Ulcerative colitis (UC) is an unpredictable and chronic inflammatory bowel disease. Common symptoms include diarrhea, bloody stools, and abdominal pain.
Symptoms of UC can come and go throughout your life. Some people experience periods of remission where symptoms disappear completely. This can last for days, weeks, months, or years. But remission isn’t always permanent.
Many people experience occasional flare-ups, which means that their UC symptoms return. The length of a flare varies. The severity of flare-ups can also vary from person to person.
Although symptoms can become active at any time, it’s possible to lengthen the time in between flares.
Getting UC under control involves knowing how to manage the return of symptoms, and recognizing factors that can trigger a flare.
Learning how to manage UC flare-ups can help you feel better and improve your quality of life. Here are a few tips to cope:
1. Keep a food journal
Write down everything you eat and drink to identify food items that may trigger your flares. Once you notice a pattern, remove suspected problem foods or beverages from your diet for a few days to see if your symptoms improve.
Next, slowly re-introduce these foods back into your diet. If you have another flare-up, eliminate these foods from your diet altogether.
2. Limit your fiber intake
Fiber contributes to bowel regularity and bowel health, but too much fiber can also trigger UC flares.
Try to only eat foods that have 1 gram of fiber or less per serving. Low fiber foods include:
- refined carbohydrates (white rice, white pasta, white bread)
- some cooked fruits (no skin or seeds)
- juice with no pulp
- cooked meats
Instead of eating raw vegetables, steam, bake, or roast your vegetables. Cooking vegetables results in some fiber loss.
Exercise can boost your mood, ease stress, and improve anxiety and depression associated with UC. Physical activity can also suppress inflammation in the body and help you feel better.
Find what type of exercise works best for you. Even incorporating low-intensity exercises like swimming, biking, yoga, and walking can help.
4. Reduce stress
Learning how to control stress can lower your body’s inflammatory response and help you overcome a flare-up sooner.
Simple ways to relieve stress include meditation, deep breathing exercises, and setting aside time for yourself every day. It’s also helpful to set realistic goals and to learn how to say no when you’re feeling overwhelmed. You should also get plenty of sleep and eat a balanced diet.
Speak with your doctor if lifestyle changes don’t improve your stress level. They may recommend medication or seeking counseling from a mental health professional.
5. Eat smaller meals
If you have abdominal pain or diarrhea after eating three large meals a day, scale back to five or six small meals a day to see if your symptoms improve.
6. Speak with your doctor
Repeated flare-ups can indicate problems with your current treatment. Speak with your doctor and discuss adjusting your medication.
Your doctor may need to add another type of medication to your regimen. Or, they may increase your dosage to help you achieve and stay in remission.
In addition to knowing how to manage flare-ups, it’s also helpful to recognize factors that can trigger your flare-ups.
Skipping or forgetting to take your medication
UC causes inflammation and ulcers in the colon. If left untreated, this condition can lead to life-threatening complications like a bowel perforation, colon cancer, and toxic megacolon.
Your doctor will likely prescribe a medication to reduce inflammation, such as an anti-inflammatory drug or an immunosuppressant drug.
These medications ease symptoms of UC, and can also function as maintenance therapy to keep you in remission. Symptoms could return if you don’t take your medication as directed.
At some point, your doctor may discuss slowly tapering you off the medication. But you should never decrease your dosage or stop taking your medication without talking to your doctor first.
A medication you take for another condition can also trigger a flare-up. This might happen if you take an antibiotic to treat a bacterial infection. Antibiotics can sometimes disrupt the balance of intestinal bacteria in the gut and cause diarrhea.
Also, certain over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen may irritate the colon and cause a flare. This doesn’t mean you should stop taking pain medications or antibiotics. But you should speak with your doctor before taking these drugs.
If you experience stomach pain after taking an NSAID, your doctor may suggest acetaminophen to reduce pain instead. If you take an antibiotic, you may also need a temporary anti-diarrheal medication to combat possible side effects.
Stress doesn’t cause UC, but it can exacerbate symptoms and trigger a flare-up.
When under stress, your body goes into fight-or-flight mode. It releases hormones that increase your heart rate and boost your adrenaline. These stress hormones also stimulate an inflammatory response.
In small doses, stress hormones are harmless. Chronic stress, on the other hand, can keep your body in an inflamed state and worsen UC symptoms.
The foods you eat can also worsen symptoms of UC. You may have a flare-up or notice that your symptoms get worse after consuming certain types of foods, such as:
- raw fruits and vegetables
- spicy foods
- artificial sweeteners
- nuts and seeds
- fatty foods
Troublesome beverages can include milk, alcohol, carbonated drinks, and caffeinated drinks.
Foods that trigger UC flare-ups vary from person to person. Also, the way your body responds to certain foods can change over time.
It’s possible to improve symptoms of UC and achieve remission with diet and lifestyle changes. The key is identifying and avoiding any factors that may trigger your flare-ups. Taking quick action during a flare-up can then bring your condition under control.