- Hormones
- Eating foods that trigger symptoms
- Missing your medications (or taking the wrong dose)
- Drinking (especially too much)
- Smoking
- Stomach bugs
- OTC drugs
- Mood
Let’s take a closer look at these potential flare-up causes.
Hormones
Your period can bring on cramping and diarrhea, which can make it confusing to tell if it’s your UC or just that time of the month.
“This is thought to be related to hormonal changes,” Tanvi Dhere, M.D., a gastroenterologist and Director of IBD at Emory Healthcare in Atlanta, tells SELF. For instance, some research suggests that spikes in estrogen can lead to worse symptoms in people with ulcerative colitis.2
You might be wondering: How could this hormonal aspect potentially affect ulcerative colitis flare-ups during pregnancy? Unfortunately, it is possible to experience UC symptoms during pregnancy, and IBD that isn’t under control during pregnancy may raise the risk of birth outcomes like premature labor.3 This is why experts recommend that people with ulcerative colitis who want to get pregnant only conceive when their disease is under control. If you are thinking of getting pregnant, it’s a good idea to talk to your doctor about the medicines you take so you can either get the all-clear to keep taking them or figure out whether other meds may be better.
“Most of the medications, including many of the immunosuppressives that we use in IBD, are considered safe in pregnancy,” Dr. Dhere says. “There are a few that should be avoided. It is important to discuss this with your IBD care-provider team prior to conception and to ensure that you have an open and honest relationship with them and have a treatment plan in place.”
Diet
The relationship between ulcerative colitis and diet is pretty complex and calls for much more research. But what’s clear is that many people with ulcerative colitis have trigger foods that can bring on flare-ups or make an ulcerative colitis episode worse. Some common ulcerative colitis food triggers include:
- Beans
- Broccoli
- Cabbage
- Carbonated drinks
- Dairy products
- High-fiber foods like fruits, vegetables, and whole grains
None of this is to say you absolutely can’t have any of these foods if you have ulcerative colitis. (And, in fact, you shouldn’t wholesale cut out a bunch of food groups in an effort to manage your conditions—at least not without medical guidance.) But if you start to notice consistent ulcerative colitis symptoms after eating or drinking certain items, it’s worth bringing up with your care team.
Skipping your medications
It’s easy to think that missing a dose here or there won’t impact your ulcerative colitis. But a medication holiday isn’t the kind of holiday you want to take. From app-based pill reminders to rewarding yourself with a fun activity every time you’re done with an injection, do whatever you need to do to remember to take your meds as prescribed.
Drinking (especially too much)
Excess alcohol consumption can worsen your symptoms. You may not have to skip it entirely, but it’s true that even drinking in moderation can be hard for those with ulcerative colitis. As with many aspects of life with this condition, it may take some trial and error to figure out exactly what’s right for you here.
Smoking
Smoking can worsen symptoms of certain inflammatory bowel conditions, such as Crohn’s disease, and make it harder for you to manage your condition. While research has shown that smoking can have a protective effect when it comes to the development and progression of ulcerative colitis, doctors say the harmful effects of smoking still don’t outweigh any potential benefits.4 Ask your doctor about treatments to help (like smoking cessation programs in your area and nicotine patches). You can also call the toll-free national smoking quitline at 1-800-QUIT-NOW (1-800-784-8669).
Stomach bugs
Gut infections can add insult to injury for those with ulcerative colitis. When you have an infection with stomach-upset side effects, your ulcerative colitis can naturally flare up. Add that to the long list of reasons why it’s a good idea to do your best to avoid coming down with things like food poisoning or the stomach flu. (Wash your hands thoroughly, especially when doing food prep, cook food thoroughly, avoid others who are ill whenever possible, etc.)
OTC pain relievers
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium are go-tos for headaches, period pains, and more. But some NSAIDs can trigger ulcerative colitis flares. Making the swap to other kinds of pain relievers, like acetaminophen, can help.
Mood
As if you didn’t already know, stress affects a whole host of bodily functions. Ulcerative colitis is no exception. Mood changes that stress you mentally can in turn stress you physically.