Although doctors don’t know exactly what causes a flare or how to predict one, there are some triggers you can avoid.
Lapses in treatment “One of the most common reasons for a flare is forgetting to take medications or not taking them appropriately," says Richard Desi, MD, a gastroenterologist with the Institute for Digestive Health and Liver Disease at Mercy Medical Center in Baltimore. Another possibility is that the medication you’ve been taking has stopped working and needs to be changed.Mixing medications Antibiotics as well as over-the-counter pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen) have also been linked to flares.Stress Many people with ulcerative colitis associate stress with a flare. According to a review published in the journal Frontiers in Pediatrics in 2019, there is a growing body of evidence to suggest stress can not only exacerbate symptoms of IBD but also may lead to a relapse in some patients.Food Some people associate certain foods such as raw fruits and vegetables and fried, greasy, fatty or spicy foods with causing ulcerative colitis symptoms. Doctors recommend keeping a food journal to see if certain foods trigger a reaction.
“But sometimes flares just happen without any particular reason," Dr. Desi adds. “A flare can last a few days to several months.” Theodore J. Saclarides, MD, a colon and rectal surgeon at Rush University Medical Group in Chicago, suggests calling your doctor if you have any of these ulcerative colitis symptoms:
Severe abdominal pain that lasts more than 24 hoursA decrease in bowel movements along with abdominal painAbdominal pain with a high feverBlood during a bowel movement that is too thick to see through
There are also some things you can do at home to temper a flare. These include:
Eat well. Pay close attention to what you’re eating during a flare. Foods that are high in fiber, like fruits and vegetables, should be cooked, not eaten raw. Drink plenty of fluids, but not alcohol and caffeine. And be careful to avoid greasy and gas-producing foods, which can worsen your ulcerative colitis symptoms.Soothe the burn. Frequent diarrhea can lead to anal irritation and even infection. You can fight this by using sanitary wipes after bowel movements and by taking frequent, warm saltwater baths or sitz baths. Ask your doctor to recommend a protective or antibiotic ointment to put in the bath.Take over-the-counter medications. Medication you can get at your pharmacy like Pepto-Bismol may help control diarrhea. Many doctors recommend Tylenol (acetaminophen) as the safest medication for ulcerative colitis pain, but check with your physician before taking any medication.Relax. Find ways to manage stress, whether it’s through meditation, mild exercise, yoga, deep breathing, or just reading a good book. A study published in March 2020 in the Journal of Psychosomatic Research found that people who participated in yoga for 12 weeks experienced less UC activity and improvements in overall quality of life. Some people may also find hypnotherapy to be helpful. A review paper published in June 2020 in the American Journal of Gastroenterology found that while hypnotherapy may not relieve ulcerative colitis symptoms, it may help improve overall quality of life and relieve stress in people with IBD. Make sure you go to a certified hypnotherapist.Plan ahead. The last thing you want is to have ulcerative colitis symptoms while you’re far from a bathroom. Know where the restrooms are whenever you leave the house and have an emergency change of underwear with you just in case. If you join the Crohn’s & Colitis Foundation of America you’ll get a “Can’t Wait” card for access to any available bathroom.Enlist support. Make sure you have a support system to help you. Ask for help from a close friend or relative who understands what a flare is all about and can lend a hand or emotional support. Many people also benefit from joining an ulcerative colitis support group, either in person or online.
During an ulcerative colitis flare, it’s recommended that you schedule regular visits to see your doctor, at least once every three months until the symptoms go away. After the flare has subsided, physicians recommend one or two checkups a year to manage the disease. When an ulcerative colitis flare strikes, you have options for getting your life back on track. It’s important to learn what you can about maintaining your health and work with your doctor to find the best ways to safely control UC. And remember to always let your doctor know when new or persistent symptoms arise.
