When you have ulcerative colitis, your large intestine can have a hard time absorbing water and salt. That can make you dehydrated. So can diarrhea, which is common with UC flares. Set a goal to drink enough water and other liquids so you're not thirsty. An electrolyte-replacement drink may help if you have diarrhea. If you're dizzy, weak, or haven't gone to the bathroom in 12 hours, call 911.
Bouts of diarrhea often can bother your skin. Use moist towelettes for wiping. Follow up with an ointment, such as a vitamin A and D cream. Need more relief? Soak in a salt water bath, which may ease soreness. Try acetaminophen for pain, but avoid NSAIDs, such as ibuprofen and naproxen. They can trigger flares and cause other problems.
A flare can zap your appetite, but you still need nutrients. Find a few go-to foods you can handle. Bland items often work. Skip fatty, greasy fare. Raw fruits and veggies can also irritate. It helps to peel or cook them, but they still bother some people. Eat small meals more often instead of three large ones each day. If you're losing weight, your doctor might suggest meal-replacement drinks.
Flares can make you have to use the bathroom ASAP. Know where restrooms are to put your mind at ease. Also, pack an emergency kit with items such as baby wipes, toilet paper, ointment, underwear and liners, deodorizer, and extra pants. It can help you feel prepared and OK before you head out.
A flare may mean it’s time to switch your medication or dose. Your doctor may prescribe suppositories and enemas. Some drugs, like corticosteroids and “5-ASAs,” can quickly get your UC inflammation under control. For day-to-day care, you might take 5-ASAs and meds that curb your immune system, such as azathioprine or 6-MP. Some doctors also prescribe “biologic” drugs for UC that’s more than mild.
If it’s hard for you to take pills, talk to your doctor or pharmacist. The pharmacy might be able to make your medicine in liquid form. If your drugs come in capsules, ask if it's safe to open them and mix the medicine with apple sauce, peanut butter, or other foods.
Have diarrhea from a mild flare? These medications may help. They're available over the counter -- such as bismuth subsalicylate or loperamide -- or by prescription. Talk to your doctor first. And don't take them if you have a fever or see blood in your stool. That could cause serious problems.
You may feel awkward talking to people about your condition. But if you need help, ask. Let others -- family, friends, co-workers, your boss -- know how UC affects you. It helps them better understand what you're going through when flares happen. It can be a relief to have people to turn to when you need a hand.
Stress doesn't cause UC, but it makes symptoms and flares worse for some people. If it affects you, try meditation, breathing exercises, or a massage. You could also see a pro to try biofeedback, hypnotherapy, or a type of counseling called cognitive behavioral therapy (which helps you learn new ways to handle problems). Being active helps, too. Try yoga, tai chi, or other low-impact exercises like walking.
Don't double up on doses of medication if you’re flaring. Although you really want relief, a change in your treatment can trigger flares or make them worse. Take medicines only as directed. The same goes for when you feel good and may be tempted to skip doses, too.
Antibiotics can trigger flares. If your ulcerative colitis gets worse while you take them, tell your doctor. Some scientists think antibiotics may cause issues because they kill helpful bacteria in your gut that aid digestion. You could try probiotics, or "good" bacteria. They are in yogurts (look for “live, active cultures” on the label) or, if you're lactose intolerant, in supplements.
Some flare symptoms are very serious. Get medical help right away if you have:
Also get help if you feel like you're going to faint or you vomit over and over.
Alcohol and your UC flares could be linked. Although you don’t have to become a teetotaler, you may want to skip it when you're flaring. It can aggravate inflammation and ulcers. So limit beer, wine, and liquor and see if that helps. If you’re out with friends, maybe order some coffee (decaf, if caffeine bothers you), instead.
Mild exercise can ease stress, prevent diarrhea, and aid digestion. Try three 30-minute walks a week. Being active also strengthens your bones. That's important because inflammatory bowel diseases like ulcerative colitis make you more likely to get osteoporosis, which makes bone fractures more likely.