Living with moderate to severe ulcerative colitis can be challenging. Flare-ups can happen even when you’re following your doctor’s orders. Managing your symptoms through medication and effective home remedies can greatly improve your quality of life and possibly prevent future flare-ups.


Moderate to severe ulcerative colitis can cause a variety of uncomfortable and sometimes debilitating symptoms, including:

  • urgent bowel movements
  • frequent bowel movements
  • abdominal pain and cramping
  • diarrhea
  • nausea
  • bloody stools
  • pus in stools
  • fever
  • rapid heartbeat
  • iron deficiency and anemia


Medication can reduce inflammation in the colon and allow it to function properly. This can keep symptoms at bay for months at a time. Sometimes a trigger or another unknown factor can cause the inflammation to return.

Avoiding your triggers is the best way to prevent flare-ups. The most common triggers include:

  • stress
  • upsetting situations
  • certain foods
  • skipping medication or incorrect dosing
  • non-steroidal anti-inflammatory drugs (ibuprofen, naproxen)
  • smoking

Finding what triggers a flare-up is crucial to managing your condition. It can be helpful to keep a food journal to document what you eat and how it affects you. Everyone is different, so what triggers a flare-up in someone else won’t necessarily be an issue for you.

It’s important to see your doctor when you have a flare-up or develop new symptoms. Flare-ups can indicate that it’s time for a new medication or surgery. Changes in symptoms can also be the result of a new complication or a different medical issue altogether.

Managing Symptoms Through Diet

Besides following your doctor’s advice and taking your medication as prescribed, you can also make some changes to your diet to help you manage your symptoms.

You should:

  • Avoid eating any foods that are triggers for you.
  • Avoid foods known to aggravate the gut, such as artificial sweeteners, fatty foods, and lactose.
  • Limit foods that are hard to digest. This includes nuts, seeds, popcorn, and raw fruits and vegetables.
  • Keep fluids to a minimum during meals, and drink after you eat.
  • Eat smaller, more frequent meals.
  • Avoid eating foods like caffeine, beans, and prunes. They can increase stool output.

While you should limit or avoid certain foods, you still need to make sure that you’re getting enough nutrients. Talking with your doctor or a nutritionist can help you get the nutrition you need while adjusting your diet to manage symptoms.


Supplements can prevent or correct deficiencies that may worsen symptoms and lead to complications. You may be at risk of not getting the right nutrition if you limit your diet because of symptoms, eat less because of a loss of appetite, and/or have frequent bouts of diarrhea. Taking a daily multivitamin can help you get the nutrition you need while symptoms are present.

There are several supplements that can help you manage the various symptoms of ulcerative colitis. For example:

  • Vitamin C. Vitamin C is an antioxidant that promotes tissue healing. Higher amounts have been found to have a protective effect and may lead to longer remission intervals.
  • Iron. Iron deficiency anemia is common in those with moderate to severe ulcerative colitis from rectal bleeding (blood in stool). Taking an oral iron supplement may be essential.
  • Omega-3 fatty acids. They’re known to reduce symptoms and may prevent flare-ups.
  • Folic acid. Adding a folic acid supplement is beneficial if you take sulfasalazine, a medication that has been found to lower levels of folic acid.
  • Probiotics. Also known as “good bacteria,” they may help reduce symptoms and improve gut health.


Research about the role of exercise in ulcerative colitis is ongoing. In 2013, researchers at the University of Illinois found that when exercise was performed freely and without stress, it reduced the inflammation and symptoms in mice that had been given an agent for ulcerative colitis symptoms.

Exercise has been shown to reduce stress and anxiety, which are common triggers of ulcerative colitis. Physical activity also has a positive impact on overall health.

As with any chronic condition, it’s important to consult a doctor before starting an exercise regimen.

Having moderate to severe ulcerative colitis can be unpleasant, but there are steps you can take to make the condition less irritating.