On July 28, 2023, Rosie White, a two-time Olympian and former professional soccer player, shared her experience with ulcerative colitis, a condition that drastically impacted her athletic career. At 19 years old, she began experiencing symptoms during an international soccer game, including blood in her stool and severe cramps. Despite initially dismissing her symptoms as a stomach bug, White’s condition worsened and interrupted a career milestone game. It took several doctors and years of frustration before she received a proper diagnosis and medication.
Ulcerative colitis, a type of inflammatory bowel disease, causes irritation, inflammation, and ulcers in the colon lining. The symptoms, such as diarrhea, cramps, pain, and fatigue, can be debilitating and often require careful management. Unfortunately, diagnosing the condition is challenging, and patients may linger for months or years without proper treatment.
White, like many others with ulcerative colitis, initially felt embarrassed discussing her condition due to the nature of the symptoms. However, she emphasized the importance of education, gathering accurate information, and building a support network. Waiting too long for help can lead to worsening symptoms and hospitalization, as White experienced.
Diet plays a significant role in managing ulcerative colitis as well. Good nutrition and healthy eating can improve the response to medication and reduce inflammation. A diet rich in variety, including fruits, vegetables, proteins, and omega-3 fatty acids, is recommended. Individuals should also be aware of their specific trigger foods and make appropriate choices to avoid exacerbation of symptoms.
Stress also plays a crucial role in gut inflammation, with many patients experiencing depression and anxiety. Addressing mental health is vital in managing ulcerative colitis. Open communication with loved ones, seeking support, and cultivating a positive relationship with healthcare professionals can help alleviate stress.
Despite the challenges she faced, White remains optimistic. She has transitioned from the soccer field to a career in television and serves as a spokesperson for Bristol-Myers Squibb. With medication, support, and a well-developed ulcerative colitis toolbox, White has taken control of her condition and continues to thrive.
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July 28, 2023: What’s the first thing that comes to mind when you hear the term “game changer”? For two-time Olympian, three-time Women’s World Cup finalist and former professional soccer player Rosie White, it’s a condition called ulcerative colitis, and it would be an acquisition neither she nor her teammates anticipated.
“I was playing college soccer at UCLA and also playing for the New Zealand national team, and I started getting symptoms during an international game,” White said. “And I thought he was sick, had diarrhea, or had eaten something weird.”
“There was blood in my stool and I was like, ‘This is not normal; this is not something I have experienced before.”
At the time, White was 19 years old, an age at which ulcerative colitis commonly arises. The disorder is a type of inflammatory bowel disease (IBD) that causes irritation, inflammation, and holes (ulcers) in the lining of the colon. For many, ulcerative colitis haunts and colors every part of life. The symptoms, which can include severe diarrhea, intestinal urgency, cramps, pain and fatigue, can literally stop people or, in White’s case, interrupt a pivotal 100th career-marking celebratory game with the New York Ferns. Zealand.
“It was supposed to be a great time to celebrate,” White said.
Instead, “it was probably the worst I’ve ever felt playing a game of football before. I remember collapsing after 90 minutes and the team doctor had to carry me off the field. I lay on the locker room floor for an hour, trying to stop the cramps in my stomach.”
Doing Doctor Shuffle
Ulcerative colitis is a condition with no known exact cause. Although researchers continue to advance their understanding, diagnosis can be difficult.
“The general idea is that it’s a condition with a genetic predisposition, but genetics alone don’t explain it because so many generations are lost,” said Dr. Victor Chedid, an IBD gastroenterologist at the Mayo Clinic in Rochester. MN. . “Environmental factors are also important components; I would not rule out diets and dietary changes, we know that many processed foods and sugars can be pro-inflammatory. And I wouldn’t rule out stress, which can trigger or increase the inflammatory load.”
Along with general symptoms like diarrhea and cramps, these things make a late diagnosis more likely.
Chedid noted that it can often take months, if not years, for patients to finally reach the right doctor’s office and get the correct diagnosis, an experience White knows all too well.
“I ended up seeing several different doctors to talk about what was going on,” she explained. “I remember getting really frustrated because I think I saw two or three different GPs because I was jumping, traveling with the New Zealand team. And everyone was like, ‘Everything looks healthy,’ and they weren’t concerned at all.”
It wasn’t until she saw another doctor at the school in Los Angeles, who finally recommended seeing a specialist, that she finally received a diagnosis and medication to help manage her symptoms.
A topic that no one wants to talk about
Like many ulcerative colitis patients, White recalled that for a long time she was “very embarrassed” about her condition.
“It’s a really hard thing to talk about. Nobody wants to talk about their poop and bowel movements,” he said, also noting that in the beginning he spent a lot of time putting out fires whenever his condition worsened.
A key missing piece of the puzzle was education. Not only did she find herself looking for information in all the wrong places, but in retrospect, she wishes she had more people around her who knew what she was going through to support her.
“I didn’t talk about it for 5 years. And what I learned the hard way is that the longer you wait, the worse your symptoms become and the more difficult to control. And I ended up in the hospital for a week and a half because I didn’t get help fast enough,” White said.
His advice to others?
Find a website that has great information, find treatment options that support your lifestyle, and get your family, friends, and support network involved and aligned.
The role of diet
“When I think about the tools I give patients to help and empower them to achieve remission from their disease, medicine is only one; another is that we have to put you in a program of good nutrition or better, of healthy eating”, said Chedid.
Kelly Issokson, a registered dietitian and certified nutrition support clinician who specializes in gastrointestinal issues at Cedars-Sinai Medical Center in Los Angeles, said one of the first questions patients ask is what they can eat.
“Nutrition is very important for the management of IBD,” he explained. “It helps improve the response to medications that help control IBD and…in managing the disease, there are certain diets or food components that we can recommend to decrease inflammation.”
Fortunately, White was following the correct diet and nutrition from the start. Although his journey included a brief stint on a doctor-recommended vegetarian diet and included trying “every diet in the book,” as a professional athlete, he had long relied on whole, unprocessed foods and avoided things like sugar and alcohol.
Issokson said that in general, people with ulcerative colitis should eat a diet rich in variety, including many food groups and sources, such as different types of fruits and vegetables and different proteins. These are parts of the Mediterranean diet, which, Chedid noted, has been shown to have fewer pro-inflammatory foods than the traditional American diet.
“There are certain things that we know about food components and how they affect ulcerative colitis in particular,” Issokson added. “We know that omega-3 fatty acids are really important to consume, not only in supplement form, but also in food form because they help control disease activity and have an anti-inflammatory effect.”
And people need to be aware and acknowledge how they feel.
“People with active disease are going to have different nutritional needs than people whose disease is in remission,” Issokson said. For example, people may have less appetite or certain gastrointestinal symptoms and may do better with small, frequent meals to decrease urgency and diarrhea.
And for people with specific trigger foods like lactose, a sugar found in dairy, Issokson advises patients to choose plain yogurt, aged cheeses, or even nondairy plant milk.
Other triggers may include sugary foods and drinks (which can worsen urgency and diarrhea) or certain medications such as prednisone (which can increase blood sugar).
Stress and Inflammation
There is a direct link between mental health and inflammation in the gut, a key reason why addressing mental health is an important part of the ulcerative colitis toolbox.
Laurie Keefer, PhD, an IBD psychologist at the Icahn School of Medicine at Mount Sinai in New York City, said about a quarter of patients with ulcerative colitis have depression and about a third have anxiety, often together and within 1 to 2 years of diagnosis. Both precede or develop as a result of things like isolating yourself from family and friends, or avoiding traveling or leaving home for fear of having an accident.
“I always describe it as a background app that tracks your location, even if you don’t need it. And that leads to fatigue,” she said.
“I think it’s a big, big part of this disease,” White said of the mental health connection. “Physically, your body is going through a lot. But also emotionally, the symptoms themselves cause a lot of stress because you’re always worried about where the bathroom is, when you have to go, stuff like that.”
For White, being open and honest with her family, friends and others in her circles, and having a good relationship with her doctor, helped her break down the stress barrier. These steps are an important part of what Keefer described as acceptance-based work.
“We do a lot with self-compassion and gratitude, telling our patients to give grace, to treat themselves like you would a friend who was talking to you about the same symptoms,” Keefer said. behavioral component, which [helps] people ‘de-catastrophize’ the meaning of the facts; we try to change the positive and make people feel more optimistic.”
Speaking of optimism, White is the epitome, and his outlook is optimistic. Now that she’s 30, she’s traded the soccer field for the TV microphone, is a spokeswoman for Bristol-Myers Squibb, and has her ulcerative colitis toolbox under control: medication, support, and a good relationship with her doctor. .
On or off the field, she has definitely become the version of herself that she has fought for for a long time.
“Learning to be the best advocate for yourself is key,” he said.
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