Overview of Ulcerative Colitis

Ulcerative colitis is a condition characterized by the inflammation of the large intestine or colon. The cause of the disease remains unknown even today, but people suffering from ulcerative colitis experience symptoms such as intermittent rectal bleeding, bloody stools, cramping abdominal pain, and severe diarrhea. Long-standing ulcerative colitis is a major risk factor for colon cancer.(1)

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Ulcerative colitis is an autoimmune disease, and there is no cure for the condition. However, treatment can help manage the condition and prolong your lifespan.

Some of the common symptoms of ulcerative colitis can include:(2)

Ulcerative colitis is frequently known to also cause additional conditions, such as:

The symptoms of ulcerative colitis come and go throughout your life. While some people experience some periods of remission during which their symptoms disappear entirely, it is often followed by periods of flare-ups, when the symptoms return, often aggressively. The remission period can last for days, weeks, months, or sometimes even years, but it is usually never permanent. People also experience a different intensity of flare-ups.

While your symptoms can become active at any time, it is possible for you to increase the time period between these flares.

5 Tips to Manage Ulcerative Colitis Flare-ups

Here are some tips to help you manage ulcerative colitis flare-ups.

Restrict your Fiber Intake

While fiber is helpful for the body and contributes to regular bowel movements and also ensures good bowel health, too much of fiber intake can prove to be a trigger for ulcerative colitis flares.

You should try to eat those foods that have just 1 gram of fiber or even less per serving. Some foods low in fiber include:

  • Tofu
  • Butter
  • Fish
  • Eggs
  • Refined carbohydrates such as white pasta, white rice, white bread
  • Juice without pulp
  • Cooked meals
  • Certain cooked fruits that have no seeds or skin

So instead of consuming raw vegetables, it is better to steam, bake, or roast your veggies. Cooking vegetables results in the loss of some fiber so that it will be better for your ulcerative colitis.

A low-fiber diet helps decrease the worst symptoms of ulcerative colitis, such as abdominal cramping and pain. However, while a low-fiber diet is not recommended for the long term, but it can still help your bowels heal when you are having an active flare-up episode. Low fiber foods help in healing the gut as this reduces the amount of poorly digestible or indigestible fibers. This will also decrease trauma to the bowel, and thereby, allow the colon to heal.(3)

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Regular Exercise

Exercising regularly will not only be good for your overall health, but at the same time, it will boost your mood, reduce stress, and also improve the levels of depression and anxiety associated with chronic diseases such as ulcerative colitis. The more you remain physically active, the better it will be for your mental health. This makes it easier for patients to cope with the physical symptoms during a flare-up.(4)

Physical activity is also helpful in suppressing inflammation in the body, making you feel better. Uncontrolled inflammation in the gastrointestinal tract can cause ulcerations and increase the symptoms of ulcerative colitis. After a session of exercising, most people find an improvement in their abdominal pain and cramping.

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Exercise also lowers your risk of colon cancer, a common complication of ulcerative colitis. Exercising regularly helps stimulate contractions in the intestine, which helps food pass through the digestive tract quickly. This dramatically reduces gastrointestinal exposure to potential carcinogens.(5)

Many people feel like that do not have time to exercise, or it might be that the flare-ups do not allow you to exercise. However, even a ten-minute walk around the block is enough to reap the benefits of exercise.

You should discuss with your doctor about which type of exercise will be best for your condition. Even low-intensity exercises such as biking, yoga, swimming, and walking will help.

Reduce Your Stress

Managing your stress levels can help reduce your body's inflammatory response, thus helping you overcome a flare-up faster and perhaps also reduce the intensity of the symptoms. In fact, it is common to observe that when you undergo a stressful event in your life, it might lead to a flare-up of your symptoms. Stress, after all, is one of the significant factors that contribute to a flare-up of ulcerative colitis, along with diet, environment, and smoking habits.(6)

The reason why stress aggravates the condition is believed to be because of the body's natural reaction to stress, which is a fight or flight response. This fight or flight response prepares your body for fleeing any high-risk situation or gets you ready to handle a perceived threat. During this fight or flight response, w a couple of things happen in the body:(7)

  • A stress hormone known as cortisol is released
  • Your heart rate and blood pressure increase
  • The body boosts the production of adrenaline, which gives you extra energy

This natural response of the body also boosts your immune system. While this is not generally an adverse reaction, but in people who suffer from autoimmune diseases, this can be a problem because a stimulated immune system causes an increase in inflammation throughout the body, including the large intestine. This increased inflammation is generally temporary, but it can work as a trigger for an ulcerative colitis flare-up.

A study carried out by the University of Stockholm in Sweden in 2013, attempted to look for relapses in 60 patients with inflammatory bowel disease who were in remission. Ulcerative colitis is a type of inflammatory bowel disease. Of the 42 participants of the study who had a relapse, nearly 45 percent of them experienced high-stress levels just the day before they had their flare-up.(8)

So although stress can be responsible for trigging a flare-up of your symptoms, but stress is still not believed to cause ulcerative colitis. Instead, experts believe that stress only works to exacerbate the condition.

There are many simple ways to relieve stress, such as deep breathing exercises, meditation, and spending some time by yourself each day. It is also helpful to draw up some realistic goals so that you do not get overwhelmed with work and other things in life. You also need to learn to say no whenever you start feeling overwhelming.

Getting plenty of sleep and eating a healthy and balanced diet is also necessary to control your stress levels.

If you find that nothing seems to be improving your stress levels, then you can discuss with your doctor about making some lifestyle changes. Your doctor can also recommend certain medications or might even advice counseling from a mental health professional.

Eating Smaller Meals

If you have abdominal pain or diarrhea after having three big meals in a day, it is a good idea to start having five or six smaller, but more frequent, meals or snacks during the day to see if your symptoms improve.

This is because digesting three big meals becomes too much work for your intestines.

Space out your meals evenly throughout the day so that you allow your bowels sufficient time to digest the food you are eating. You may find that this technique of eating helps reduce your symptoms.

Apart from helping decrease the discomfort from your symptoms, this strategy of having smaller meals is also an excellent way of coping with the loss of appetite and nausea that often accompanies ulcerative colitis symptoms.

Watch What You Drink

The beverages you consume during the day also has a significant role to play in triggering your symptoms. You need to drink plenty of liquids each day, but you should opt for having water rather than any carbonated or caffeinated beverages.

If you are having alcoholic drinks, then keep in mind that the alcohol present in these drinks is going to stimulate your intestines even more and this is only going to make your diarrhea worse. The same holds true for beverages that contain caffeine, such as iced tea, soda, and coffee.

Carbonated drinks also frequently produce gas, another factor that will make you feel worse. Sodas and any other drinks with carbonation are known to cause irritation to the lining of your intestinal tract. Many of these drinks also contain sugar and caffeine, both of which are going to contribute further to diarrhea. So you might just be giving yourself a double dose of irritation, especially during a flare-up.

Another possible mistake you can make is not drinking enough fluids. If you are experiencing diarrhea, then there is a big risk of becoming dehydrated without realizing it. When you have diarrhea, the body ends up losing more fluids than what it is taking in. This is why it is so essential that you remain well-hydrated. Being dehydrated can be harmful to your body's overall health and also affect the body's ability to heal.

If you are experiencing an ulcerative colitis flare, you should all the more drink as much water as you can.

Conclusion

It is very much possible to improve the symptoms of ulcerative colitis by practicing a little bit of common sense and practicality on your part. This will not only help you achieve remission but also prolong the periods of remission. You can do this by making certain healthy dietary and lifestyle changes.

The key to avoiding ulcerative colitis flare-ups is to identify and avoid any factors that are likely to trigger your symptoms. Furthermore, taking quick action when you feel a flare coming on will also help bring your condition under control faster.

References:  

  1. Information, H., Diseases, D., Colitis, U. and Colitis, U. (2019). Ulcerative Colitis | NIDDK. [online] National Institute of Diabetes and Digestive and Kidney Diseases. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/ulcerative-colitis [Accessed 31 Aug. 2019].
  2. Crohn’s and Colitis. (2019). Find Out About Common Symptoms of Ulcerative Colitis. [online] Available at: https://www.crohnsandcolitis.com/ulcerative-colitis/symptoms [Accessed 31 Aug. 2019].
  3. Pituch-Zdanowska, A., Banaszkiewicz, A. and Albrecht, P., 2015. The role of dietary fibre in inflammatory bowel disease. Przeglad gastroenterologiczny, 10(3), p.135.
  4. Engels, M., Cross, R.K. and Long, M.D., 2018. Exercise in patients with inflammatory bowel diseases: current perspectives. Clinical and experimental gastroenterology, 11, p.1.
  5. National Cancer Institute. (2019). Physical Activity and Cancer Fact Sheet. [online] Available at: https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet [Accessed 31 Aug. 2019].
  6. Mawdsley, J.E. and Rampton, D.S., 2005. Psychological stress in IBD: new insights into pathogenic and therapeutic implications. Gut, 54(10), pp.1481-1491.
  7. EverydayHealth.com. (2019). The Link Between Ulcerative Colitis and Stress. [online] Available at: https://www.everydayhealth.com/hs/ulcerative-colitis-treatment-management/ulcerative-colitis-stress-link/ [Accessed 31 Aug. 2019].
  8. Jaghult, S., Saboonchi, F., Moller, J., Johansson, U.B., Wredling, R. and Kapraali, M., 2013. Stress as a trigger for relapses in IBD: A case-crossover study. Gastroenterology research, 6(1), p.10.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: September 10, 2019

This article does not provide medical advice. See disclaimer

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