Ulcerative colitis (UC) is an ongoing condition that can cause inflammation and open sores, called ulcers, in the lining of your large intestines. It can start suddenly but usually begins slowly over time. UC can range from mild to severe. For most people, it comes and goes. Sometimes remission – time between flare-ups – can last for years.
If your condition is relatively mild, you may only have two to four bowel movements a day. The more serious your condition, the more likely you are to experience other common symptoms such as tiredness, fever, nausea, or weight loss.
About half of people with ulcerative colitis have symptoms that are classified as mild. This type of UC can usually be treated without surgery or other extreme measures.
Medications for Treating Mild UC
Ulcerative colitis is often treated with medications. The medication used will depend on how severe it is. These drugs work by reducing inflammation in the large intestine. For mild cases, your doctor may prescribe:
- Aminosalicylates. These are the type of drug most often used for mild to moderate ulcerative colitis. It’s also used to help those in remission stay in remission longer. These can be given as an oral pill, or by enema or suppository.
- Corticosteroids. Because of their side effects, these are not usually the first line of treatment if you have mild or moderate ulcerative colitis, but they may be used for the short-term if you aren’t responding to aminosalicylates.
There are also over-the-counter drugs that can help manage symptoms. These might include:
- Acetaminophen. This pain reliever is safer for people with ulcerative colitis than nonsteroidal inflammatory drugs (NSAIDs) such as ibuprofen, which can make symptoms worse.
- Calcium and vitamin D supplements. Your doctor might recommend these to help slow bone loss and osteoporosis, which can be a side effect of long-term steroid use.
- Iron supplements. These may be given if you often pass blood when you poop. This is caused by bleeding in the intestines, which can make you anemic, meaning you have low levels of iron in your blood. This is also less common in mild cases, but it can happen.
- Probiotics. The research on these is still in its early stages, but there is some evidence that they can help, possibly by directly reducing inflammation, restoring balance to your gut bacteria, or healing the cells that line your intestines. Talk with your doctor before taking probiotics.
Changes to Make to Your Diet To Help With UC
Eating a healthy and well-balanced diet is important even for mild cases of ulcerative colitis. This could help prevent it from getting worse. While research hasn’t found which specific foods cause ulcerative colitis symptoms, you may have certain “trigger foods” that can make symptoms worse. Talk with your doctor about creating a meal plan. They may refer you to a dietitian who can help you find a pattern.
A diet for ulcerative colitis generally involves:
- Limiting dairy. People often find that this reduces diarrhea, cramps, and gas.
- Eating smaller meals. You may feel less discomfort if you eat five or six small meals a day instead of just a few large ones.
- Drinking lots of liquids. Stick to water and other flat, sugar-free beverages. Don’t drink too much alcohol or caffeine, which stimulates your intestines, or soda or sparkling water, because carbonation can make you gassy.
- Avoid greasy, sugary, and high-fiber or “gassy” foods. This includes takeout, sweets, and bowel-moving foods like bran, beans, and broccoli.
Reduce Stress to Combat UC Flare-Ups
While stress doesn’t cause ulcerative colitis, it can trigger flare-ups and make your symptoms worse. Try the following for lowering your stress levels:
- Exercise. You’ve probably heard it a lot, but it’s true – even mild exercise is important for combating stress and inflammatory disease. It can also give you a boost in fighting depression, and it can help keep you more regular.
- Biofeedback. This is a technique that uses a device to help you reduce tension in your muscles and slow your heart rate. There are lots of types of biofeedback machines out there. They give you information about how your body is functioning by measuring different things using sensors. These include brain waves, your breathing or heart rate, muscle contractions, sweat glands, and temperature. Talk with your doctor about what device might be best for you.
- Relaxation and breathing exercises. This could include trying things like yoga and meditation. There are many options depending on your needs, from in-person classes to videos online.
- Get enough sleep. This can help you better cope with stress and prevent flare-ups.
- Talk to a mental health pro. A therapist, counselor, or psychiatrist can help you navigate all of these strategies. They can also help you talk through the negative and sometimes embarrassing effects that UC can have on your life.
Monitoring Ulcerative Colitis
Even if your condition is mild, your doctor may want you to occasionally get colonoscopies. These help your care team monitor the inside of your rectum and colon to make sure your treatments are working and you’re healing. It will also help them watch for signs of colon cancer, which is an increased risk for people with IBD.