There’s no foolproof way to prevent a flare-up, but there are steps you can take to minimize your symptoms and reach remission faster. Here are 10 common mistakes you might be making. Correct them, and you may start feeling better, faster. A variety of medications can treat UC, depending on the severity of your condition and your overall health. While it may be tempting to skip doses once you start feeling better — a report published in the journal Intestinal Research reported that medication adherence is a “significant problem” for people who have inflammatory bowel disease (IBD) — doing so can cause your symptoms to reappear. Skipping medications is the biggest reason people experience flares, says Laura Yun, MD, a gastroenterologist and assistant professor of medicine at Feinberg School of Medicine at Northwestern University in Chicago. Whether your doctor has you taking an anti-inflammatory drug, an immunosuppressant, or a combination of medications, none of them will work if you don’t take them as your doctor prescribes.
2. You’re ignoring how stressed you really are.
Drs. Bloomfeld and Yun agree: When asked, people with UC often report experiencing stress before a flare. A study published in March 2019 in the Journal of Crohn’s and Colitis followed 417 people with IBD, which includes UC, and found that experiencing a stressful life event or new stressors in the previous three months was commonly linked to a flare-up. Stress can trigger inflammation in the gut, worsening the symptoms of UC, according to a study published in 2019 in Frontiers in Pediatrics. Plus, stress can interfere with your usual routine, leading to poor sleep and medication and eating habits. At Yun’s clinic, a psychologist teaches relaxation exercises to people with UC. Learning techniques such as meditation or yoga may help you manage stress.
3. You’re not avoiding trigger foods.
“There’s no food or food group that causes or cures ulcerative colitis,” Yun explains. But many people with UC say that certain foods either bring on symptoms or make them worse. During a flare-up, your doctor may recommend adjustments to your diet. This can mean avoiding foods that trigger symptoms, such as bloating, diarrhea, and cramping. For example, dairy products can be particularly irritating for people who have both UC and lactose intolerance. Aside from dairy, common trigger foods include beans, whole grains, nuts, seeds, some raw fruits and vegetables, high-fat foods, sugary foods, and sugar alcohols (a type of carbohydrate that’s used as a sweetener). If you’re trying an elimination diet to determine which foods you need to avoid, keep a food diary, and always work with a healthcare practitioner to ensure you’re getting all the nutrients you need.
4. You’re avoiding certain healthy foods.
It can be hard to eat a healthy diet — or anything at all — if you’re experiencing abdominal pain, cramps, or nausea. But if you’re not eating the right foods, you could be at risk of nutrient deficiencies, malnutrition, and unwanted weight loss. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says that because people with ulcerative colitis can lose their appetite, it is important to focus on eating a healthy, balanced diet. While there’s no one meal plan that works for everyone, many people find they can tolerate low-fiber fruits (bananas, cantaloupe, cooked fruits), lean proteins, cooked veggies, sourdough bread, and grains such as oatmeal. A doctor or dietitian who specializes in IBD can help you develop a personalized meal plan.
5. You’re not drinking enough fluids…
If you’re experiencing bouts of diarrhea, you run the risk of becoming dehydrated, because your body is losing more fluids than it’s taking in. This can be harmful to your overall well-being and interfere with your body’s ability to heal. Drink as much water as you can during a UC flare. Just keep in mind that there are some liquids you should think twice about if you have diarrhea, including pear, peach, or prune juice, according to the Crohn’s & Colitis Foundation; all of them contain nonabsorbable sugars that can be rough on your gut. Try, too, to avoid alcohol, caffeinated drinks, and carbonated beverages.
6. …but you do drink caffeine or alcohol.
Coffee, tea, and soda can make UC flare-ups worse, says Yun, because caffeine is a stimulant that can get your intestines going — not what you need when you have diarrhea. The same goes for beer, wine, and liquor. If you have active UC symptoms, you should consider skipping alcoholic drinks and try to wean yourself off caffeine.
7. You’re drinking carbonated beverages.
When you’re in the midst of a UC flare, sodas and other carbonated drinks can make you uncomfortably gassy. Because many of these drinks contain caffeine and sugar, both of which can contribute to diarrhea, you might be giving yourself a triple dose of irritation. Opt for plain water instead.
8. You’re eating large meals.
When UC symptoms are active, you can ease your body’s burden by eating frequent, smaller meals so the volume of food and fluid is stable and limited. Consider having five or six fist-sized meals every three to four hours instead of three large meals a day. On top of helping reduce discomfort from UC symptoms, this strategy is also a way to cope with nausea or loss of appetite that might accompany your flare.
9. You need your meds adjusted.
Antibiotics for an infection outside of your gut could aggravate UC symptoms. (Keep in mind that your doctor may also put you on an antibiotic to prevent or treat a UC-related infection.) Let your doctor know if you experience diarrhea after starting antibiotics, since a switch in the type of drug might be needed. Aspirin, ibuprofen, and naproxen can also trigger a UC flare. Your doctor may also suggest taking an antidiarrheal medication. Probiotics — beneficial live microorganisms that live in your gut —may also help reduce diarrhea, according to the NIDDK, although it’s not clear how many of them you have to take or which strains may be most helpful. If you do decide to take a probiotic, always talk to your doctor first.
10. You’re not on the right treatment plan.
UC treatment plans are typically based on how severe your symptoms are and how well you respond to medications. Usually, you’ll start with the least aggressive treatment and move on to stronger medications if necessary. Frequent flares, hospitalizations, or the need for short-term corticosteroid prescriptions are signs that you might need to adjust your current treatment strategy. If you aren’t satisfied with the level of control you have over your UC, talk to your doctor about other options.
