It’s crucial to manage UC, even if you’re not experiencing symptoms.
Ulcerative colitis, or UC, cannot be cured, but it can be managed. The goal of treatment for UC is to help the individual reach and maintain long-term remission—a period of no symptoms. In fact, about half of people with UC are in remission in any given year, according to the Crohn’s and Colitis Foundation.
Following your doctor’s treatment recommendations and making certain lifestyle changes can help you reach remission, but once symptoms are absent, quitting that regimen is not a good idea.
“A lot of people think that the treatments will cure their colitis. They feel well; they’re in remission; everything is good,” says Todd B. Linden, MD, gastroenterologist. “What they don’t realize is that the treatment is just controlling their colitis. When they stop the treatment, many people will eventually flare.”
Not adhering to the prescribed treatment (including lifestyle changes) has several consequences, according to a 2017 study by researchers at the University of Naples. For starters, it can increase the risk of a UC flare (the return of UC symptoms, like diarrhea, bloody stools, and abdominal pain) by five times.
But that’s not all. According to the study, not sticking to treatment can also increase the risk of colorectal cancer and and can increase healthcare costs by two to three times.
The following habits do not necessarily *cause* UC to develop, but they can increase your risk of experiencing a flare of UC symptoms:
Skipping or taking the wrong dose of your UC medication can cause inflammation and symptoms to return. During remission, you should continue taking medications at the correct dose and at the scheduled time.
Using anti-inflammatory pain relievers (such as ibuprofen, aspirin, and naproxen) can irritate the bowel lining. Talk to your doctor about using OTC pain relievers; your doctor might suggest using acetaminophen instead.
Taking antibiotics may change the balance of intestinal bacteria. This phenomenon is known to cause diarrhea in anyone (with or without UC), and this can cause UC symptoms to return.
Quitting smoking, surprisingly, can cause a UC flare-up. The theory is that nicotine suppresses the immune system, so when smoking stops, the immune system revs up again and may resume attacking the colon. However, due to the numerous and serious health risks of smoking, using cigarettes to manage your symptoms is not advised.
Stress has a reciprocal relationship with UC. Flare-ups are common during times of stress, and experiencing painful or disruptive UC symptoms can increase stress levels. This relationship can partly be explained due to stress’s effect on the body’s hormone levels. The hormones affect and control various bodily processes, including the immune response. Here are other ways chronic stress affects the body.
Certain foods may irritate the digestive system more than others and potentially cause a flare-up. These tend to be foods that are more difficult to digest in general, and people with inflammatory bowel diseases may be especially sensitive to these foods. Common trigger foods for UC include lactose (a sugar in dairy), high-fat foods, foods with insoluble fiber, sugar and sugar alcohols, caffeinated drinks, alcohol, and spicy foods. Eating large meals in general may also trigger a flare-up.
These triggers demonstrate the importance of sticking to medication and lifestyle changes every day, even during remission. If your medication is causing unwanted side effects or not giving you the desired results, talk to your doctor.
If you’re struggling to stick to the lifestyle changes that can help treat UC, don’t be afraid to enlist help. Establish a good relationship with your doctor, and consider finding a registered dietitian to help with dietary changes. A support system of family and friends can also be a valuable tool in managing UC—or any condition, for that matter.
Stress management can also be an effective strategy against UC flares. Breathing exercises, meditation, yoga, and other stress-busting activities can help you find calm, and seeing a therapist regularly may also be helpful.
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A lot of people think that
the treatments will cure their colitis.
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They feel well, they're in remission,
everything is good.
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What they don't realize is, the treatment
is just controlling their colitis.
00:00:12,242 --> 00:00:15,836
When they stop the treatment,
many people will eventually flare.
00:00:15,836 --> 00:00:18,446
Almost everybody sooner or
later is going to flare again.
00:00:18,446 --> 00:00:24,016
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A flare up is a situation where
somebody's been in remission and
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then all of a sudden at
some point it's not.
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The symptoms that people have
with a new presentation or
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with a flare are really very similar.
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New onset of diarrhea, cramps, urgency.
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Maybe they have joint pain.
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Maybe they have fatigue.
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Maybe they have canker sores in the mouth.
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Some people don't take their regular
maintenance medicines as prescribed and
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as a result, they have flares all
the time and they end up taking too much.
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That's why we generally recommend that
people stay on treatment forever really,
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because otherwise, it will come back
again, and we don't want that to happen.
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There probably is a relationship
between stress and ulcerative colitis,
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especially with flares, but
nobody really knows that for sure.
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When it comes to lifestyle and habits and
things, we do ask people to be
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moderate in how much caffeine, and
alcohol, and spicy food they have.
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Fatty food is sometimes
more difficult to digest.
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So, we think about not overdoing
it in that department also.
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Sometimes the question of smoking
in ulcerative colitis comes up.
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It just has not been all that helpful in
terms of what will get the colitis to
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go away and go back under control.
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In terms of just being a healthier person
in general, the best other stuff you have
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going on health-wise,
the more you can focus on your colitis and
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the less debilitating it all becomes for
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I think a good dialogue is important.
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The doctors really need to know if you're
not feeling well, so being honest,
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being open, having a good back and forth
dialogue, this is what I'm really feeling.
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How do you make sure that I
can be 100% in remission.
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These are things that are very important.
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Mayer EA. Psychological stress and colitis. Gut. 2000;46(5):595-6.
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