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.