Even the most independent woman can feel unnerved in the face of an ulcerative colitis flare-up. Your UC may have been in remission for years. Then suddenly, the old familiar symptoms -- diarrhea, urgent bowel movements, bloody stools -- rev up, sometimes for weeks.
For as long as they do, you may be afraid to lose sight of the bathroom, much less leave the house. And the side effects of some of the medications used to treat UC flares -- stretch marks, mood swings, and weight gain, especially around the face and midsection -- can also make you feel out of control and embarrassed.
Try this action plan to help you ease flares when they occur -- and even reduce your flares in the future.
Start by looking for what triggered it. Sometimes there is no obvious reason for an ulcerative colitis flare-up. Other times it may be triggered by:
- Skipping doses of UC medication
- Infections
- Taking certain medications
- Eating certain foods
- Stress
The First Thing to Do for a UC Flare
“I tell my patients to let me know at the first evidence of any flare of the disease,” says R. Balfour Sartor, MD, professor of medicine, immunology, and microbiology at the University of North Carolina in Chapel Hill, and chief medical advisor of the Crohn’s and Colitis Foundation of America (CCFA). “The quicker you hop on a flare to treat it, the more likely you are able to treat it without having to go to aggressive therapy.”
If you’ve had UC for a while, you’re probably on moderate, maintenance doses of aminosalicylates, which relieve inflammation in the intestines, or immunosuppressive drugs, which suppress an overactive immune system.
When your UC flares up, your gastroenterologist may want to make sure you’re taking the right dose and the right number of doses. Or your doctor may decide to change your UC medication.
If you don’t treat flares right away or if increasing your current medication doesn’t work, your doctor may add a corticosteroid to get inflammation under control. Corticosteroids used to be standard treatment for UC. But they have some unpleasant side effects as well as long-term health issues.
“Steroids such as prednisone can be especially troubling to women,” says Yolandra Johnson, MD, a gastroenterologist at NorthShore University HealthSystem in Evanston, Ill. “Gaining weight and having stretch marks and a swollen face is difficult. These days we try to avoid steroids if we can, and if we use them, we certainly try to keep the treatment course as short as possible.”
Some flares can be a sign of serious UC complications. Go to the emergency room if you have:
- Heavy, persistent diarrhea
- Rectal bleeding with blood clots in the stool
- Constant pain and high fever
- Dehydration
In severe cases, you may need to be hospitalized to get inflammation under control and to make sure your body has enough blood, fluids, and minerals.
If other treatments don't work, you may need surgery to remove your colon, called a colectomy.
