The Impact of Circadian Misalignment on Colonic Barrier Homeostasis in Ulcerative Colitis

Prior treatment

• Use of biologic or immunomodulatory medications (i.e. Infliximab, Adalimumab, azathioprine, Vedolizumab, methotrexate, etc.)
• Gastrointestinal surgery
• Chronic use of NSAIDS. A washout period of 3 weeks is needed before the subject could be enrolled into the study. Low dose aspirin is allowed.
• Chronic Alcohol use. A washout period of 3 weeks is needed before the subject could be enrolled into the study.
• Chronic use of NSAIDS. A washout period of 3 weeks is needed before the subject could be enrolled into the study.
• Chronic Alcohol use. A washout period of 3 weeks is needed before the subject could be enrolled into the study.
• Regular use of medications that affect intestinal permeability, intestinal motility and/or endogenous melatonin including metoclopramide, NSAIDs, antibiotics, beta blocker, psychotropic medication, hypnotics and exogenous melatonin products during 4 weeks prior to the study
• People who crossed more than 2 time zones in the previous month

Other illness

• Patients with other forms of colitis such as Crohn's disease (CD) or indeterminate colitis
• Other GI diseases or systemic diseases (cardiac, renal failure, cirrhosis)

Lab values

• History of drug abuse, gastrointestinal (GI) surgery, GI diseases, or systemic diseases such as renal (creatinine\>1.2 mg/dl), liver, cardiac, or diabetes (Hgb-A1c\>8%)

Other

• UC patients:
• Patient with active UC (Mayo \> 2)
• Pancolonic UC (colitis past the splenic flexure, Montreal E3))
• Shift work in the last 6 months
• Antibiotic use within last 12 weeks
• Patients who have used anti-diarrheal agents such as Lomotil or Imodium within 3 days of the study
• Prednisone use the last 30 days
• Significant Depression (score ≥ 14 BDI)
• Significant Anxiety (score ≥ 40 STAI)
• Use of probiotic supplement in last 4 weeks except yogurt.
• Intentional change in diet.
• Have children under 6 months
  • Healthy Controls:
• Antibiotic use within last 12 weeks
• Shift work in the last 6 months
• Use of probiotic supplement except yogurt in last 4 weeks.
• Atypical American diet with daily fiber ≥ 16 grams or daily saturated fat ≤ 11 grams by Food Frequency Questionnaire
• Significant Depression (score ≥ 14 BDI)
• Significant Anxiety (score ≥ 40 STAI)
• Inability to sign an informed consent form.
• Have children under 6 months

• UC patients:
• M/F, 18-50 y/o
• Inactive Disease (Mayo Score ≤ 2)
• Stable medications with no disease flares for the \> 3 months
• Left-sided UC (Montreal E1 or E2)
• Normal psychological evaluation and negative drug screen (See Below)
  • Healthy Controls:
• M/F, 18-50 y/o, age ± 3y sex, race, and BMI match with UC subject
• No clinical evidence of any medical illness
• Normal psychological evaluation and negative drug screen (See Below)