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