Some tips to help you manage ulcerative colitis flare-ups may include exercising, reducing stress, taking medication, and keeping a food journal, among others.

Ulcerative colitis (UC) is an unpredictable and chronic inflammatory bowel disease (IBD).

Flare-ups are periods when your symptoms return or get worse. If you’re living with mild UC, flare-ups may get better on their own by avoiding common triggers, reducing stress, and exercising.

However, if you have moderate to severe UC, you may always experience some degree of symptoms. Following a treatment plan that includes medication may be the best way to help keep your symptoms under control.

Keep reading to discover 6 tips that could help you manage UC symptom flare-ups and improve your quality of life.

Writing down everything you eat and drink in a food journal may help you identify items that could trigger flare-ups.

For example, you may notice a pattern whereby eating a particular food triggers flare-ups. In this case, try removing the suspected food from your diet for a few days to see if your symptoms improve.

According to the Crohn’s and Colitis Foundation, some common trigger foods for UC include:

  • whole grains
  • nuts and seeds
  • raw, unpeeled, and unseeded fruits and vegetables
  • cruciferous vegetables
  • lactose
  • gluten
  • spicy, fried, or highly processed foods
  • added sugars
  • alcohol
  • caffeinated drinks, such as coffee

After removing the foods from your diet for a few days, slowly reintroduce them back in. If you experience another flare-up, you may want to eliminate these foods from your diet altogether.

That said, it’s important to speak with a healthcare professional before eliminating too many foods. Diet restriction may lead to nutrient deficiencies. This may increase your risk of complications like osteoporosis and anemia.

Researchers have not yet found that specific foods cause or worsen UC. However, health-promoting diets appear to help reduce the risk of developing the disease and support your gut microbiome.

Eating a low fiber diet during a flare-up may provide symptom relief. Fiber contributes to bowel regularity, health, and consistency. However, too much fiber could be hard to digest, which may worsen your UC flare-ups.

During a flare-up, stick to foods that have no more than 2 grams of fiber per serving. Low fiber foods can include:

  • refined carbohydrates like white rice, white pasta, and white bread
  • fish
  • lean proteins
  • eggs
  • tofu
  • butter
  • juice with no pulp

Instead of eating raw vegetables, steam, bake, or roast them to help lower the amount of fiber.

A low fiber diet is only recommended during flare-ups for a short period. During remission, eating fiber may help improve your gut health. Research also suggests that low fiber diets are associated with UC development.

Eating smaller, more frequent meals may help improve symptoms that occur after eating three large meals daily.

A 2021 review notes that when eating smaller meals, guidelines suggest choosing nutrient-dense items that provide higher energy.

A 2023 review suggests that low to moderate exercise may have several health benefits for people living with UC. These may include reducing inflammation, as well as improving:

  • cardiovascular fitness
  • quality of life
  • gut microbiome
  • sleep
  • stress, anxiety, and depression associated with UC

The authors also suggest that high intensity exercise may be beneficial. However, more research is needed.

For the best health benefits, it’s important to make exercise part of your routine. For example, a 2019 review suggests that the anti-inflammatory effect of exercise depends on the FITT principle, which includes:

  • Frequency: Aim to exercise 3–5 times per week.
  • Intensity: Choose moderate intensity exercise that increases your energy expenditure.
  • Time: Exercise for at least 30 minutes per day.
  • Type: Work up to a mix of endurance and resistance exercises to use all big muscle groups.

Some low to moderate intensity exercises for UC include swimming, biking, yoga, and walking.

Research suggests that stress may trigger or worsen a UC flare-up. This may be because stress hormones affect your digestive tract, which could:

  • cause gastrointestinal inflammation
  • prevent stomach emptying
  • accelerate colon movement

Managing stress levels may help lower your body’s inflammatory response and help you overcome a flare-up sooner. Some ways to help relieve stress include:

  • journaling
  • deep breathing exercises
  • meditation
  • exercise, such as yoga
  • learning how to say “no” when feeling overwhelmed
  • getting quality sleep
  • eating a well-balanced diet
  • staying hydrated
  • reducing or eliminating alcohol, caffeine, sugar, and carbonated drinks from your diet

Speak with a doctor if these lifestyle changes don’t improve your stress levels. They could help develop a treatment that may include medication or counseling, such as cognitive behavioral therapy (CBT). CBT may help you recognize negative thought patterns and behaviors and teach you strategies to manage stress.

UC causes inflammation and ulcers in the colon. Symptoms of UC may improve with proper treatment and avoiding triggers. However, without treatment, UC may lead to life threatening complications, such as:

  • bowel perforation
  • colorectal cancer
  • toxic megacolon

Treatment options for UC may include:

Repeated flare-ups are a sign that your current treatment plan may not be working properly, so speak with a doctor to discuss adjusting your medication.

The only way to definitively treat UC is to have surgery.

The most common type of UC surgery is the proctocolectomy. This involves the removal of the rectum and colon, which is why UC cannot return.

You may require UC surgery if you:

  • have sudden or severe disease
  • have a perforated colon
  • are at risk for colorectal cancer
  • are unable to tolerate UC medications due to side effects
  • have stopped responding to UC medications

Recognizing factors that may trigger UC symptoms may also help you prevent flare-ups. Some common triggers of UC flare-ups include:

  • skipping or forgetting to take your UC medication
  • taking certain medications for other conditions, such as antibiotics
  • stress
  • hormonal changes
  • eating certain types of foods

How long should an ulcerative colitis flare last?

The duration, severity, and onset of a UC flare-up varies for each person. These periods may be followed by remission, which could last up to several months.

How do you calm the inflammation of colitis?

Some ways to help you reduce inflammation caused by UC include eating a low fiber diet, exercising, and taking certain medications, such as aminosalicylates, biologics, and corticosteroids

How do you stop the urgency of colitis?

The authors of a 2023 review suggest that bowel urgency requires a multifaceted treatment approach. However, some medications that help reduce inflammation and affect rectal hypersensitivity may help slow down the urgency.

It’s possible to improve symptoms of UC and achieve periods of remission through diet and lifestyle changes if you have mild UC. However, if you have moderate to severe UC, taking your medication as directed is key to preventing any flare-ups.

Taking quick action during a flare-up may help return your condition to a more manageable state.

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