Do Any Medications Have Nutritional Side Effects
Moderate to severe flares of IBD are often treated with corticosteroids , cholestyramine and 5-ASA compounds . These medications have nutritional side effects that should be addressed. If you use any of these medications, talk to your doctor or registered dietitian for treatment advice.
- Prednisone causes decreased absorption of calcium and phosphorus from the small intestine. It also causes increased losses of calcium, zinc, potassium and vitamin C. With continual use of high doses of prednisone, the result may be bone loss and development of bone disease. People on prednisone may need up to 1200 milligrams a day. Protein needs also are increased for people taking prednisone because it increases protein breakdown in the body.
- Cholestyramine decreases absorption of fat-soluble vitamins , as well as folate, vitamin B-12, calcium and iron.
- Sulfasalazine interferes with folate absorption. People taking this drug also should take a 1 milligram folate supplement each day.
And Be Proactive About Probiotics
Youve probably heard about probiotics. Theyre the living microorganisms that help keep the healthful bacteria flourishing in your digestive tracthome to the largest part of your immune system. Your favorite yogurt is loaded with probiotics . According to one 2019 study, more than half of those who regularly consumed probiotics saw improvements in their general quality of life and in specific UC symptoms, including more regular bowel movements.
What Should I Ask My Doctor On Behalf Of My Child Or Teenager
Ask your healthcare provider the following questions in addition to the ones listed above:
- What vitamins should my child take?
- Will my other children have pediatric ulcerative colitis?
- Is my child at risk for other conditions?
- Can you recommend a psychiatrist or therapist to help my child with emotional issues related to pediatric ulcerative colitis?
- Is my child growing at a normal rate?
- What can I do to help my child cope at school?
A note from Cleveland Clinic
When you have ulcerative colitis, its essential to work closely with your healthcare team.
Take your medications as prescribed, even when you dont have symptoms. Skipping medications youre supposed to take can lead to flareups and make the disease harder to control. Your best shot at managing ulcerative colitis is to follow your treatment plan and talk to your healthcare provider regularly.
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Complications Of Ulcerative Colitis
Complications of UC are classified as either local or systemic and are most common with severe, long-standing inflammation:
Malnutrition An estimated 62% of patients with UC experience malnutrition, which is likely due to less food intake, loss of fluids as a result of diarrhea, and the inability to absorb nutrients. The most common deficiencies include the micronutrients calcium, selenium, zinc, and magnesium and vitamins B12, A, D and K.
Autoimmune Comorbidities Experts have shown that once one autoimmune disease develops, a person is at a much greater risk of developing additional conditions . One study, which included 950 IBD patients , found that 113 of the UC patients had one or more of the following: arthritis, ankylosing spondylitis, and psoriasis. Not only that, research shows that the risk of developing additional autoimmune conditions increases with one of the most common treatment methods for Ulcerative Colitis: antibiotics.
Mental and Emotional Symptoms Researchers have linked the TLR2 protein to the production of serotonin. Serotonin is a neurotransmitter that delivers messages to the brain and is known as one of the âfeel goodâ hormones. An imbalance of bacterial flora can alter serotonin levels and contribute to depression and anxiety in those with Ulcerative Colitis.
What Are The Common Side Effects Of Ulcerative Colitis Medication
All ulcerative colitis medications may have side effects, but these side effects will differ depending on the drug. This is not a complete list, so please talk to a healthcare provider about any questions you have about possible side effects, drug interactions, or any other concerns.
Aminosalicylates are the first-line treatment for ulcerative colitis because they are generally safe medications with few side effects. Side effects are usually limited to headache, abdominal pain, nausea, and loss of appetite. Sulfasalazine, however, is a sulfa drug, so it should not be taken by people with allergies to sulfa drugs.
Topical corticosteroids such as rectal suppositories, creams, or foams usually have few or only mild side effects. They most commonly provoke site reactions such as burning, irritation, and itching. Oral and injected corticosteroids, however, may produce side effects in many people including mood and behavior changes, increased appetite, weight gain, high blood pressure, high blood sugar, acne, thinning skin, fluid retention, and cataracts.
Immunosuppressants can weaken the immune system and decrease the bodys production of white blood cells that serve as the front-line defense against infection and cancer. The most serious side effects of immunosuppressants, then, are potentially severe infections and cancers. Other severe side effects might include liver, kidney, or lung damage.
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How Long Does An Ulcerative Colitis Flare
Ulcerative colitis is a chronic disease that causes inflammation and ulcers in the inner lining of the large intestine and rectum. If you have UC, you may experience repeated cycles of flare-ups and remissions .
A flare-up can last a few days or a few weeks and then be followed by a remission that lasts for months or even years. How long a flare-up lasts depends on factors such as:
While there is no cure for UC, several treatment options and lifestyle modifications can help reduce symptoms or prevent flare-ups.
Can Surgery Affect Nutritional Status
Some patients need surgery for severe inflammation, strictures, fistulas and abscesses. In Crohn’s disease, the affected portion of the digestive tract is removed. In ulcerative colitis, the colon is often removed and the ileum may be attached to the anus.
Removal of portions of the intestine can affect nutritional status. When sections of the small or large intestine are removed, surface area for absorption of nutrients is decreased. The following diagram illustrates where nutrients are absorbed. If certain portions of the intestine are severely inflamed, or have been removed, absorption of nutrients may be affected. Malnutrition and nutrient deficiencies can result.
If you have had or are planning to have surgery to remove intestines, talk to your doctor or registered dietitian about which vitamins and minerals you need to take.
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Limit Your Fiber Intake
Fiber contributes to bowel regularity and bowel health, but too much fiber can also trigger UC flare-ups.
Try to stick to foods that have no more than 2 grams of fiber per serving. Low fiber foods include:
- refined carbohydrates such as white rice, white pasta, and white bread
- some cooked fruits
- juice with no pulp
Instead of eating raw vegetables, steam, bake, or roast your vegetables. Cooking vegetables results in some fiber loss.
How Does Pediatric Ulcerative Colitis Affect My Childs Mental/emotional Health
Like many conditions, ulcerative colitis can have a negative psychological effect, especially on children. They can experience physical, emotional, social and family problems. Because of the medications and/or general stress from the situation, your child may experience:
- Mood swings.
- Worry about appearance and physical stamina.
- Vulnerability because their body doesnt function normally.
- Poor concentration.
- Misunderstandings with friends and family.
Children need mutual support from all family members. Its helpful for the entire family to learn about the disease and try to be empathetic. Seek out a psychiatrist and therapist to help your child manage such challenges of their ulcerative colitis.
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Managing Ulcerative Colitis Flares: The Most Important Step
The key to managing an ulcerative colitis flare is to get a confirmed diagnosis and begin treatment as soon as possible. But doing so can be tricky, because people with the condition may attribute their symptoms to other GI problems, says Oriana Mazorra Damas, MD, an assistant professor of gastroenterology at the University of Miami Miller School of Medicine in Miami.
The goal for remission is to feel well enough that you forget that you have the condition for most of the day in other words, you experience few, if any, symptoms, Dr. Damas explains.
Consider Therapy To Help Manage Stress And Pain
Working with a therapist on certain mind-body techniques can help you control ulcerative colitis symptoms.
Cognitive behavioral therapy and a technique called biofeedback may be useful, as these processes teach skills to cope with stress and pain. In CBT, you learn to recognize and change behaviors and emotions that affect you physically. According to an article in Therapeutic Advances in Gastroenterology, CBT can ease abdominal pain for some people. Biofeedback will teach you how to identify and control some bodily processes, such as heart rate or tension in your muscles, and it can be effective in helping manage chronic pain.
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Who Gets Ulcerative Colitis
Anyone at any age, including young children, can get ulcerative colitis. Your chance of getting it is slightly higher if you:
- Have a close relative with inflammatory bowel disease .
- Are between 15 and 30 years old, or older than 60.
- Are Jewish.
- Use frequent nonsteroidal anti-inflammatory drugs like ibuprofen .
Who Diagnoses Ulcerative Colitis
If you have symptoms of ulcerative colitis, your regular healthcare provider will probably refer you to a specialist. A gastroenterologist a doctor who specializes in the digestive system should oversee the care for adults. For young patients, a pediatric gastroenterologist who specializes in children should manage the care.
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Symptoms Of Ulcerative Colitis Flares
An ulcerative colitis flare is when your disease symptoms reappear after a period of time without symptoms. Depending on where the inflammatory bowel disease is located in your gastrointestinal tract, youll have unique symptoms. Common symptoms of ulcerative colitis flares include:
- Frequent and urgent bowel movements
- Eye pain, redness, or difficulty seeing
Make Time For Activities That Make You Happy
Tip number three to help you prevent an ulcerative colitis flare-up: Always make time for things that make you happy. For me, its dancing. I have been taking dance classes since my pre-school years and continues to do so to this day. Its wonderful exercise, I have met amazing friends through this hobby, and it is also my favourite form of exercise. When I am in the dance studio, I forget about everything else in the world and focus on being in the present. So, whether it be dance, a sport that you love, or something as beautiful as painting, make time to feed your hobbies with your time and hopefully you will feel more fulfilled and less stressed!
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Identify Daily Stressors And Put Your Health First
The second tip to help you prevent an ulcerative colitis flare-up is to ensure that you learn how to identify daily stressors so that you may eliminate them. Stressors for many people come up on a daily basis, whether it be work based, family based, or even relationship/friends based. I think that always keeping in mind that your health comes first no matter what. In other words, no issue is as important as your own health. By always keeping this in mind I find that it helps me mentally to filter things that brings stress instead of peace.
What Is The Best Medication For Ulcerative Colitis
The severity and extent of ulcerative colitis will determine the most appropriate medications for the condition. For this reason, there is no best medication for ulcerative colitis. Instead, a patients medical situation and tolerance for side effects will determine the best medications for treating ulcerative colitis.
|Best medications for ulcerative colitis|
|Administered weeks 0 and 4 then every eight weeks subcutaneously.||Upper respiratory tract infections, headache, diarrhea, sore throat|
Many of the standard dosages above are from the U.S. Food and Drug Administration or the National Institutes of Health . Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
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Nutrition Tips For Inflammatory Bowel Disease
Inflammatory Bowel Disease is a term used for two specific and separate diseases: Crohn’s disease and ulcerative colitis. Nutritional recommendations are different for each disease and for each individual patient. It is important to discuss the treatments that are right for you with a registered dietitian and with your doctor.
Fasting Generally Is Safe
People can get really, really freaked out about fasting. Like if you go a few hours without eating youll die or something. Its crazy.
Our genes have millions of years of survival mechanisms built in to keep us alive in times of little food or famine.
Because were so used to eating all the time in this ridiculous modern world, it seems like not eating for 24 or 36 hours is like this big scary thing.
In my own case years ago, I was so sick and inflamed eating made me feel terrible. Hungry as I was, not eating felt better than eating most anything.
Fasting is quite safe, particularly in very short doses of a day or two.
Just take it easy. You will be tired and light-headed sometimes. This is something to try over a few days that you have to yourself where you can take it slow and easy.
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Does Ulcerative Colitis Make You Immunocompromised
Ulcerative colitis doesnt make you immunocompromised. Some of the medicines that treat it may change the way your immune system responds. This change is different for each medication. Some of these changes may increase the risk of certain infections or other issues. A discussion with your health care team before starting a medication is the best way to understand these risks and ways to prevent them.
Prednisone Is A Steroid Use It Like One
I spent many years in the bodybuilding world. Prednisone is a catabolic steroid, as opposed to the anabolic steroids that bodybuilders use.
Bodybuilders cycle steroids so they remain effective and side-effects are kept as low as possible.
When I got into trouble with a flare-up in years past, Id go high on the prednisone and then taper it down and get off it. Just like a bodybuilder on anabolic steroids.
The original GI doctor I had in 2004 wanted me on high-dose prednisone for life.
A lifetime of prednisone would have wrecked my mind and body and I knew there was no way I could take a powerful, high side-effect drug like that indefinitely.
If youre currently in a flare-up and have a good GI doc that you can work with, discuss a short course of prednisone, maybe a month or two.
You might start high and stay there for a week or two and then taper it down over a few weeks and get off it.
I did the above about 10 times over the years when I was still really bad with UC.
I had a sympathetic and somewhat modern-thinking primary care physician who helped me and wrote the prescriptions for the prednisone. They are out there. You just have to look and leave the doctors you dont resonate with.
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When Should I Seek Urgent Or Emergency Care
You will know your body and condition better than anyone. If you feel you need urgent care telephone 111. If you need emergency care call 999. It’s important to go to hosptial if you’re advised to.
Some signs could include:
- Stoma blockage: not passing wind or poo or passing watery poo, nausea, bloating or swelling tummy, tummy cramps, swollen stoma, nausea/vomiting or both.
- Severe dehydration, malnourishment and vomiting.
- Severe tummy pain, a high temperature and a rapid heartbeat.
- All medicines have a small risk of side effects, such as chest pain, rapid heartbeat or hives. If you experience any side effects that you are worried about while taking your medicine, contact your IBD team or your GP as soon as possible.
Diet Recommendations For Ulcerative Colitis Flare
- Follow a low residue diet to relieve abdominal pain and diarrhea.
- Avoid foods that may increase stool output such as fresh fruits and vegetables, prunes and caffeinated beverages.
- Try incorporating more omega-3 fatty acids in your diet. These fats may have an anti-inflammatory effect. They are found in fish, including salmon, mackerel, herring and sardines.
- Patients often find that smaller, more frequent meals are better tolerated. This eating pattern can help increase the amount of nutrition you receive in a day.
- Consider taking nutritional supplements if appetite is poor and solid foods are not tolerated well .
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How To Manage Ulcerative Colitis Flares
Although there isnt a cure for ulcerative colitis, there are plenty of treatment options to reduce inflammation and help you return to your daily routine. Depending on the severity of your flare-up and your individual needs, your healthcare provider can recommend treatment to help you manage ulcerative colitis flares.
The end goal of treatments for ulcerative colitis flare-ups is to maintain remission. You might always have ulcerative colitis, but if you care for yourself you can avoid intense flare-ups. Your healthcare provider might recommend a medication to reduce swelling, heal tissue, relieve symptoms, reduce pain, and avoid diarrhea:
You can’t completely avoid flare-ups. If you eat well and take your medicine as prescribed, its likely that your disease will stay in remission. See your healthcare provider regularly to make sure that youre always doing whats best for your body, even when its been a while since you had a flare-up.
Ulcerative colitis flares can affect how you travel, your personal relationships, your professional life, and more. The most important thing you can do is to face your fears and worries instead of letting them control your life.