Calming flares when they happen is an important part of your treatment. But you should also work closely with your doctor to keep your ulcerative colitis (UC) in remission, so flares become rare, says Leyla J. Ghazi. She's a gastroenterologist who specializes in inflammatory bowel disease at the University of Maryland School of Medicine in Baltimore.
"It's about disease control and finding adequate treatment to keep patients in remission for as long as possible," she says.
Stay on Your Meds
To keep flares at bay, many patients stay on low amounts of drugs such as 5-ASA, which eases inflammation in the intestines, or meds such as azathioprine, 6-MP, and methotrexate, which suppress an overactive immune system.
It can be easy to forget to take these medicines when you have no active symptoms. But doctors say don't miss a dose. Missed doses can trigger a flare.
Watch for Triggers
People with UC tend to figure out what foods set them off, and they should stay away from those, says Roberta Muldoon, MD. She's an assistant professor of surgery in the Division of General/Colorectal Surgery at Vanderbilt University Medical Center in Nashville.
Other things that can trigger a flare include stress, an infection, and antibiotics to treat an infection. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil and Motrin), and naproxen (Aleve) can cause a flare, too.
Be Ready, Let Your Doctor Know
For many people with UC, flares translate to little more than mild diarrhea and bloating from time to time. For others, flares can be very uncomfortable, involving urgent bowel movements, bloody diarrhea, abdominal pain, and even nausea and fever.
If the flare doesn't clear up within 48 hours, call your doctor, says Thomas Cataldo, MD. He's a staff surgeon in colon and rectal surgery at Beth Israel Deaconess Medical Center in Boston.
"Many gastroenterologists try to establish a collaborative plan with their patients who have UC, so that when flares start, the patient knows exactly what to do," he says. "That said, though, every flare is unique, and doctor and patient should talk, if not have a visit."
Once you've zeroed in together on the cause of the flare, your doctor can adjust your medicines. You might need a larger dose or a new medicine. Corticosteroids such as prednisone help get inflammation under control. But because corticosteroids have some unpleasant side effects, as well as long-term health issues, they aren't used long-term, he says. They're just for helping get through a flare.
Unless your doctor has okayed it ahead of time, don't self-medicate, says Cataldo.
"People with UC may have leftover prednisone from a previous flare, or they may have steroid enemas still in the closet. Maybe they helped last time. But by now all of this could have expired, or maybe those therapies wouldn't be appropriate for this particular flare," he says. "Wait to talk to your doctor."