Take Control of Ulcerative Colitis Flares
Jennifer Robinson, MD
An important part of your ulcerative colitis (UC) treatment is to calm flares when they happen. But if you keep your disease in check, you may also have fewer symptoms over time. Here are six ways you can work to make flares become rare.
Stay on Your Meds
Many people with UC stay on low doses of drugs such as 5-ASA, which eases inflammation in the intestines, or meds such as azathioprine, 6-MP, and methotrexate, which turn down an overactive immune system.
It can be easy to forget to take these medicines when you feel good. But doctors say don't miss a dose. That can cause a flare.
Watch for Triggers
If you've figured out what foods make you feel bad, you 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 UC triggers include stress, an infection, and antibiotics. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil and Motrin), and naproxen (Aleve), can set a flare off, too.
Be Ready, Let Your Doctor Know
For some people, flares mean mild diarrhea and bloating from time to time. For others, they can be very uncomfortable, with urgent bowel movements, bloody diarrhea, belly pain, and even nausea and fever.
If the problem 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 on the cause, your doctor can adjust your medicines. You might need a larger dose or a new drug. Corticosteroids such as prednisone control inflammation. But because they have some unpleasant side effects and can cause long-term health issues, you shouldn’t take them for very long, he says. They're just to get you through a flare.