Dealing with Ulcerative Colitis Flare-Ups

Ulcerative colitis can really send patients on a life-changing roller coaster ride. And not the good kind of roller coaster.

UC can be unpredictable and cause people to experience a range of inconsistent symptoms such as diarrhea, constipation, abdominal pain, bloating, urgency, and more. Not only can this make going through the actions of daily life a challenge, but it can also leave people feeling embarrassed and like they must hide from society.

People with UC may shy away from social situations or activities that they previously loved out of fear of a flare up creating a potentially embarrassing situation that is out of their control. Additionally, UC can make working difficult or even impossible for some people depending on the type of job that they have. As a result, this can decrease quality of life and eventually lead to more complications like depression, financial struggles, and difficulties with family members.

No one wants to deal with the barriers that UC flares can create, but there are some things that can be done to help.

UC is tough because while you may feel pretty good one week, you could have a flare-up and be totally out of commission the next. A recent article in Healthline discusses UC flares and some tricks of the trade when dealing with them.

Research has shown that among people who have UC, about 70 percent will have relapse of symptoms in the span of a year. While treating ongoing symptoms is of course important, preventing these flares from occurring in the first place is the key to maintain quality of life. When a flare-up does occur, it is important that you have the tools and resources that work for you to help end that flare as soon as possible.

What is a flare-up exactly?

According to the Mayo Clinic, a UC flare means that symptoms have returned after a period of remission. This can involve diarrhea, rectal pain and bleeding, abdominal pain, and urgent bowel movements. A loss of appetite coupled with weight loss can also occur. Secondary symptoms such as dehydration as a result of diarrhea can make it even more complicated. With UC treatment, the goal is typically to get a patient into remission, and to then minimize the occurrence of flares. Knowing what flares are is the first step in being able to prevent them. The second step involves some self-awareness.

Knowing your triggers

As with everything in life, we are all different and unique. While this typically something to be celebrated, with UC, it can just make treatment even more difficult. Looking at how other people effectively manage their UC can be helpful, but ultimately going through the trial and error process of discovering your own flare triggers, and what treatments work for you is necessary. With that being said, looking at common triggers can help people figure out where to start.

Common UC triggers

Unfortunately, there are many medications that can contribute to flares. Some of these may even be commonly used among UC patients. While necessary for treating infections, antibiotics can take a toll on your gut. They do their job by killing off whatever bacteria may be making you ill, but they can also kill off the good bacteria in your gut that aids digestion. This can result in an increase in UC symptoms. In addition, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, as well as other pain medications can negatively impact the digestive system and increase the likelihood of a flare up.

Most medications are not supposed to be withdrawn from abruptly, and doing so can have a negative impact on the health of people with or without UC. Most commonly though, steroids and abrupt withdrawal are associated with negative side effects. Steroids that have been taken for any length of time typically need to be tapered off. Not doing this can not only cause a UC flare, but in some cases, can even be life threatening. This becomes more relevant in the younger population who are less likely to follow a treatment plan in the way that their provider recommends them to.

As if pregnancy was not tough enough, pregnant women have yet another thing to worry about if they have UC. It turns out that the same hormones that keep your pregnancy healthy can also cause you to have more UC flares. This certainly does not mean that you cannot have a child if you have UC. All this means is that if you are thinking about becoming pregnant anytime soon, have a chat with your provider. This way he or she can help you do so safely and healthily.

When you have an autoimmune disease such as UC, your immune system wreaks havoc on your body. Some people with UC may be on medications that suppress their immune system. While this can help with your UC symptoms, it can also make you vulnerable to other infections. Conditions that can alter the electrolyte balance in your body or affect the digestive tract can throw you into a flare as well. So, it is definitely a delicate balance when it comes to immunosuppressive medications.

How to deal with flares

Providers will often use corticosteroids to help stop a flare once it has begun. While they do not always work, they are something that your provider may try with you. They can be taken orally, given systemically, or through an enema. Another type of medication that can help with flares are 5-Aminosalicylates. These medications release in different parts of the gastrointestinal tract to help calm inflammation and thus reduce the symptoms of a flare. Frequently infections can be associated with flares, so antibiotics may also be a medication that is used. Biologics are medications that work on the immune system to block an inflammatory protein that is thought to play a role in the symptom development in UC.

While medications can certainly be life-changing, UC patients are not limited just to these.

Lifestyle changes have been shown to be quite effective in preventing and managing flares. Since stress is linked to UC flares, any lifestyle change that can decrease stress could also improve quality of life by decreasing the occurrence and frequency of flares. Everyone with a chronic disease has some degree of stress and managing it can be quite difficult. However, there are so many ways in which people can tackle the stress in their lives. For some this may involve professional or spiritual support. For others, exercise, yoga, and meditation may do the trick. At times, all you need is someone to chat with about whatever is stressing you out. By building a supportive community around you, you can have easy access to people who can help support you in your efforts to decrease stress in your life.

When trying to analyze what triggers your flares, it can be beneficial to start with a symptom diary coupled with a food and medication diary. Make daily lists of what you are eating, what medications you are taking, as well as any physical activity, and compare this to your symptom diary. This can help you and your provider pinpoint what things trigger flares for you. Then you can adjust your treatment plan accordingly, and hopefully achieve a great quality of life.