Much like a toxic ex that just won’t quit, ulcerative colitis (UC) symptoms tend to fade away for a while and then come back with a vengeance. Enter: The UC flare-up.
UC is a type of chronic inflammatory bowel disease (IBD) that causes inflammation and ulcers in your large intestine. Sometimes, this bowel inflammation is worse than others (aka a flare-up). When they kinda disappear for a while, it’s called remission.
Most people with UC have certain triggers that cause flare-ups. So if you have UC, understanding these triggers and flare-up symptoms can help you best manage them. Here’s how.
The experts aren’t exactly sure what causes UC, but they think it’s prob an autoimmune condition. Autoimmune conditions are basically what happens when the body’s defense mechanism is a little overzealous and attacks healthy tissue. Your body *means* well, but it causes inflammation.
In the case of UC, scientists think that the immune system might accidentally mistake perfectly harmless bacteria in the colon for serious threats, which causes the whole region to essentially swell up.
Though they don’t know exactly what contributes to flare ups, a few possibilities include:
- Stress. According to 2016 research, being stressed out may trigger IBD flare-ups. Even though stress doesn’t seem to directly cause UC, it does appear to weaken the intestinal wall and make it more vulnerable to issues. Researchers found that stress increased microbe activity in the colon and hindered the immune response.
- Diet. In a 2020 review, researchers found a correlation between diet and UC flare-ups. However, the research on exactly what triggers them just isn’t there yet.
- Certain medications. Abruptly stopping medications like steroids or maintenance therapies, which slow the bod’s natural cortisol levels, can lead to flares and other negative side effects. Always talk to a doc before halting these drugs.
- Hormonal changes. There seems to be a link between IBD and hormonal changes in women, with some research from 2018 suggesting that UC symptoms worsen during pregnancy in particular.
UC symptoms tend to change based on how intense the flare-up and the location of intestinal inflammation. Symptoms might include:
- achy joints or eye pain
- blood in stool or rectum
- frequent bowel movements
- moderate to intense ab pain or cramps
- weight loss from loss of appetite or diarrhea
- issues having a bowel movement that feels “finished”
- moderate to severe diarrhea that can sometimes dehydrate you
Flares can happen weeks, months, or even years apart and can vary a lot in severity.
Now that you know what causes flares, how tf do you stop them? Here are some tips that might help:
1. Soothe stress
Since stress seems to be a big trigger for flare-ups – as well as a number of other health probs – finding ways to relax can do your UC and overall health a favor.
Here’s what might help:
- Yoga. Can you down-dog your UC flares away? Maybe. In a small 2017 study, researchers compared the impact of self-care practices with regular yoga on UC symptoms. Scientists concluded that the participants who did yoga reported a significantly higher disease-specific quality of life after 12 weeks.
- Mindfulness. In a small 2014 study, researchers concluded that regular mindfulness practices may improve quality of life for those with UC, especially for those who typically have a high stress reactivity. Heads up, though: All that living in the moment didn’t seem to lower the severity of flare-ups. Still, those who did it regularly coped with their symptoms better and reported leading a more fulfilling life.
- Regular exercise. In a 2018 study on exercise in patients with inflammatory bowel disease, researchers concluded that working out more is associated with lower levels of disease activity. The study points out that even though high intensity physical activity can be a challenge for some with IBD, moderate intensity exercise can be safe and effective. Bonus: Researchers say it also improves your sleep and mood.
2. Take meds
Prescription medication can help manage your condition, including:
- Aminosalicylates like sulfasalazine, which help soothe inflammation in the gut.
- Corticosteroids like budesonide or hydrocortisone help tame your immune system and ease inflammation.
- Immunosuppressants like azathioprine or cyclosporine, which help calm an overreactive immune system and help keep inflammation in check.
- Biologics like infliximab-abda help regulate the immune system by inhibiting inflammatory proteins.
OTC pain relievers like acetaminophen (Tylenol) can also help manage pain. Avoid ibuprofen (Advil), naproxen (Aleve), and aspirin, though, as they affect your gut and may potentially worsen UC symptoms.
3. Adjust your diet
We’ll be real, there’s no go-to diet to prevent UC flare-ups. However, there are some foods you might want to avoid.
While fiber is typically recommended in a healthy, well-rounded diet, it might trigger a UC flareup. Minimizing your fiber intake might help calm things down a bit.
The experts also think it may help to avoid:
A 2015 research review suggests that a liquid diet could benefit people with IBD, including those with severe UC. The idea is that since severe UC can cause people to have issues absorbing nutrients, liquids can help you get lots of nutrients as easily as possible.
But we don’t really have enough evidence to be sure. So before you start downing soup and smoothies, talk with your doc.
And TBF, a 2019 review concluded that the research on the link between UC and diet just isn’t there yet. So as of now, the pros can’t say conclusively what will help.
Since everyone’s triggers can vary a lot, it’s a good idea to track yours in a food diary. When in doubt, a medical pro can help you out with this.
P.S. Staying hydrated, especially with electrolyte-rich liquids, also seems to help. That’s because people with UC often don’t absorb electrolytes very well.
Those with colon cancer, extreme complications from UC, or severe side effects from taking meds, may need surgery to treat their UC.
Surgery for UC involves removing the colon and rectum in a procedure called a proctocolectomy. Since you still need to use the bathroom post-surgery, the surgeon will attach the end of your small intestine to a hole in your abdominal wall. A bag is then attached to the opening to help you go.
5. Natural remedies
Win: A 2019 research review found that taking probiotics along with aminosalicylates significantly boosted the time between flares. Even though we need more research to know for sure, it may be worth with adding some probiotics or a little kombucha to your life if you have UC.
Meanwhile, a 2018 review found that curcumin, aka an active ingredient in turmeric, led to higher remission rates in combo with the aminosalicylate mesalamine.
If you have a nutritional deficiency from UC, your doc may recommend that you take certain supplements or vitamins to fill in the gaps.
It’s also worth understanding what seems to trigger your flares so you can work to avoid these.
It’s a good idea to see a doc on the reg to help monitor and manage your UC. Regularly monitoring your UC symptoms, flares and triggers with a doctor can help you identify patterns that help you determine the best mode of treatment.
But in rare cases, you might need medical intervention ASAP. Head to the doctor right away in the instance of:
Even though there’s not a cure for UC yet, there are ways to manage your symptoms and live well. Minimizing stress, taking meds, working with a doc and avoiding any known triggers might help prevent or reduce flare-ups.
With a solid management regimen, you could have slim-to-no UC symptoms for months to years at a time.