Ulcerative colitis (UC) is a chronic condition that often causes flare-ups of symptoms between periods of remission. People can try several strategies to minimize the severity of UC symptoms.
UC is a form of inflammatory bowel disease (IBD) in which inflammation causes sores called ulcers to appear on the colon’s lining. It is a lifelong condition that typically involves alternating periods of flare-ups and remission.
People can try making lifestyle changes to help manage and prevent flare-ups. These include consuming easily digestible foods, eating smaller meals, exercising regularly, and reducing stress levels where possible. People may also learn to recognize the warning signs of a flare.
In this article, we explore strategies for stopping a UC flare-up, how long symptoms usually last, and what strategies may help prevent severe flare-ups. We also speak with Daisy Warner about her personal experience managing UC flares.
UC affects the gastrointestinal tract, causing inflammation of the lining of the large intestine, also called the colon. This inflammation results in ulcers that discharge mucus and pus.
If symptoms reappear during or after a period of remission, doctors refer to this as a flare-up or flare.
UC symptoms
Common symptoms of UC
People may also report symptoms such as the following:
- body and joint aches
- lack of appetite
- eye problems, including pain, redness, or loss of vision
Daisy’s story: “My flare-ups cause fatigue and persistent pain.”
During a flare-up, I experience bloating, and the consistency of stools is much looser. A big thing is fatigue alongside the pain.
I’ve found that sometimes it’s really hard to distinguish between menstrual cramps and UC pain.
The pain feels like a cramp, but the difference is that I often don’t find relief from UC pain. It feels like a continuous pain concentrated in the middle of the stomach, just below the belly button.
Occasionally, when it’s really bad, I have blood spotting when wiping. Sometimes, some food won’t have been digested and will be in the stool.
Learning how to stop, manage, or decrease symptoms during a flare-up can help improve the quality of life of people with UC.
Although managing flare-ups is important, knowing what can trigger a flare-up can help stop one from happening in the first place.
Some of the following strategies may be helpful:
1. Recognize the warning signs
It may help to learn to recognize when a flare-up is beginning. A person with UC can try to pay close attention to their body and any unusual feelings they may be experiencing.
By doing this, they may be able to recognize which symptoms they have before a flare-up worsens. They may then be able to take steps to reduce the severity of symptoms.
It can help to keep a diary of what symptoms occur at what time. Apps are also available that can help people track their symptoms and toilet activity.
2. Adjust dietary choices
Foods that are high in fiber can make UC symptoms worse during a flare-up.
During a flare-up, people can try
- greasy foods
- fried foods
- whole grains
Doctors recommend keeping a food journal to document symptoms after each meal. This will help a person identify what foods they may need to avoid.
A doctor or registered dietitian can help a person create a diet plan that works for them.
Daisy’s story: “Following the specific carbohydrate diet helps prevent and manage my flare-ups.”
Diet is the biggest thing for me, and I follow the specific carbohydrate diet. I avoid gluten, dairy, grains, and really sugary things. This is a way to manage but also prevent flares.
I also make my own yogurt. If I’ve eaten something “bad,” I’ll have some of my yogurt, and I feel it makes such a difference. I’ll also try to be extra strict with my diet and avoid anything that might be triggering, like spicy food.
3. Try intermittent fasting
Intermittent fasting is a dietary strategy in which an individual extends their overnight fast. Some people fast for 12–16 hours each day, whereas others may fast for 36 hours once per week.
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This type of fasting may be useful for people with UC, particularly during flare-ups.
4. Eat small meals
Smaller and more frequent meals are easier on the gut and less likely to worsen symptoms.
Instead of eating three large meals throughout the day, a person can try eating five or six smaller meals.
Daisy’s story: “I eat frequently and have plenty of snacks.”
If I’ve had a large meal, it affects me. I used to get very hungry within an hour of eating, so I’ve solved that by having more snacks.
5. Reduce alcohol consumption
Alcohol intake, whether moderate or in excess, may also make UC symptoms worse during flare-ups.
People may not need to abstain from alcohol entirely, but doctors recommend only drinking in moderation.
6. Exercise regularly
Exercise is extremely beneficial for those experiencing a UC flare-up and individuals hoping to extend the time between flare-ups.
Exercising may help promote the release of
Although UC can limit the amount and intensity of exercise a person can undertake, even light exercise may be beneficial during a flare-up. A person can consider doing low intensity activities, such as:
- walking
- yoga
- Pilates
- gentle stretching
Daisy’s story: “Exercise helps prevent my UC flare-ups.”
I notice if I haven’t done much exercise or moved much, then I get more cramping. When I’m exercising regularly, my gut health is much better.
7. Reduce stress levels
Stress causes the body to release certain hormones that stimulate an inflammatory response.
Stressful situations can affect IBD and the severity of a flare-up. Learning how to manage their stress levels can help a person overcome a flare-up more effectively.
Some stress relief strategies that may help stop flare-ups include:
Learn more about relaxation techniques.
8. Be careful with medications
Even when they are not experiencing symptoms, people with IBD may need to continue to take their medications. Missing doses or weaning off the drugs may result in flare-ups.
However, certain medications can also trigger flare-ups. For example, nonsteroidal anti-inflammatory drugs, including aspirin and ibuprofen, can lead to a flare. Doctors usually recommend acetaminophen instead.
In some circumstances, antibiotics can also cause flare-ups. As well as treating bacterial infections, antibiotics alter the bacteria that usually live in the intestine.
A person with UC will need to ensure that any doctors who prescribe them medications are aware of their condition.
9. Consult a medical professional
If UC symptoms are severe, it may be best to speak with a primary care physician or an IBD nurse, who will suggest management strategies. They may also prescribe certain medications to ease the symptoms.
Learn more about how to manage a flare-up.
UC is a condition that is unique to every individual. Some people experience flare-ups that last a few days. For others, flares may go on for weeks.
The duration of flares will vary from person to person based on the severity of their UC and how well-managed it is. People with mild flare-ups may be able to prevent them using the techniques described above.
Doctors consider a flare-up severe if it is persistent. If this is the case, it is best to speak with a doctor. A doctor will try to help a person manage their symptoms and improve their quality of life.
Strategies to prevent a flare-up include:
- Modifying the diet: Eating less insoluble fiber will ensure that people can digest food easily and prevent flare-ups. A plant-based diet may also reduce the risk of a UC relapse.
- Taking supplements:
Research suggests certain dietary supplements, such as curcumin, green tea, and selenium, may reduce UC symptoms. Supplementing the diet with additional omega-3 fatty acids and vitamin D has also hadpositive effects . - Keeping a food journal: By keeping track of the foods they eat and their symptoms, individuals can narrow down what irritates their gut. This will help them determine how their diet relates to their symptoms.
- Exercising frequently: Exercise
reduces disease activity and fatigue levels in people with UC. These symptoms are common during a flare-up. - Joining an IBD support group: A person may find meeting with individuals with the same condition beneficial. They can learn from these people’s experiences and seek support during flare-ups. These groups also often play an important role in
raising awareness of IBD.
Daisy’s story: “Supplements help me manage my UC.”
I take supplements and find that these have made such a difference! I regularly take calcium, zinc, and magnesium. I also take turmeric, which is a natural anti-inflammatory.
Learn more about UC support groups.
Individuals with UC will need to learn what dietary and lifestyle factors worsen their symptoms and cause flare-ups. By keeping track of these triggers, individuals can help manage their condition and improve their quality of life.
If a person needs any help developing strategies or is in the middle of a severe flare-up, they can reach out to a doctor or an IBD nurse for help.
IBD resources
Visit our dedicated hub for more research-backed information and in-depth resources on inflammatory bowel disease (IBD).
It is possible to minimize and improve symptoms of UC by implementing various lifestyle and dietary changes. People can start identifying what causes their flare-ups and learn how to reduce their severity.
If a person suspects that a flare-up is beginning, they may be able to take certain steps to help ease their symptoms.