Eating Poorly: “There’s no food or food group that causes or cures ulcerative colitis,” Yun explains. Likewise, no specific food has been shown to trigger a flare. But doctors do recommend an overall healthy diet, even when you’re not experiencing ulcerative colitis symptoms. Sticking to nutrient-rich foods — and avoiding those that have caused digestive issues in the past — may help keep you in remission. What you eat may also make a difference when you’re having an ulcerative colitis Inflammatory Bowel Disease flare. “I recommend a low-residue diet when symptoms are active,” says Yun. This means eating low-fiber foods that are easy to digest and cooking your veggies before you eat them. It also means cutting out foods that put your bowels to work, such as beans, whole grains, nuts, seeds, and some raw fruits and vegetables.
Not Drinking Enough Fluids: If you’re experiencing a bout of diarrhea, you run the risk of becoming dehydrated because your body may be losing more fluids than it’s taking in — especially if you’re not drinking enough. This can be harmful to your body’s overall well-being and ability to heal. Drink as much water as you can during an ulcerative colitis flare. However, there are some liquids that you should think twice if you have diarrhea. These include caffeinated coffee, soda, and the ultimate no-no: prune juice.
Drinking Coffee and Caffeine: Can caffeine make diarrhea worse? You bet it can, says Yun. That’s because it’s a stimulant. If you’re constipated, this can work to your benefit. But while there’s no evidence to show that drinking coffee specifically triggers an ulcerative colitis flare, people with active ulcerative colitis Inflammatory Bowel Disease symptoms or those who are worried about having them should consider skipping the coffee and caffeinated drinks.
Drinking Carbonated Beverages: When you’re in the midst of an ulcerative colitis flare, avoid sodas and other drinks with carbonation — they can be irritating to the lining of your digestive tract. Also, because many of these drinks contain caffeine and sugar, both of which can contribute to diarrhea, you might be giving yourself a double dose of irritation. Opt for plain water instead.
Eating Large Meals: When ulcerative colitis symptoms are active, you can ease your body’s burden by eating frequent yet smaller meals so the volume of food and fluid is stable and limited. Consider having five fist-sized meals every three to four hours instead of three large meals a day. On top of helping reduce discomfort from ulcerative colitis symptoms, this strategy is also a way to cope with nausea or loss of appetite that might accompany your symptoms.
Not Paying Attention to Trigger Foods: If you’ve never kept a food diary, now may be the time. Although there are no specific foods that have been found to be universal triggers of ulcerative colitis flares, many people with ulcerative colitis find certain foods seem to either bring on symptoms or make symptoms worse. It pays to avoid these foods once you know what they are. For example, dairy products can be particularly irritating for people who have both ulcerative colitis and lactose intolerance. If this is the case for you, be vigilant about cutting out all dairy products.
Not Treating Infections: Infections outside of the gut won’t aggravate ulcerative colitis Inflammatory Bowel Disease, but the antibiotics you take for them could. If you’re taking an antibiotic for an infection, let your doctor know if you start to experience diarrhea. A switch in antibiotics might be needed. Your doctor may also suggest taking a probiotic, which may help reduce antibiotic-related diarrhea. It’s also possible to develop a gut infection with similar symptoms, so if an antibiotic medication switch doesn’t help, see your doctor make sure you don’t have an additional infection that needs attention.
Ignoring Stress: Dr. Bloomfeld and Yun both agree: When asked, people with ulcerative colitis Inflammatory Bowel Disease often report experiencing stress before a flare. A study published in the October 2013 issue of the journal Inflammatory Bowel Disease, which looked at 75 people with ulcerative colitis Inflammatory Bowel Disease, found that short-term stress was a risk factor for relapse. Stress can lead to a flare in a variety of ways, such as potentially starting an immune system response that leads to inflammation, or simply knocking you out of your usual routine, leading to poor diet, sleep, and medication habits. At Yun’s clinic, a psychologist teaches relaxation exercises to people with ulcerative colitis. Learning techniques such as meditation or yoga may help manage the stress in your life.