Tips for Taming the Symptoms of Ulcerative Colitis
Just when you think you’re in control of ulcerative colitis, symptoms can rage without warning. “Flares can still occur even if ulcerative colitis has been well-controlled for a long time,” says Sara Horst, MD, a gastroenterologist at the Vanderbilt Digestive Disease Center and an assistant professor in the division of gastroenterology, hepatology, and nutrition at the Vanderbilt University Medical Center in Nashville.
It’s not always possible to pinpoint the cause of a flare, but it is crucial to do everything you can to keep ulcerative colitis in check. “Uncontrolled inflammation over a long period of time can have serious consequences, such as weight loss, fatigue, vitamin deficiencies, anemia from low iron, and even blood clots,” Dr. Horst says. To play it safe, follow these tips to keep ulcerative colitis symptoms at bay and calm them quickly when they do flare.
In an article published in the journal Clinical Gastroenterology and Hepatology in March 2012, researchers examined the impact of stress and mental health on ulcerative colitis flares. It’s thought that stress, and the hormones it triggers, affects the motility of the gut and worsens inflammation.
Horst recommends doing your best to avoid stress as much as you can and, when that’s not possible, finding healthy ways to cope with it. Try getting regular exercise and practicing a stress-relieving technique such as yoga, meditation, deep breathing, or progressive muscle relaxation.
Take Your Meds
Your ulcerative colitis medications aren’t just meant to soothe symptoms when they strike, but to also keep them from flaring. Continue to take medications as prescribed by your doctor, even in periods of remission, says Nancy McGreal, MD, an adult and pediatric gastroenterologist at Duke University Medical Center in Durham, N.C. “Research shows that people with ulcerative colitis who miss more than 20 percent of their weekly medication dosages are more prone to flares,” Dr. McGreal says, citing the results of a study published in the January 2003 issue of the American Journal of Medicine. “Daily medication compliance is key to maintaining ulcerative colitis remission.”
Just as taking your ulcerative colitis meds is a must, so is skipping over-the-counter drugs that can aggravate your condition. Nonsteriodal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are major culprits. “These medications inhibit prostaglandins, lipid compounds which protect the gut lining against injury,” McGreal says. “Taking them disrupts the protective prostaglandins in the gut and can trigger flares.” Antibioticscan also be problematic, so be sure your doctor knows about your ulcerative colitis before he or she prescribes an antibiotic.
Check Your Diet
Foods affect everyone differently, so there’s no strict ulcerative colitis diet for all people with ulcerative colitis. However, alcohol, raw fruits and veggies, and greasy foods are common triggers you may want to avoid. Eat a healthy, balanced, nutritious diet broken up into small meals. Make sure to drink plenty of fluids, particularly when symptoms flare, because diarrhea increases fluid loss. And try jotting down everything you eat and drink in a diary along with any symptoms you experience to look for a connection between the foods you consume and your ulcerative colitis symptoms.
Get Good Sleep
Sleep is essential for mind and body — and that goes for your gut, too. In fact, research published in the World Journal of Gastroenterology in December 2013 discussed a relationship between sleep disturbances and gastrointestinal diseases, including ulcerative colitis. The findings? Sleep problems are linked to an increase in inflammation and symptom flares.
To sleep more soundly, get daily exercise, cut out alcohol and caffeine, create a soothing sleep environment, and stick to a consistent sleep and wake schedule.
Track Your Highs and Lows
“It’s important to understand what may cause you to have more symptoms,” Horst says. “Some people with ulcerative colitis find it beneficial to track their symptoms to help them find things that may trigger their disease.” Keep a log of symptoms and all the potential factors that could trigger them — your sleep, your diet, your stress, and your medications. McGreal recommends an app offered by the Crohn’s & Colitis Foundation of America called “GI Buddy.”
React to Early Signs of a Flare
When ulcerative colitis symptoms flare, take action quickly. “It’s easier to calm a flare if it’s treated early,” McGreal says. The longer flares persist, the more difficult it may be to stop the inflammation driving the flare, she says. And don’t dismiss diarrhea and rectal bleeding as minor. At the first sign of either symptom, call your doctor and put your flare medication plan into action.