Hydroxocobalamin Approach for Reducing of Calprotectin With Butyrate for Ulcerative Colitis Remission

Inclusion Criteria: 1. Age 18-75 2. Ability to give consent 3. Patients with a confirmed diagnosis of UC for \> 3 months 4. History of \> 15 cm of colonic involvement as confirmed by colonoscopy 5. Disease activity based on calprotectin \> 200 6. Allowed medications: mesalamine and sulfasalazine 7. Partial Mayo score of \> 4 for phase one or a total Mayo score \> 5 in phase 2 8. Patients with primary sclerosing cholangitis are eligible to enroll Exclusion Criteria: 1. History of uncontrolled hypertension with a systolic BP \> 140 and a systolic BP \> 90 2. Chronic kidney disease as defined by a GFR \<60mL/min 3. Impaired hepatic function (transaminases elevated \> 2.5 x ULN) unless due to PSC 4. Evidence of C. difficile - negative test result within 1 month is acceptable to confirm 5. Infectious Colitis or drug induced colitis 6. Crohn's Disease or Indeterminate colitis 7. Decompensated liver disease 8. Patients who are pregnant or breastfeeding 9. Prohibited medications: Vitamin C, prednisone, immune modulators (including but not limited to azathioprine, 6-mercaptopurine, mycophenolate mofetil, tacrolimus, cyclosporine, thalidomide, interleukin-10 and interleukin-11) and anti-TNF agents within the past six weeks 10. Use of rectal therapies 11. Patients who have a confirmed malignancy or cancer within 5 years 12. Participation in a therapeutic clinical trial in the preceding 30 days or simultaneously during this trial 13. Congenital or acquired immunodeficiencies 14. Other comorbidities including: Diabetes mellitus, systemic lupus 15. Patients with a history of kidney stones 16. Patients with a history or risk of cardiovascular conditions, including arrhythmia, long QT syndrome, congestive heart failure, stroke, or coronary artery disease 17. High likelihood of colectomy in the next 2 months