Ulcerative colitis typically varies between periods when the disease is active, or flaring up, and when it is in remission (few or no symptoms). UC is experienced differently by each person, and can be progressive, so over time, your symptoms could get worse or change altogether.
An ulcerative colitis (UC) flare-up may cause frequent or urgent bowel movements, diarrhea, bloody stool, and/or abdominal pain. You may also experience fatigue, lack of appetite, and weight loss. You should talk to your doctor any time you are experiencing symptoms or worsening of symptoms. Having a restroom request card on hand can be helpful when unexpected symptoms arise.
What can affect ulcerative colitis flares?
There are many factors that can have an effect on ulcerative colitis symptoms:
Skipping doses or taking the wrong dose of your medication
If you have symptoms and are taking your treatment as prescribed, talk to your doctor about changing your dose, frequency, or type of medication.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs such as aspirin, naproxen, and ibuprofen may irritate the bowel, which can cause symptoms to flare up. Check with your doctor if you’re able to take acetaminophen instead for fever or mild pain.
Antibiotics treat bacterial infections, but can also change the balance of intestinal bacteria, which can cause diarrhea. Tell your gastroenterologist if you experience a flare while taking antibiotics.
When some people with ulcerative colitis stop smoking, it can cause a flare-up. However, as you probably know, smoking carries many health risks and therefore is not recommended that people with UC smoke.
Because stress can affect ulcerative colitis symptoms, it may help to learn some stress-management techniques such as yoga or meditation.
Foods that irritate your gastrointestinal (GI) tract
Even though there is no evidence that food causes ulcerative colitis, certain foods can impact your symptoms. Keeping a food diary can help you determine which foods to avoid based on your experience—and consulting with your doctor and/or a dietitian can help you plan a diet that works for you.
Managing ulcerative colitis flares
Here are a few tips that may help you handle ulcerative colitis flare-ups better:
Take medications as prescribed
As your doctor may have told you, it’s important to take your current treatment exactly as prescribed even if you are feeling better. Although managing ulcerative colitis is more than just taking medicine, the best way to handle ulcerative colitis symptoms and flare-ups is to find an effective treatment plan. Many people can keep UC in remission (sustained relief from symptoms) with the medications that are right for them.
Corticosteroids (Steroids)Given orally, as an injection, rectally, or intravenously, these medications help reduce inflammation by suppressing the immune system and are usually given to help with moderate to severe Crohn’s and ulcerative colitis symptoms. Steroids are not intended for long-term use. are often prescribed to treat flare-ups. However, they are best suited for short-term control of symptoms, and should not be used for long periods of time. If not used appropriately, patients can become steroid dependent or resistant.
See your doctor regularly
It’s likely that your gastroenterologist will expect to see you for regular checkups, and you should also reach out to your doctor whenever you have concerns or if you need help managing a UC flare. Establishing a good relationship with your doctor can help you be honest about your symptoms and how they affect you so that your gastroenterologist can determine which treatment is best for you.
Turning to your healthcare team (nurses, a nutritionist, a social worker or psychologist) for guidance can also help you manage ulcerative colitis. Keep in mind that your healthcare team is there to work with you on your treatment as well as your overall well-being.
Establish a support system
Sharing what life’s like with ulcerative colitis with your family and close friends will help them understand what you may be going through. Don’t be afraid to ask for support when you need it.
Keep up with regular tests
Diagnostic tests and/or procedures can help you identify many treatment side effects or signs of disease progression. Check with your doctor about how often you should get them.
Focus on a healthy diet
There’s no such thing as one appropriate diet for all people with ulcerative colitis. But getting proper nutrition is essential to help reduce the effects of UC. Talk to your doctor or with a dietitian or nutritionist to help you figure out your own diet plan and whether you may need to take vitamin and/or mineral supplements.
Refocusing the mind
Brandi Chastain, world-renowned soccer player and IBD caregiver, talks to IBD psychiatrist Dr. Eva Szigethy about ways to enhance emotional wellness and the importance of having social support.
Eva Szigethy, Ph.D., M.D., M.S., is a Professor of Psychiatry, Medicine and Pediatrics at the University of Pittsburgh School of Medicine. She specializes in the psychological impact of chronic digestive diseases.
Here are some other ways you can help reduce ulcerative colitis flares:
Talk to your doctor about setting up an exercise plan that works for you.
Control your stress levels
Find ways to stay calm by trying stress-management techniques that can help.