Ulcerative Colitis Flare-Up: Causes, Symptoms & What To Do

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that affects the large intestine (colon) and rectum. It’s characterized by inflammation and ulcers in the lining of the colon, leading to various uncomfortable and disruptive symptoms. While many people with UC experience periods of remission, flare-ups – times when symptoms worsen – are a common challenge. Understanding the causes, recognizing the symptoms, and knowing how to manage a flare-up are crucial for improving your quality of life with UC.

What Causes Ulcerative Colitis Flare-Ups?

Pinpointing the exact cause of a UC flare-up can sometimes feel like detective work. While the underlying cause of UC itself isn’t fully understood, several factors are known to trigger or worsen symptoms. Here’s a breakdown of common culprits:

1. Diet

What you eat can significantly impact your UC symptoms. Certain foods are more likely to trigger flare-ups in some individuals. Common dietary triggers include:

• High-fat foods: Fried foods, fatty meats, and excessive amounts of oils can be difficult to digest and may exacerbate inflammation.
• Dairy products: Lactose intolerance is common in people with IBD. Dairy can lead to gas, bloating, and diarrhea.
• Spicy foods: Capsaicin, the active compound in chili peppers, can irritate the digestive tract.
• Alcohol and caffeine: These substances can stimulate bowel activity and increase inflammation.
• Processed foods: These often contain additives, preservatives, and unhealthy fats that can contribute to inflammation.
• Insoluble Fiber: While fiber is generally healthy, insoluble fiber (found in foods like wheat bran and some vegetables) can be hard to digest during a flare-up.

Actionable Tip: Keep a food diary to track what you eat and how it affects your symptoms. This can help you identify your personal trigger foods. Consider working with a registered dietitian specializing in IBD for personalized dietary guidance.

2. Stress and Anxiety

The gut-brain connection is a powerful one. Stress and anxiety can significantly impact your digestive system and trigger UC flare-ups. When you’re stressed, your body releases hormones that can increase inflammation in the gut and alter bowel function.

Actionable Tip: Practice stress-reducing techniques such as:

• Mindfulness meditation: Focus on the present moment to calm your mind.
• Deep breathing exercises: Slow, controlled breathing can help regulate your nervous system.
• Yoga or Tai Chi: These practices combine physical movement with mindfulness and relaxation.
• Regular exercise: Physical activity can help reduce stress and improve mood.
• Therapy or counseling: Talking to a therapist can help you develop coping strategies for managing stress and anxiety.

3. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), can irritate the lining of the stomach and intestines, increasing the risk of a UC flare-up.

Actionable Tip: Avoid NSAIDs if possible. If you need pain relief, talk to your doctor about safer alternatives, such as acetaminophen (Tylenol).

4. Antibiotics

Antibiotics can disrupt the balance of bacteria in your gut, potentially leading to inflammation and a UC flare-up.

Actionable Tip: Only take antibiotics when absolutely necessary and prescribed by a doctor. If you need to take antibiotics, consider taking a probiotic supplement to help restore the balance of gut bacteria.

5. Missed Medications

Inconsistently taking your prescribed UC medications is a major cause of flare-ups. These medications, such as aminosalicylates, corticosteroids, immunomodulators, and biologics, work to control inflammation and keep your UC in remission.

Actionable Tip: Set reminders to take your medications as prescribed. If you’re having trouble remembering, use a pill organizer or enlist the help of a family member or friend. Don’t stop taking your medication without talking to your doctor first, even if you’re feeling better.

6. Infections

Infections, whether in the gut or elsewhere in the body, can trigger inflammation and potentially lead to a UC flare-up.

Actionable Tip: Practice good hygiene to prevent infections. Wash your hands frequently, especially before eating and after using the bathroom. Get vaccinated against common illnesses like the flu and pneumonia.

Recognizing the Symptoms of a UC Flare-Up

Early recognition of a flare-up is crucial for prompt management and preventing the condition from worsening. Common symptoms include:

• Increased frequency of bowel movements: You may experience more frequent trips to the bathroom, often with urgency.
• Diarrhea: Stools may be loose, watery, and difficult to control.
• Abdominal pain and cramping: Inflammation can cause pain and spasms in the abdomen.
• Rectal bleeding: Blood in the stool is a common symptom of UC.
• Urgency: A sudden and intense need to have a bowel movement.
• Fatigue: Inflammation and nutrient malabsorption can lead to fatigue and weakness.
• Fever: In severe cases, a flare-up can cause a fever.
• Weight loss: Loss of appetite and malabsorption can lead to unintentional weight loss.

What To Do During an Ulcerative Colitis Flare-Up

If you suspect you’re experiencing a UC flare-up, take these steps:

1. Contact your doctor: It’s essential to consult your gastroenterologist as soon as possible. They can assess your symptoms, determine the severity of the flare-up, and adjust your treatment plan accordingly.
2. Adjust your diet: Stick to easily digestible foods that are less likely to irritate your digestive system. Examples include:
   • Cooked white rice
   • Bananas
   • Applesauce
   • Toast
   • Broth-based soups
   • Lean protein (chicken or fish)
3. Stay hydrated: Diarrhea can lead to dehydration, so it’s important to drink plenty of fluids. Water, electrolyte-rich drinks, and herbal teas are good choices.
4. Manage stress: Use stress-reduction techniques to help calm your body and mind.
5. Rest: Get plenty of rest to allow your body to heal.
6. Follow your doctor’s instructions: Adhere to your prescribed medication regimen and any other recommendations from your doctor.
7. Consider Probiotics: Ask your doctor if taking a probiotic supplement could be beneficial. Some strains of probiotics can help restore the balance of gut bacteria and reduce inflammation.

Preventing Future Flare-Ups

While it’s not always possible to prevent flare-ups entirely, you can take steps to reduce your risk:

• Adhere to your medication regimen: Take your medications as prescribed, even when you’re feeling well.
• Identify and avoid trigger foods: Keep a food diary and work with a dietitian to identify and eliminate foods that worsen your symptoms.
• Manage stress: Practice stress-reduction techniques regularly.
• Get regular exercise: Physical activity can help reduce stress and improve overall health.
• Get enough sleep: Aim for 7-8 hours of sleep per night.
• See your doctor regularly: Schedule regular checkups with your gastroenterologist to monitor your condition and adjust your treatment plan as needed.

Conclusion

Ulcerative colitis flare-ups can be challenging, but by understanding the causes, recognizing the symptoms, and taking proactive steps to manage your condition, you can improve your quality of life. Remember to work closely with your doctor to develop a personalized treatment plan and address any concerns you may have. Don’t let UC control your life – take control of your UC! If you’re experiencing frequent or severe flare-ups, schedule an appointment with your gastroenterologist today to discuss your treatment options.