10 Keys to Conquer Crohn's & Colitis
Tackling an Ulcerative Colitis Flare
An ulcerative colitis flare can come when you least expect it, causing discomfort and pain. Find out the causes and how to deal with it.
By Chris Iliades, MD
Medically Reviewed by Robert Jasmer, MD
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If your ulcerative colitis (UC) symptoms suddenly worsen, you could be experiencing a flare. A flare involves painful cramping, bloody diarrhea, fever, and nausea, and it can be the most stressful part of living with this unpredictable disease.
Although doctors don’t know exactly what causes a flare or how to predict one, there are some triggers that 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. Although there is not a lot of research that proves stress causes a flare, doctors agree that stress reduction can be helpful.
- Food. Some people associate certain foods such as raw fruits and vegetables and fried, greasy food 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," Desi adds. “A flare can last a few days to several months.”
When to Call Your Doctor About a Flare
Flares come with different levels of intensity. You may be able to manage a mild flare-up of symptoms on your own. But a more severe flare may be a warning sign of an ulcerative colitis complication that needs immediate attention.
Theodore J. Saclarides, MD, director of the Division of Colon and Rectal Surgery at Loyola University Health System in Chicago, suggests calling your doctor if you have any of these ulcerative colitis symptoms:
- Severe abdominal pain that lasts more than 24 hours
- A decrease in bowel movements along with abdominal pain
- Abdominal pain with a high fever
- Blood during a bowel movement that is too thick to see through
Your UC Flare Management Plan
Your doctor may help you deal with a flare by changing your medications or offering new ones. “Treatment of flares can include mesalamine products and usually a steroid, such as prednisone," says Desi.
There are also some things you can do at home to temper a flare. These include:
- Eating 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.
- Soothing 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.
- Taking 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.
- Relaxing. 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 2014 in the journalDigestionfound that stress management practices can improve the quality of life for people with ulcerative colitis by reducing the negative effects of a flare.
- Planning 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. By joining the Crohn's & Colitis Foundation of America you'll get a for access to any available bathroom.
- Enlisting 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 to 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 quality of 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.
Additional reporting by Michael H.
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