Managing Ulcerative Colitis

Medically Reviewed by Minesh Khatri, MD on May 23, 2022
Written by Stephanie Langmaid
6 min read

Ulcerative colitis (UC) is a long-term disease, but it's possible to take charge of it and live well. Your doctor will work with you to find a treatment that controls your symptoms and helps keep them from coming back.

When you go a while without symptoms, that's called remission. When they quickly get worse again, that's called a flare-up. You can't prevent flares completely. But you can take steps like these to keep your UC in check.

Take your UC medications exactly as prescribed. It's one of the best things you can do to manage ulcerative colitis and prevent flares.

You may take some drugs only when you have a flare-up. You may need others every day, even if you feel fine.

Your symptoms are more likely to flare if you miss doses or take the wrong dose. If you're taking your meds as prescribed and still have trouble, talk to your doctor. They may need to change your dose or have you try a different medication.

Let your doctor know about any other drugs, even over-the-counter medicines, that you take. They can tell you which ones they recommend for diarrhea, gas, and pain.

Certain medications can make UC symptoms worse, including:

NSAIDs: These pain relievers, including aspirin, ibuprofen, and naproxen, can cause inflammation in the intestines. Use a different drug, like acetaminophen, for pain and fever.

Antibiotics: These can cause diarrhea and inflammation by changing the balance of bacteria in your intestines. If a doctor prescribes antibiotics for you, let your ulcerative colitis doctor know before you use them.

You'll need to see your UC doctor regularly. It may be every 6 months while you're in remission. You'll have routine procedures like colonoscopies and bloodwork to check on your UC.

If you're having a flare-up, make sure to check in with your doctor. UC isn't the only thing that causes digestive symptoms. They may need tests to rule out something else, like an infection. Or you may need your prescriptions adjusted.

Certain symptoms mean you need help right away. Call your doctor if you:

  • Can't keep liquids down
  • Have severe diarrhea
  • Pass blood in your stool
  • Are in constant pain
  • Have a fever

When you have a flare, you can ask your doctor questions like these:

  • Is UC causing my symptoms, or could they be due to another condition?
  • Do I need to take any tests? If so, how often will I need to get them?
  • Will you need to change the dose or type of my medication?
  • If I need to take a new medication, what side effects could it cause?
  • Should I make any lifestyle changes?
  • When should I come back for another appointment?

While you work with your doctor to get your flare under control, you can take steps to ease certain symptoms:

Pain. Experts say acetaminophen is the safest way to get pain relief. If it doesn't help you enough when you have pain in your stomach or another body part, ask your doctor what other meds they'd recommend.

Sometimes UC is linked to pain beyond your gut. If you get eye pain or if your eyes feel sensitive to light, see a doctor called an ophthalmologist as soon as possible. Some people living with UC develop eye problems that need fast treatment.

If you have leg pain or pain in another large joint, it might be due to arthritis linked to your UC. Your doctor may tell you to rest the joint that hurts. They may also recommend that you occasionally soothe it with moist heat, like from a warm bath or heated wash cloth. You could also ask the doctor if physical therapy might help.

Irritated bottom. Keep it clean with moist wipes and protect it with diaper cream. You could also soak in a saltwater bath.

At night, put on all-purpose skin protectant, like zinc oxide (Desitin), to ease irritated skin around your anus.

Good hygiene helps, too. Shower off with a hand shower. Or use a product that cleans the area around your anus, like Balneol.

Diarrhea. Ask your doctor if you can take an anti-diarrheal drug, like bismuth subsalicylate (Pepto-Bismol) or loperamide (Imodium).

Canker sores. Medicated mouthwash may ease the irritation that these small mouth ulcers bring on. A balanced diet and a multivitamin or mineral supplement may help, too. Talk to your doctor before you try any new supplement.

In general, give yourself extra TLC when you have a flare. Get enough sleep, eat healthy, take charge of stress, and take some breaks for “me” time.

You can play an active role in managing your UC. Keep track of your symptoms and note any changes. Log what you eat and drink, how you're feeling, and what's going on in your life. Record your medications and procedures. You might discover a link between what you do and how you feel that can help you and your doctor tailor your treatment. It will also help you spot complications early.

You may have heard about diets for people with ulcerative colitis. There's no evidence that certain foods can cause UC, cure it, or set off a flare. But if you're having a flare, what you eat and drink can make symptoms worse:

  • Fried or greasy foods can cause diarrhea and gas.
  • Foods like beans, cabbage, and broccoli are likely to give you gas.
  • Dairy products can cause gas, diarrhea, and cramps if you're lactose intolerant.
  • High-fiber foods, like raw fruits and vegetables, and whole grains, can make you have to poop more often. Don't skip fruits and veggies, though. You can steam, bake, roast, or grill them instead of eating them raw.
  • Carbonated drinks like soda can give you gas.
  • Alcohol and caffeine can cause diarrhea.

When you're having a flare:

  • Eat smaller meals eaten more often. It may be easier on your system.
  • Drink plenty of water. Diarrhea that comes with UC can make you dehydrated.
  • Avoid or cut back on dairy, alcohol, and caffeine.
  • Stay away from high-fiber snacks like nuts, seeds, corn, and popcorn. Then see if your symptoms improve.

UC can make it hard to eat normally, so you may lose weight. Your body also may not be able to absorb the nutrients you need.

Talk to your doctor to see if they recommend you take supplements. You could think about seeing a nutritionist, too. They can come up with an eating plan that works for you.

You can also use these tips to make an ulcerative colitis diet plan.

It won't stop flare-ups from happening, but being active can improve your overall health, lift your mood, boost your immune system, and prevent some complications of the disease. UC may limit what activities you can do, but even light exercise, like walking, can help.

Having UC may make you anxious to leave the house because you don't know when you might have to go. You can manage that by being prepared.

  • Carry a supply kit with things like baby wipes and spare underwear.
  • Figure out where public bathrooms are ahead of time.
  • If your symptoms tend to strike at certain times of the day, schedule outings for other times.
  • Have someone you can call to help you in an emergency.
  • Talk to your human resources department at your job about any accommodations you may need at work.

It's stressful to live with a disease like UC. Stress may not bring on a flare, but it does make digestive symptoms worse. Along with exercise, some things you can do to lower your stress include:

 

You may feel embarrassed to talk about UC. But if you let your family and friends know what you're going through, they can help and support you. Find a support group to talk to others who are managing UC. It's good to connect with people who know what you're going through. Don't be afraid to reach out for professional help if you're having trouble managing your feelings or think you might be depressed.