic antibiotics use (within 3 months of screening) or active use of anti-diarrheal medications
• Taking supplements known to affect metabolism or gut microbiota composition (probiotics, fiber, etc.), unless willing to stop for the study duration
• Use of Total Parenteral Nutrition (TPN)
• Use of cyclosporine, tacrolimus, or thalidomide within 2 months prior to screening
• Taking exogenous hormones (e.g., hormone replacement therapy)
• Recent weight fluctuations (\>10% in the last 6 months)
• Smoker or living with a smoker
• Use of \>20 g of alcohol per day
• Unable or unwilling to comply with the study protocol (including unwillingness to avoid watermelon and other lycopene-rich foods for the whole duration of the study)
• Unable to provide consent