Ulcerative colitis can begin very early. At the age of 12, for instance, Amanda Sina Griffith found herself the object of a custody battle -- and was besieged by painful stomach cramps and bloody diarrhea. “I’d had very mild stomach symptoms before; my doctor thought it was a bacterial infection. But now, it was worse,” she recalls. The diagnosis was ulcerative colitis.
Now 31, the Norton, Mass., public relations consultant and mother of a 7-month-old still finds that when she’s under stress her symptoms flare up. “My system is very sensitive. If I’m under stress, I feel tired, run-down, and crampy in the belly,” says Griffith, who worked full time until recently, but reduced her hours when she found job pressures worsened her stomach problems.
Griffith’s story sounds familiar to Gerard E. Mullin, MD, director of integrative GI nutrition services at Johns Hopkins Hospital in Baltimore. While stress doesn’t cause ulcerative colitis, research shows it can increase the risk of flare-ups, says Mullin.
Ulcerative colitis is a disease that affects the large intestine (also known as the colon) and the rectum. Although the causes of ulcerative colitis are unknown, some researchers believe that an autoimmune process may be a factor in the disease. When the body’s immune system is oversensitive and attacks its own healthy organs and tissues, disease can occur. Other factors that may contribute to the development of ulcerative colitis include genetics, environmental factors, smoking, and psychological stress.
Symptoms include abdominal pain or cramping, mild fever, rectal bleeding and diarrhea, and, less commonly, fatigue, loss of appetite, weight loss, and anemia. Some people may have joint pain, with redness and swelling, and liver problems.
Ulcerative Colitis Treatment
Treatment of mild to moderate ulcerative colitis usually begins with drugs to relieve inflammation and help prevent flare-ups. If these drugs do not work, doctors can prescribe stronger medications. And while dealing with stress is not a substitute for medication, doing so can help ease the emotional anxiety that often comes with the disease, Mullin says.
“People with these diseases are often more vulnerable to stress. They have an immune system that is overactive to begin with. Their immune system needs to be calmed down,” Mullin says.
Stress and Ulcerative Colitis
When someone is under stress, the body gears up for a fight-or-flight response by secreting certain hormones, including adrenalin, as well as molecules called cytokines. They stimulate the immune system, which triggers inflammation. In people whose ulcerative colitis is in remission, this sets the stage for the return of their symptoms, known as a flare-up. (Other factors linked to flare-ups include antibiotics, oral contraceptives, and nonsteroidal anti-inflammatory drugs, like aspirin, ibuprofen, and naproxen. Also, while what you eat doesn’t cause ulcerative colitis, some people may find certain foods worsen their bowel symptoms.)