Creating a stronger, healthier gut microbiome can go a long way toward reducing symptoms and preventing flares.
With inflammatory bowel disease (IBD) conditions such as ulcerative colitis and Crohn’s disease, flare-ups can sometimes seem to come out of nowhere, no matter what you’ve been eating.
Not only can that be frustrating and limit your activities, but it can also make management more difficult, says Ashkan Farhadi, MD, a gastroenterologist at MemorialCare Orange Coast Medical Center in California.
“IBD is notorious for flares,” he says. “But even if you’ve had a history of sudden onset, there are ways to reduce their frequency and intensity, and it starts with focusing on a healthy gut microbiome.”
Also called your gut flora, the microbiome is made up of all the microbes in your intestines, including bacteria, viruses, and fungi.
While some have a negative impact, many are crucial for a range of functions, from heart health to emotional responses.
Keeping the “good guys” healthy can affect your whole system, not just your digestion, and it’s key for lowering inflammation and improving immune response — which play a major role in IBD.
Here are some ways to boost the happiness of your flora.
“It’s hard to overstate the importance of sleep for IBD, and I often see people who struggle with sleep issues having more flare-ups,” he says. “Your gut needs rest as much as you do; it’s how it maintains proper function.”
Start with creating a bedtime routine, like limiting screen time for at least half an hour before sleep, going to bed and waking up at the same time every day — yes, even on the weekends — and avoiding foods in the evening that tend to give you trouble.
Much like skimping on sleep, being sedentary can be tough on your gut microbiome, says Farhadi. And much like getting quality sleep can improve function, regular exercise provides a breadth of advantages.
Even during flare-ups, gentle exercise like a slow yoga flow can help symptoms fade and improve gut function, says UK-based movement and mobility coach Luke Jones, CPT, who also has Crohn’s disease.
“Even 15 to 20 minutes of simple stretches and focused movement can be helpful,” he says. “And when you’re not having a flare-up, doing more intense exercise can act as a great way to get a healthier gut overall.”
One reason that exercise is so powerful for gut health is that it helps lower stress, says Rudolph A. Bedford, MD, a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, California.
Stress and inflammation are very closely associated, which means feeling overwhelmed, anxious, and frazzled can not only
“Chronic stress is tough on your gut microbiome,” he says. “That’s why it’s worth the effort to find as many ways as possible to keep stress levels in check — and prevent it from occurring in the first place.”
In addition to regular activity and good sleep, stress prevention might include:
- putting a gratitude practice into place
- walking outside in fresh air
- doing deep breathing exercises
- taking mini-meditation breaks throughout the day
- keeping a journal
Diet already plays a huge role in the management of IBD, and it also has a significant impact on your gut microbiome, says Bedford.
However, some food choices geared toward general gut health improvement may not work well for those with IBD, he adds. For example, fermented foods and dairy — such as probiotic-rich yogurt and sauerkraut— are often recommended for boosting good bacteria, but may be problematic when you have Crohn’s or ulcerative colitis.
What tends to be less challenging and hugely helpful is fruits and vegetables, Bedford says. Particularly if they’re prepared in a way that is gentle to the gut — such as lightly steamed or baked. Vegetables offer vitamins, minerals, fiber, enzymes, and even protein.
Just as sleep deprivation, being sedentary, and living with chronic stress can all have a negative effect on your gut microbiome, loading up on sugary foods can also be tough on your beneficial bacteria, says Maria Zamarripa, RD, a functional medicine dietitian.
“Sugar can increase inflammation, and for someone with IBD, this can exacerbate the condition,” she says. “This can also cause the ‘bad’ bacteria to thrive, which creates an imbalance in your microbiome.”
This doesn’t apply to the natural sugars found in fruits, whole grains, and dairy, but the added sugars you find in processed foods, she says. Those can be seen not just in sugary dessert foods, but also in less likely products, such as condiments, pasta sauce, beverages, and other choices.
Zamarripa suggests checking labels when you shop for terms like corn syrup, cane juice, sucrose, rice syrup, and other sweeteners.
In general, all of these strategies are helpful for everyone, not just those with IBD. But they can be especially nourishing for those who have Crohn’s or ulcerative colitis, since creating a stronger, healthier gut microbiome can go a long way toward reducing symptoms and preventing flares.
Elizabeth Millard lives in Minnesota with her partner, Karla, and their menagerie of farm animals. Her work has appeared in a variety of publications, including SELF, Everyday Health, HealthCentral, Runner’s World, Prevention, Livestrong, Medscape, and many others. You can find her and way too many cat photos on her Instagram.