Ulcerative colitis (UC) is an inflammatory bowel disease. According to the Crohn’s and Colitis Foundation of America, it affects an estimated 900,000 people in the United States. This disease causes inflammation in your colon and rectum, and ulcers in the lining of your intestine.

Your doctor plays a big role in your treatment plan, so it’s critical to have an open dialogue and mention your concerns on follow-up appointments. These should involve more than getting a refill order for prescriptions. This is your opportunity to ask questions and speak up about your general health. It’s also important to discuss your daily routine on these appointments.

Other than surgery, there isn’t a cure for UC. But several therapies can minimize the impact this disease has on your life. So you need to tell your doctor how UC is really affecting you.

A UC diagnosis not only affects your physical health, but also your daily routine. People living with mild UC may have fewer flare-ups, and the disease may rarely interrupt their life. It’s a different story if you have moderate to severe UC. Here are ways UC can affect your daily routine:

Inability to attend work or school

Frequent diarrhea and abdominal pain can cause missed days from work or school. You may fall behind on classwork if you miss too many days from school, or lose pay if you miss too many days from work.

Difficulty sleeping

Frequent bowel activity and abdominal pain can keep you awake at night and make it difficult to fall asleep. Lack of sleep can raise your stress levels, which may worsen flare-ups and contribute to daytime tiredness.

Tendency to skip meals

If your symptoms get worse after eating, you may find yourself skipping meals to avoid a flare-up. Abdominal pain can also cause loss of appetite and weight loss.

Fear of public places

UC is an unpredictable disease. You may stray away from public places or miss out on special events because you’re anxious about an attack.

Inability to exercise

Exercise may ease symptoms of UC and offer other health benefits. Regular activity can strengthen your immune system and boost your mood. But some exercises use your stomach muscles and put pressure on your gastrointestinal tract. This can trigger symptoms and worsen flare-ups.

Sexual problems

Although it’s possible to have a healthy, active sex life with UC, this disease can affect sexual intimacy. Worries of incontinence or abdominal pain can reduce your interest in sex. Because UC can have a major physical impact on your body, you may also lose interest in sex due to fatigue or low energy. Chronic intestinal bleeding caused by UC increases the risk of anemia, which can contribute to low energy.

A strong relationship with your gastroenterologist is essential to your recovery. With proper treatment, UC can go into remission. Don’t be anxious about discussing your symptoms with your doctor or how this disease interrupts your life. Your doctor can’t properly treat the illness until you explain how it’s really affecting you.

The severity of your UC symptoms can change over the years. You may have had mild symptoms — classified by no more than four loose stools a day and otherwise feeling well — when you first received a diagnosis. As a result, your doctor likely recommended a treatment intended for patients with mild UC. Providing information about your daily routine and your symptoms can help your doctor assess whether your current treatment plan is working or you need to switch to a different type of therapy.

Your doctor may first prescribe aminosalicylates (anti-inflammatories) and recommend over-the-counter anti-diarrheal medication. If your condition becomes moderate or severe and doesn’t improve with this therapy, a corticosteroid or an immunosuppressant drug may reduce inflammation and induce remission.

You’ll follow up with your doctor after a few weeks to discuss your progress. If the disease continues to affect your daily routine, you may be a candidate for biologics. This is a type of therapy that targets the proteins responsible for causing inflammation in your intestines.

In severe cases of UC, surgery may be necessary to remove your colon and rectum. Your doctor may recommend surgery if you have more than 10 loose stools a day, require a blood transfusion for severe intestinal bleeding, or have life-threatening complications. Depending on the type of surgery, you may have an external bag attached to the outside of your abdomen to collect waste.

Although UC can be challenging at times, it’s possible to enjoy life to the fullest. Finding the right treatment for UC can help you achieve and stay in remission. Be honest with your doctor and explain how UC affects your life. The more your doctor knows about your daily routine and your health, the easier it’ll be to recommend a therapy that can provide long-term relief and heal your colon.