What Should I Ask My Doctor
If you have ulcerative colitis, you may want to ask your healthcare provider:
- How much of my large intestine is affected?
- What risks or side effects can I expect from the medication?
- Should I change my diet?
- Will ulcerative colitis affect my ability to get pregnant?
- What can I do at home to manage my symptoms?
- What are my surgical options?
I Take Medication Regularly Can A Flare
Unfortunately, yes. Ulcerative colitis is a chronic condition. Medications and lifestyle changes can help reduce the intensity and frequency of ulcerative colitis flare-ups, but not stop them completely.
Regular flare-ups may indicate a problem with your current treatment. If you are taking your medications as prescribed and still experiencing flare-ups, you should contact your physician who may adjust your medication or suggest other treatment options.
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.
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How To Calm An Ulcerative Colitis Flare
This article was co-authored by Peter Gardner, MD. Peter W. Gardner, MD is a board certified physician who has practiced Gastroenterology and Hepatology for over 30 years. He specializes in diseases of the digestive system and liver. Dr. Gardner earned his Bachelors degree from the University of North Carolina and attended Georgetown Medical School. He completed his residency in Internal Medicine and then his fellowship in Gastroenterology at the University of Connecticut. He is a previous Chief of Gastroenterology at Stamford Hospital and remains on the staff. He is also on the staff of Greenwich Hospital and New York Presbyterian Hospital. Dr. Gardner is an Approved Consultant in Internal Medicine and Gastroenterology with the American Board of Internal Medicine.There are 8 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, 100% of readers who voted found the article helpful, earning it our reader-approved status. This article has been viewed 13,681 times.
Diet Progression Following Flares For Ulcerative Colitis And Crohns Disease
- Continue to follow a low residue diet and slowly add back a variety of foods.
- Begin with well-tolerated liquids and advance to soft solids, then solids .
- Introduce one or two items every few days and avoid any foods that cause symptoms.
- Add fiber to diet as tolerated. Well-tolerated fiber sources include tender cooked vegetables, canned or cooked fruits, and starches like cooked cereals and whole wheat noodles and tortillas.
- Between flares, eat a wide variety of foods as tolerated. This includes fruits, vegetables, whole grains, lean protein, and low-fat and nonfat dairy products.
- Increase your calorie and protein intake following a flare. Abdominal pain, diarrhea and decreased appetite may have caused poor food intake. Steroids used to treat flares also can increase protein needs.
Suggestions for first foods after a flare include:
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Make Sure Youre Getting Enough Probiotics And Prebiotics
Whether you take probiotics tablets, eat fermented vegetables or other fermented products, or take kefir, I personally try to intake something with probiotics and prebiotics at least a few times a week. My personal favourite is a kefir smoothie its an excellent combination of probiotics and prebiotics! Learn more about how to choose the right probiotics here.
Bonus Step Five: Speak To An Expert
The wide variety of symptoms and causes means that it can be difficult to recommend a single approach. Instead its best to have a plan tailored to your specific needs. Im always happy to discuss your particular circumstances with a free consultation to work with you and understand your exact circumstances.
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Can I Drink Alcohol With An Ulcerative Colitis Flare
Alcohol has a significant impact on the gut microbiome, leading to changes that can promote inflammation. While a small amount may be well tolerated, for some, alcohol even when consumed in small amounts, can lead to an increase in symptoms such as diarrhoea and pain.
The changes in the gut microbiome are noted in Ulcerative colitis patients who consume alcohol. Specifically, an increased number of bacteria that promote inflammation in the gut. This may then lead to increased permeability along the gut lining and the overactivation of the immune response which then leads to the tissue damage seen in this condition.
How To Stop Ulcerative Colitis Bleeding
During an ulcerative colitis flare-up, one of the most common and most concerning symptoms is increased blood when passing a stool. This can often come with increased mucus production.
Due to the irritation and inflammation along the gut lining, reducing the fibre content of the food can be helpful. This can reduce irritation along the gut.
When preparing food it may be helpful to remove stems and skins from fruits and vegetables as well as ensure these are well cooked and perhaps pureed to a smooth texture. Other high-fibre foods such as popcorn as well as nuts and seeds may also be limited to reduce the irritation along the gut wall.
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Gut Bacteria And Ulcerative Colitis
Imbalances in the gut microbiome have been linked with the onset of IBD. This is likely due to an inappropriate immune response to the gut bacteria leading to inflammation.
Its also been noted that in those with IBD, there are imbalances in the gut bacteria. This bacterial imbalance is referred to as dysbiosis and is seen as a reduction in the diversity of the gut bacteria. This also results in a reduced number of specific beneficial bacteria that have anti-inflammatory properties.
How Often Do I Need A Colonoscopy
Especially when you have symptoms or are just starting or changing medications, your doctor may want to periodically look at the inside of the rectum and colon to make sure the treatments are working and the lining is healing. How often this is needed is different for each person.
Ulcerative colitis also increases your chance of developing colon cancer. To look for early cancer signs, your healthcare provider may have you come in for a colonoscopy every one to three years.
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What Are The Symptoms Of An Ulcerative Colitis Flare
The main symptoms of an Ulcerative colitis flare-up include an increase in many digestive complaints.
- Bloody diarrhoea
- Abdominal pain that often improves after a bowel movement
The area of pain in the abdomen can be related to the region of the intestine that is inflamed. This can lead to a range of foods becoming more problematic and increasing the sensation of pain and discomfort in the gut. These are generally higher fibre foods that can increase symptoms during an Ulcerative colitis flare which include nuts, seeds as well as some fruits and vegetables
Before a flare in ulcerative colitis, symptoms can be stable but then increase gradually over a period of time which often leads to a flare-up.
Is It Important To Treat A Flare Early Or Is It Ok To Wait A Bit
Inflammation typically does not resolve without treatment and early intervention has a better outcome than waiting to treat. At an early stage of a flare, a more optimal baseline treatment is often enough to get the inflammation under control. If you wait, there is a greater risk that you might need drugs with greater side effects, such as oral steroids. By waiting, you will have to manage longer with your symptoms before getting relief. Living with constant or longer periods of inflammation might increase your risk for future complications, as inflammation might cause damage to the gut wall that accumulates in severity with each flare.
If you are experiencing worsening symptoms, you have probably already had the flare for some time without symptoms. Evidence shows that a stool test for inflammation in the colon, called fecal calprotectin, is often elevated for two to three months before any symptoms appear. Your colon might also start to show visual evidence of inflammation before you have symptoms, or at least indicate an increased risk for a flare.
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What To Do During An Ulcerative Colitis Flare To Minimize Symptoms
Youll inevitably experience another UC flare-up at some point, despite your best prevention efforts. When this happens, there are a few ways youll need to tweak your normal routine to minimize the severity of your symptoms and get back into remission ASAP. Even some of your typically healthy habits like loading up on veggies may be a no-go. Here are a few natural remedies that may help:
Tap Into ‘good’ Bacteria
Antibiotics can trigger flares. If your UC gets worse while you take them, tell your doctor. Some scientists think antibiotics cause issues because they kill “good” bacteria in your gut that aid digestion. Although research is limited, there is some evidence that probiotics, which contain these bacteria, along with other medications may be helpful, but this has not been proved.
Some flare symptoms are very serious. Get medical help right away if you have:
- Constant, heavy diarrhea
- New or more blood in your stool, or any blood clots
Also get help if you feel like you’re going to faint or you vomit over and over.
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Medications For Other Conditions
A medication you take for another condition can also trigger a flare-up.
This might happen if you take an antibiotic to treat a bacterial infection. Antibiotics can sometimes disrupt the balance of intestinal bacteria in the gut and cause diarrhea.
Certain over-the-counter nonsteroidal anti-inflammatory drugs , such as aspirin and ibuprofen , may also irritate the colon and cause a flare-up.
This doesnt mean you should stop taking antibiotics or pain medications, but you should speak with your doctor before taking these drugs.
If you take an antibiotic, you may also need a temporary antidiarrheal medication to combat possible side effects.
If you experience stomach pain after taking an NSAID, your doctor may suggest acetaminophen to reduce pain instead.
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.
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Causes Of Ulcerative Colitis
The exact cause of ulcerative colitis isnt known. However, its thought to be a combination of unknown environmental triggers, genetics and your immune system reacting abnormally.
Over a quarter of people with ulcerative colitis have a family history of it if a close relative has it, you are 10 times more likely to develop it. Certain gene changes have been identified that increase your risk of developing ulcerative colitis if exposed to a trigger for the condition. Some of these genes are thought to be involved in your immune system.
Ulcerative colitis is also more common in black people and white people of European descent, particularly in Ashkenazi Jewish communities. It is less common in people of Asian descent.
Ulcerative colitis may be caused by an autoimmune response. This is when your immune system mistakenly attacks healthy tissue. There are several theories as to what happens in ulcerative colitis:
- A harmful bacterial or viral infection triggers your immune system, which is a healthy response, but after the infection has cleared, the immune system continues to attack your colon, causing inflammation
- There is no infection to trigger your immune system but it behaves in an abnormal way, which causes inflammation
- Your immune system mistakenly attacks good bacteria in your colon, causing inflammation
Another theory suggests that ulcerative colitis is caused by an imbalance between good and bad bacteria in your colon.
Give Yourself Some Tlc
Stress doesn’t cause UC, but it makes symptoms and flares worse for some people. If it affects you, try meditation, breathing exercises, or a massage. You could also see a pro to try biofeedback, hypnotherapy, or a type of counseling called cognitive behavioral therapy, which helps you learn new ways to handle problems. Being active helps, too. Try yoga, tai chi, or other low-impact exercises like walking.
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When To Get Treatment
An increase in inflammation causes a flare, and the nature of inflammation means that you should treat it as quickly as you can. Inflammation grows exponentially, because inflammation itself causes an increase in inflammation. The longer you leave it untreated, the worse it will get. In addition, untreated inflammation not only leads to the symptoms associated with ulcerative colitis, it can also increase your risk of developing complications such as colorectal cancer down the line. Pay attention to your symptoms, and visit your physician if you notice that they change or increase even a small amount.
Eat These Foods To Avoid A Flare Up Of Ulcerative Colitis
The Heal Your Gut Cookbook: Nutrient-Dense Recipes for Intestinal Health Using the GAPS Diet by Hilary Boynton contains more than 200 easy, straightforward recipes that restore the balance between beneficial and pathogenic intestinal bacteria. These recipes contains foods that are natural remedies for painful ulcerative colitis symptoms by sealing the gut through the elimination of grains, processed foods, and refined sugars.
Gut and Psychology Syndrome refers to disorders, including ADD/ADHD, autism, addictions, depression, and obsessive-compulsive disorder, stemming from or exacerbated by leaky gut and dysbiosis. GAPS also refers to chronic gut-related physical conditions, including celiac disease, rheumatoid arthritis, diabetes type one, and Crohns disease, as well as asthma, eczema, allergies, and thyroid disorders.
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What Are The Symptoms Of A Flare
When you start to have a flare-up, you may experience a variety of symptoms. These can include:
- Redness on the skin and some swelling
Are these symptoms a definite sign someone has a flare of ulcerative colitis?
No. These symptoms overlap with other gastrointestinal conditions such as ulcerative colitis or Crohns disease. You can read more on the difference between ulcerative colitis and Crohns disease on our Inflammatory Bowel Disease page.
Can a flare-up be serious?
The vast majority of flare ups can be managed at home with medication meaning it is rare to need hospital admission. However, if someone gets a fever or severe abdominal pain, or excessive bleeding then they should attend either their Dr surgery or see their specialist.
More Tips To Ease Ulcerative Colitis Symptoms
The best way to shorten a flare, of course, is to get treated by your doctor. But there are steps you can take at home too.
When you have a flare, try to follow a low-residue diet for several weeks, Damas says. The goal is to let the colon rest by avoiding fiber. That means staying away from seeds, nuts, fresh fruit, dried fruit, raw vegetables, whole grain bread and cereal, and tough meat.
Were learning more now about the influence that diet can have on control of inflammation, Damas notes. When patients are having an acute flare, its important in the short term to have a low-fiber diet. Many times, for a short period of time, until the flare-up is controlled, we recommend whats called a low FODMAP diet. However, this diet is not recommended long term, because it has no impact on inflammation itself and only on control of symptoms.
Indeed, once youre in remission, Damas says your doctor will likely recommend reintroducing fruits and vegetables as tolerated. Its better to cook vegetables without the skin and consume no more than 2 cups of milk a day.
If youre lactose intolerant, be sure you choose lactose-free dairy products. Its also a good idea to cut down on fat during this time to prevent bulky stools. Avoid other potential triggers, too, such as spicy foods.
Additionally, we recommend patients avoid eating processed foods, as well as those high in fat and animal protein, as these have been associated with inflammation in some studies, Damas says.
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How Long Do Flare
UC is a condition that is unique to every individual. Some people experience flare-ups that last a few days, while others experience flare-ups that last weeks. Likewise, individuals may go from a mild flare-up to a severe one and then back again.
If a person is experiencing a severe flare-up that persists, they should speak with a doctor. The doctor will help them get their symptoms under control and improve their quality of life.
How Do I Know If My Uc Has Gone Into Remission
UC doesn’t have a cure. Instead, the goal of any treatment plan is to send the disease into remission.
When UC is in remission, you don’t experience as many symptoms and start to feel better. If your UC medications and lifestyle changes work well for you, remission may last for months or even years. There are several different kinds of remission:
- Clinical remission: When a patient isn’t experiencing symptoms and may feel better.
- Endoscopic remission: Testing of the intestinal lining shows no inflammation
- Biochemical remission: Blood and stool tests show no sign of inflammation
- Surgical remission: When UC goes into remission after surgery to treat it
- Histologic remission: When both clinical and endoscopic tests didn’t show signs of UC
With UC, it can feel like life revolves around symptoms. If UC symptoms keep coming back, it can be a sign that medications aren’t working. Consider taking part in a clinical trial researching an investigational treatment option for people living with UC.
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