Woman Staying Hydrated
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Stay Hydrated

When you have ulcerative colitis (UC), your large intestine can have a hard time absorbing water and salt. This can cause diarrhea, which is common with UC flares. That can make you dehydrated. 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 peed in 12 hours, see your doctor right away.

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Soothe Skin Irritation and Pain

Bouts of diarrhea often can bother your skin. Use moist towelettes for wiping. Follow up with a petroleum jelly ointment. Need more relief? Soak in a saltwater 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.

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Eat Easy-to-Digest Foods

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.

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Plan Ahead, Locate Bathrooms

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.

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Tell Your Doctor

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. Sometimes doctors also prescribe “biologic” drugs for UC.  

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Make Medications Easier to Take

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 applesauce, peanut butter, or other foods.

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Meds for Diarrhea

Have diarrhea from a mild flare? These medications may help. They're available over the counter -- bismuth subsalicylate or loperamide, for example -- 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.

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Seek Support

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.

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Give Yourself Some TLC

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.

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Keep Up With Your Medicine

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. Let your doctor know when you have a flare while you're on your usual medication plan. Take medicines only as directed. The same goes for when you feel good and may be tempted to skip doses, too.

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Tap Into 'Good' Bacteria

Antibiotics can trigger flares. If your UC gets worse while you take them, tell your doctor. Some scientists think antibiotics cause issues because they kill "good" bacteria in your gut that aid digestion. Although research is limited, there is some evidence that probiotics, which contain these bacteria, along with other medications may be helpful, but this has not been proved.

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Warning Signs

Some flare symptoms are very serious. Get medical help right away if you have: 

  • A high fever
  • Severe belly pain
  • Constant, heavy diarrhea
  • New or more blood in your stool, or any blood clots

Also get help if you feel like you're going to faint or you vomit over and over.

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Happy Woman at Bar
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Cut Down on Drinking

Alcohol and your ulcerative colitis 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.

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Walk It Off

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.

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Sources | Medically Reviewed on 10/14/2018 Reviewed by Nayana Ambardekar, MD on October 14, 2018

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SOURCES:

Crohn's & Colitis Foundation of America: “Diet and Nutrition,” “Managing Flares and Other IBD Symptoms.”

U.S. National Library of Medicine: “PubMed Health: Ulcerative Colitis.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Ulcerative Colitis.”

Gastroenteritis & Hepatology: “Probiotics in the Management of Ulcerative Colitis.”

UpToDate: “Patient education: Ulcerative colitis (Beyond the Basics).”

The American Journal of Gastroenterology: “Psychological distress, social support, and disease activity in patients with inflammatory bowel disease.”

Inflammatory Bowel Diseases: “Quality-of-life measurement in patients with inflammatory bowel disease receiving social support.”

The American Journal of Gastroenterology: “Stress and exacerbation in ulcerative colitis: a prospective study of patients enrolled in remission.”

Journal of Gastroenterology and Hepatology: ”Probiotics in the Management of Ulcerative Colitis.” 

Gut: “Maintaining remission of ulcerative colitis with the probiotic Escherichia coli Nissle 1917 is as effective as with standard mesalazine.”  

Cleveland Clinic: “Ulcerative Colitis.”

Gut: “Influence of dietary factors on the clinical course of ulcerative colitis: a prospective cohort study.”

Canadian Journal of Gastroenterology and Hepatology: “Exercise and inflammatory bowel disease.”

Reviewed by Nayana Ambardekar, MD on October 14, 2018

This tool does not provide medical advice. See additional information.

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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