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Dr. Shustina is an incredibly knowledgeable doctor who truly takes time to find root cause.
RG
Rochel Gordon
Condition · Inflammatory Bowel Disease
Ulcerative Colitis
Bloody diarrhea, urgent bowel movements, and unpredictable flares disrupting daily life aren’t simply "digestive stress", they may signal ulcerative colitis, the most prevalent form of inflammatory bowel disease affecting millions worldwide with an annual incidence of 9 to 20 cases per 100,000 persons. Research increasingly demonstrates that gut microbiome dysbiosis plays a central role in ulcerative colitis pathogenesis, with reduced bacterial diversity, depleted butyrate-producing species, and compromised mucosal barrier function driving chronic inflammation. Our comprehensive approach addresses these underlying imbalances through gut microbiome restoration, anti-inflammatory protocols, and immune system modulation to achieve lasting remission and prevent disease progression.
What Exactly Is Ulcerative Colitis?
Ulcerative colitis is a chronic inflammatory bowel disease (IBD) characterized by continuous mucosal inflammation that begins in the rectum and extends proximally in a continuous pattern throughout the colon. Unlike Crohn’s disease, which can affect any part of the gastrointestinal tract and penetrates all bowel wall layers, ulcerative colitis is confined to the colon and affects only the innermost mucosal lining, causing characteristic ulcerations, redness, and bleeding. The disease results from a complex interplay between genetic susceptibility, environmental triggers, immune dysregulation, and significant alterations in the gut microbiome, including reduced biodiversity, abnormal bacterial composition, and deficient short-chain fatty acid production essential for colonic health. Ulcerative colitis typically follows a relapsing-remitting course, with approximately 90% of patients experiencing rectal bleeding and watery stools during active disease.
Types of Ulcerative Colitis
Ulcerative colitis is classified by the extent of colonic involvement using the Montreal Classification system, with disease extent significantly influencing symptoms, treatment approach, and cancer risk.
| Type | Extent of Inflammation | Common Symptoms | Considerations |
|---|---|---|---|
| Ulcerative Proctitis (E1) | Rectum only | Urgency, tenesmus (feeling of incomplete evacuation), rectal bleeding | Mildest form; affects 30-60% at presentation; no increased cancer risk; may progress proximally |
| Left-Sided Colitis/Distal Colitis (E2) | Rectum to splenic flexure | Bloody diarrhea, abdominal cramping, urgency, weight loss | Affects 16-45% at presentation; moderate cancer risk; responds well to topical therapy |
| Extensive Colitis/Pancolitis (E3) | Beyond splenic flexure to entire colon | Severe bloody diarrhea, significant abdominal pain, fatigue, weight loss, fever | Affects 14-35% at presentation; highest cancer risk; requires systemic therapy; 10-19% progress from limited disease within 5 years |
| Fulminant/Toxic Colitis | Severe pancolitis with systemic toxicity | High fever, severe bloody diarrhea, abdominal distension, tachycardia | Medical emergency; may require hospitalization or surgery; risk of toxic megacolon |
Why Ulcerative Colitis Impacts More Than Digestive Health
Ulcerative colitis extends beyond the colon due to its systemic inflammatory nature and the profound gut-immune connection. Chronic colonic inflammation triggers widespread immune responses affecting joints (peripheral and axial arthritis), skin (erythema nodosum, pyoderma gangrenosum), eyes (uveitis, episcleritis), and liver (primary sclerosing cholangitis in up to 5% of patients). The damaged mucosal barrier allows bacterial products to enter systemic circulation, perpetuating inflammation throughout the body. Malabsorption and chronic blood loss lead to nutritional deficiencies, particularly iron, folate, and vitamin D, contributing to anemia, fatigue, and bone loss. The gut-brain axis dysfunction associated with ulcerative colitis contributes to the anxiety and depression commonly experienced by patients, while chronic inflammation increases cardiovascular disease and colorectal cancer risk over time.
Common Signs of Ulcerative Colitis Include
Gastrointestinal Symptoms:
- Bloody diarrhea (present in approximately 90% of patients)
- Increased stool frequency and urgency
- Rectal bleeding and mucus discharge
- Tenesmus (sensation of incomplete evacuation)
- Abdominal cramping, especially before bowel movements
- Nocturnal bowel movements disrupting sleep
- Paradoxical constipation in some patients with proctitis
Systemic Symptoms:
- Fatigue and malaise
- Unintentional weight loss
- Fever during severe flares
- Loss of appetite
- Night sweats
Complications and Severe Disease:
- Dehydration from chronic diarrhea
- Severe anemia from blood loss
- Toxic megacolon (medical emergency)
- Bowel perforation
- Increased colorectal cancer risk (especially with pancolitis)
Extraintestinal Manifestations:
- Joint pain and arthritis (peripheral and spine)
- Skin conditions (nodules, ulcerations, rashes)
- Eye inflammation (redness, pain, light sensitivity)
- Liver and bile duct complications (primary sclerosing cholangitis)
- Blood clotting abnormalities
Diagnostic Options at Whole Gut Health
Comprehensive ulcerative colitis evaluation requires thorough assessment to determine disease extent, severity, and underlying factors contributing to inflammation. At Whole Gut Health, we use advanced diagnostics to create personalized treatment protocols that address root causes alongside disease management.
Testing options may include:
Colonoscopy with Biopsy to visualize the entire colon, assess disease extent and severity, obtain tissue samples for definitive diagnosis, and differentiate from Crohn’s disease. Dr. Shustina is no longer performing colonoscopies. We will review any prior records of colonoscopies. If a colonoscopy is needed during your care. We will refer you to one of the carefully screened Gastroenterologists within our network who will perform the procedure on our behalf.
Applied Kinesiology or muscle testing to help delineate root causes and confirm precise customized treatment protocols
Comprehensive Stool Analysis with Microbiome Profiling to assess gut microbiome composition, identify dysbiotic patterns characteristic of ulcerative colitis, and measure inflammation markers including calprotectin and lactoferrin.
Inflammatory Markers and Serologic Testing including CRP, ESR, pANCA antibodies, and ASCA to help confirm diagnosis, monitor disease activity, and differentiate from Crohn’s disease.
Complete Blood Count and Nutritional Assessment to evaluate anemia severity, nutritional deficiencies (iron, folate, vitamin D, vitamin B12), and overall disease impact.
Short-Chain Fatty Acid Analysis to evaluate butyrate and other metabolite production critical for colonic health and mucosal integrity.
SIBO Breath Testing since small intestinal bacterial overgrowth is more prevalent in ulcerative colitis patients and may contribute to symptoms.
We customize testing protocols based on symptom patterns, disease history, and suspected contributing factors to ensure comprehensive evaluation and optimal treatment planning.
Our approach
Why Whole Gut Health is different
At Whole Gut Health, we go beyond conventional symptom management and traditional functional medicine protocols. We trust your body's innate ability to heal itself when given the right support.
In Dr. Shustina's many years of practice, she has seen that many digestive diseases have their root cause in emotional traumas and unhealed wounds. When these underlying causes are healed, the body can heal from the inside out in a lasting way.
We focus on the mind-gut connection, incorporating energy healing techniques, personalized nutrition that evolves as you heal, and integrative approaches addressing mind, body, and spirit. If this resonates with you, contact our office to schedule your consultation and take the first step on your healing journey.
Our Crohn’s Disease Treatment Approach
Our Three-Phase Crohn’s Resolution Protocol Includes:
Phase 1 — Assessment and Root-Cause Identification
- Comprehensive evaluation of disease extent, severity, and flare patterns
- Detailed microbiome analysis to identify characteristic dysbiotic patterns
- Dietary triggers and food sensitivities
- Gut microbiome imbalances and reduced diversity
- Short-chain fatty acid production and butyrate deficiency
- Nutritional deficiencies and their systemic effects
- Stress and gut-brain axis dysfunction
- Previous infections and antibiotic history
Phase 2 — Targeted Intervention
- Visceral Manipulation: A manual technique used to help optimize motility as well as address the mind body connection.
- Energy Medicine: A powerful technique to address the body’s vibration, the mind-gut connection and to empower the body’s unique ability to heal itself.
- Anti-Inflammatory Protocols: Strategic use of natural anti-inflammatory compounds such as curcumin, customized herbal regimens, and omega-3 fatty acids).
- Gut Microbiome Restoration: Evidence-based probiotic strains, prebiotics, and targeted interventions to restore beneficial bacterial populations and butyrate production
- Dietary Modification: Personalized anti-inflammatory nutrition plans including protocols which address dietary changes needed with improvement and flares
- Mucosal Healing Support: Targeted nutrients and compounds to restore mucosal integrity and reduce intestinal permeability
- Nutritional Repletion: Comprehensive supplementation to address iron, folate, vitamin D, and other common deficiencies
Phase 3 — Long-Term Remission and Prevention
- Standard Medical Therapies: Many patients are on medications when joining Whole Gut Health. We use these only when necessary and patients are often able to stop them safely and effectively.
- Sustained Microbiome Balance: Long-term protocols for maintaining healthy gut bacterial populations and optimal short-chain fatty acid production
- Flare Prevention: Identification and avoidance of individual triggers with early intervention protocols
- Nervous System Regulation Customized sustainable and consistent practices along personalized lifestyle changes
- Cancer Surveillance: Appropriate colonoscopy screening based on disease extent and duration
- Immune Modulation: Ongoing support for balanced immune function through nutrition, lifestyle, and targeted supplementation
- Quality of Life Optimization: Comprehensive support addressing fatigue, mental health, and extraintestinal manifestations
- Tapering of medical therapies is often possible in collaboration with patient goals
Expert-Led, Personalized Care
Dr. Alexandra Shustina is a board-certified gastroenterologist and internist specializing in complex digestive disorders, gut health, and the gut–brain connection. Drawing from both conventional gastroenterology and integrative medicine, she takes a comprehensive approach to uncovering the underlying factors contributing to illness and guides patients toward lasting wellness.
At Whole Gut Health, every patient receives highly personalized care rooted in a deep understanding of digestive health, nutrition, the gut microbiome, and the interconnected systems that influence overall well-being. By combining evidence-based medicine with a thoughtful, individualized approach, we help patients move beyond symptom management and create a clear path toward long-term healing and vitality.
Frequently Asked Questions
Common questions, answered
What is ulcerative colitis?
+
Ulcerative colitis is a chronic inflammatory bowel disease (IBD) that causes continuous inflammation and ulceration of the colon's innermost lining, always beginning in the rectum and extending proximally in a continuous pattern. Unlike Crohn's disease, ulcerative colitis is confined to the colon and doesn't involve deeper bowel wall layers. The disease results from complex interactions between genetics, immune dysfunction, environmental triggers, and gut microbiome imbalances that reduce beneficial bacteria and compromise mucosal protection.
What are the different types of ulcerative colitis?
+
Ulcerative Proctitis (E1) - 30-60% at presentation
- Inflammation limited to rectum
- Symptoms: urgency, tenesmus, rectal bleeding
- Mildest form with no increased cancer risk
Left-Sided Colitis (E2) - 16-45% at presentation
- Inflammation from rectum to splenic flexure
- Symptoms: bloody diarrhea, cramping, urgency, weight loss
- Moderate cancer risk; responds well to topical therapy
Extensive Colitis/Pancolitis (E3) - 14-35% at presentation
- Inflammation beyond splenic flexure to entire colon
- Symptoms: severe bloody diarrhea, significant pain, fatigue, fever
- Highest cancer risk; requires systemic therapy
Fulminant/Toxic Colitis
- Severe pancolitis with systemic toxicity
- Medical emergency requiring immediate intervention
What are the common signs and symptoms of ulcerative colitis?
+
Gastrointestinal: Bloody diarrhea (90% of patients), increased stool frequency and urgency, rectal bleeding, tenesmus, abdominal cramping, nocturnal bowel movements, paradoxical constipation in proctitis
Systemic: Fatigue, weight loss, fever during flares, loss of appetite, night sweats
Complications: Dehydration, severe anemia, toxic megacolon, bowel perforation, increased colorectal cancer risk
Extraintestinal: Joint pain, skin conditions, eye inflammation, liver complications, blood clotting abnormalities
How is ulcerative colitis diagnosed?
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Comprehensive evaluation includes multiple assessment approaches:
Colonoscopy with Biopsy
- Gold standard for diagnosis and disease extent assessment
- Differentiates from Crohn's disease
Applied Kinesiology
- Helps delineate root causes
- Confirms precise customized treatment protocols
Comprehensive Stool Analysis
- Assesses microbiome composition and inflammation markers (calprotectin)
Blood Testing
- Inflammatory markers (CRP, ESR) and serologic antibodies (pANCA, ASCA)
- Complete blood count and nutritional assessment
Short-Chain Fatty Acid Analysis
- Evaluates butyrate production critical for colonic health
SIBO Breath Testing
- Assesses concurrent bacterial overgrowth
What does ulcerative colitis treatment involve?
+
Our comprehensive three-phase ulcerative colitis resolution protocol includes:
Phase 1: Assessment and Root-Cause Identification
- Evaluation of disease extent, severity, and flare patterns
- Microbiome analysis for dysbiotic patterns
- Assessment of dietary triggers, nutritional deficiencies, and contributing factors
Phase 2: Targeted Intervention
- Visceral Manipulation is used to help optimize motility as well as address the mind body connection.
- Energy Medicine addresses the body’s vibration, the mind-gut connection and empowers the body’s unique ability to heal itself.
- Anti-inflammatory protocols using natural compounds and appropriate medical therapy
- Gut microbiome restoration with targeted probiotics and prebiotics
- Personalized dietary modification and trigger elimination
- Mucosal healing support and nutritional repletion
Phase 3: Long-Term Remission and Prevention
- Sustained microbiome balance protocols
- Flare prevention and early intervention strategies
- Cancer surveillance based on disease extent
- Quality of life optimization
- Tapering of medical therapies is often possible
How does gut microbiome dysfunction contribute to ulcerative colitis?
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Ulcerative colitis patients consistently show reduced bacterial diversity, decreased butyrate-producing bacteria, and abnormal microbial composition compared to healthy individuals. This dysbiosis reduces short-chain fatty acid production (especially butyrate) essential for colonic epithelial cell energy and mucosal integrity. The resulting barrier dysfunction allows bacterial products to contact immune cells, triggering the chronic inflammatory response characteristic of ulcerative colitis.
Can ulcerative colitis go into remission?
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Yes, with comprehensive treatment, most patients achieve periods of remission. The goal of modern ulcerative colitis management is mucosal healing, not just symptom control, which significantly reduces complication risk and colorectal cancer development. Our approach combines root cause healing with gut microbiome restoration, anti-inflammatory nutrition, and lifestyle modification to maximize remission duration and quality of life. Conventional medical treatment is used only when necessary.
What makes your approach to ulcerative colitis treatment different?
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At Whole Gut Health, we take a comprehensive approach to ulcerative colitis that addresses underlying factors alongside disease management:
- Focus on true root causes of the disease
- Nervous system regulation as an important part of healing the mind- gut connection
- Gut microbiome restoration as an important therapeutic target
- Integration of conventional gastroenterology with functional medicine approaches
- Personalized dietary protocols based on individual triggers and tolerances
- Comprehensive nutritional assessment and repletion
- Emphasis on sustained remission and quality of life rather than just symptom suppression
Who provides ulcerative colitis care at your practice?
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Dr. Alexandra Shustina is a board-certified gastroenterologist and internist who serves as Miami's premier gut health specialist. She has training in both conventional gastroenterology and functional gut health, with particular expertise in inflammatory bowel diseases and comprehensive gut microbiome restoration protocols.
How do I get started with ulcerative colitis evaluation and treatment?
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The first step is scheduling a comprehensive consultation where we'll:
- Review your symptoms, disease history, and current management in detail
- Assess your gut microbiome status and identify contributing factors
- Determine the most appropriate testing and treatment strategy
- Develop a personalized ulcerative colitis management plan addressing root causes alongside disease control
Contact our office to schedule your initial consultation and begin your journey toward sustained remission and optimal gut health.
Reviews
The body remembers when it's finally heard
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Dr. Shustina goes to the root level of the issue, not only superficial, so there's healing.
LG
Leah Glickman
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She has significantly improved my health. I was suffering from Ulcerative Colitis and now live normally.
ML
Monica LaBadia
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Dr. Shustina has helped me change my lifestyle and heal my gut in a way I thought impossible.
DL
Dalit Lonstein
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She listens to patients and treats conditions, not symptoms.
GS
Gabriela Salazar
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Dr. Shustina is the best doctor I have ever been to. She assesses the root of the problem.
MS
M. S.
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She is an outstanding doctor who understands the body's ability to heal itself and holistic remedies.
SS
Sibel Sebi Sharabi
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Dr. Shustina has a wealth of knowledge and is helping me heal years of gastrointestinal issues.
DC
Daniela Chaparro
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Dr. Shustina is an amazing doctor. She diagnosed my cancer early and saved my life.
MW
Mordechai Weinstein
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After one session with Dr. Shustina, my digestive pain went away.
TP
Taryn Parascand
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Doctor Shustina is the absolute best. She has helped me resolve numerous issues other doctors dismissed.
RS
Rachel S.
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Dr. Shustina is a fantastic doctor who truly cares. Her holistic approach attacks the root cause.
CS
Clay Simonsen
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