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6 Tips To Help Manage Ulcerative Colitis Flare-Ups
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:
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:
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:
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:
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:
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:
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.
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:
Recognizing factors that may trigger UC symptoms may also help you prevent flare-ups. Some common triggers of UC flare-ups include:
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.
Read this article in Spanish.
Ulcerative Colitis
Content
Colon Cancer
Although most patients with ulcerative colitis will not develop colon cancer, patients with ulcerative colitis are at a 2 to 5 fold increased risk of developing colon cancer compared to persons without ulcerative colitis. Researchers believe the increased risk of colon cancer is related to chronic inflammation in the colon. In order to detect colon cancer at an early stage, most patients with ulcerative colitis will need to undergo colonoscopies on a regular interval that is more frequent than for patients without ulcerative colitis. The risk of colon cancer may be even higher in individuals who have a condition of the liver called primary sclerosing cholangitis (PSC) or with family members who have had colon cancer. All patients with ulcerative colitis should discuss the timing and frequency of colonoscopy with their gastroenterologist.
Surgery
Most patients with ulcerative colitis will not require surgery. However, some patients may not respond to medications or have other severe symptoms that require removal of the colon. Removal of the colon is the closest thing to a "cure" for ulcerative colitis because unlike Crohn's disease, ulcerative colitis does not affect other parts of the digestive system and should not recur after complete removal of the colon. After removal of the colon, patients may require either an ostomy (bag) or reconstructive surgery, referred to as a "J-pouch" or ileal pouch-anal anastomosis (IPAA). The choice of these options is between the patient and the surgeon as each option has its' advantages and disadvantages.
Patients with ulcerative colitis may have symptoms in parts of their bodies outside of the digestive system.
Joints
There are forms of arthritis and back pain that are related to ulcerative colitis. Some of these conditions improve with medications for the digestive symptoms of ulcerative colitis. The use of over-the-counter pain medications such as ibuprofen, naproxen, and aspirin may increase the symptoms of ulcerative colitis. Patients with ulcerative colitis should speak with their gastroenterologist before using these medications.
Eyes
Some patients with ulcerative colitis develop inflammation in the eyes, called iritis or uveitis. Iritis may result in redness or eye pain and may fluctuate with the severity of the digestive symptoms of ulcerative colitis. Uveitis may result in severe eye pain and loss of vision. Patients with ulcerative colitis should see an eye doctor on a regular basis and report any changes in their vision to their doctor immediately.
Skin
There are two conditions related to ulcerative colitis, erythema nodosum and pyoderma gangrenosum. Erythema nodosum consists of painful red bumps under the skin that may develop when the ulcerative colitis flares; these lesions will often respond to the medication for ulcerative colitis. Pyoderma gangrenosum consists of skin ulcers that may form either with or without a flare of ulcerative colitis digestive symptoms.
Other Complications
Other complications of ulcerative colitis disease include kidney stones, a liver condition called primary sclerosing cholangitis (PSC), and malabsorption of vitamins and nutrients.
UC College Life
For many with ulcerative colitis, the excitement of entering college can easily be overshadowed by one huge preoccupation.Jessalyn Smiley
Bathroom…bathroom's the biggest one…Narrator
Jessalyn Smiley works for the Office of Disability Services at Emory University in Atlanta. Part of her job is to help students with chronic illnesses, like ulcerative colitis, adjust to campus life. Smiley provides practical answers to a host of student anxieties.Jessalyn Smiley
Am I going to be close enough to the bathroom If I'm living in a residence hall to get to it when I need to; when I'm in the classroom am I going to be close enough to the bathroom to get to it when I need to; how do I tell my professor if I need to go to the bathroom and I might not be coming back? These are concerns that IBD patients don't take lightly.Emily Moore
Here was the bathroom and here was my room. So and I don't know what I would have done if my room would have been much farther from the bathroom because I need to get to the bathroom.Narrator
Not to mention that confined spaces, having to sit for long periods and increased social and academic demands can all ramp up the stress—which can sometimes trigger a flare.Jessalyn Smiley
A lot of the times, our students coming in are aware of how they need to take care of themselves. That part's usually not the area that trips them up. It's usually…I've introduced new foods into my diet that weren't there before. I've introduced new germs, to my body, that weren't there before. I'm not sleeping…I'm trying to do all of my school work plus all of the fun extra-curricular things.Narrator
Students with IBD should start preparing for college-life almost from the moment they get the acceptance letter.Jessalyn Smiley
First and foremost would be to contact your university. Find out what type of documentation they're going to need from your healthcare provider.Narrator
This legitimizes a student's condition and opens the door for school counselors to help the student plan a curriculum that's not too heavy, provide adequate dorm accommodations, or make allowances for specialized meals, if necessary. Many schools, like Emory, have protocols in place to help students navigate potentially thorny or embarrassing situations during long exams and lectures periods.Jessalyn Smiley
The student works out with their professor a little signal. So the professor knows that they're leaving and that they may not be returning. The professor doesn't know why. We let the students decide how much or how little they're going to tell their professors, but as an accommodation we let the professors know that the student may need to leave suddenly from the lecture and they may not return.Narrator
New students should learn the layout of their campus so they not only know where the bathrooms are in relationship to their classes, but where the student clinic is as well. It's also recommended that students find a local gastroenterologist should more specialized care become necessary.Jessalyn Smiley
Cause it's hard for you to maintain your health when you're out of state and your doctor's at home and you have a flare or something's going on and you're here.Narrator
For WebMD, I'm Damon Meharg.","publisher":"WebMD Video"} ]]>
Hide Video Transcript
Narrator
For many with ulcerative colitis, the excitement of entering college can easily be overshadowed by one huge preoccupation.Jessalyn Smiley
Bathroom…bathroom's the biggest one…Narrator
Jessalyn Smiley works for the Office of Disability Services at Emory University in Atlanta. Part of her job is to help students with chronic illnesses, like ulcerative colitis, adjust to campus life. Smiley provides practical answers to a host of student anxieties.Jessalyn Smiley
Am I going to be close enough to the bathroom If I'm living in a residence hall to get to it when I need to; when I'm in the classroom am I going to be close enough to the bathroom to get to it when I need to; how do I tell my professor if I need to go to the bathroom and I might not be coming back? These are concerns that IBD patients don't take lightly.Emily Moore
Here was the bathroom and here was my room. So and I don't know what I would have done if my room would have been much farther from the bathroom because I need to get to the bathroom.Narrator
Not to mention that confined spaces, having to sit for long periods and increased social and academic demands can all ramp up the stress—which can sometimes trigger a flare.Jessalyn Smiley
A lot of the times, our students coming in are aware of how they need to take care of themselves. That part's usually not the area that trips them up. It's usually…I've introduced new foods into my diet that weren't there before. I've introduced new germs, to my body, that weren't there before. I'm not sleeping…I'm trying to do all of my school work plus all of the fun extra-curricular things.Narrator
Students with IBD should start preparing for college-life almost from the moment they get the acceptance letter.Jessalyn Smiley
First and foremost would be to contact your university. Find out what type of documentation they're going to need from your healthcare provider.Narrator
This legitimizes a student's condition and opens the door for school counselors to help the student plan a curriculum that's not too heavy, provide adequate dorm accommodations, or make allowances for specialized meals, if necessary. Many schools, like Emory, have protocols in place to help students navigate potentially thorny or embarrassing situations during long exams and lectures periods.Jessalyn Smiley
The student works out with their professor a little signal. So the professor knows that they're leaving and that they may not be returning. The professor doesn't know why. We let the students decide how much or how little they're going to tell their professors, but as an accommodation we let the professors know that the student may need to leave suddenly from the lecture and they may not return.Narrator
New students should learn the layout of their campus so they not only know where the bathrooms are in relationship to their classes, but where the student clinic is as well. It's also recommended that students find a local gastroenterologist should more specialized care become necessary.Jessalyn Smiley
Cause it's hard for you to maintain your health when you're out of state and your doctor's at home and you have a flare or something's going on and you're here.Narrator
For WebMD, I'm Damon Meharg.
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