Ulcerative colitis (UC) is a chronic disease that causes inflammation and ulcers in the lining of the colon, rectum or both. It can be mild to severe but usually has periods of remission — when there are no symptoms.
A flare-up is a sudden worsening of UC symptoms, such as diarrhea, nausea, and pain. Certain factors increase the chance of a flare-up, such as not taking UC medications, as well as stress, smoking, and some medications.
Read on to learn how to stop a UC flare-up, when to contact a doctor for flare-up symptoms, and tips to help prevent flare-ups.
5 ways to stop an ulcerative colitis flare-up
An unusual immune system reaction drives the inflammation and symptoms of UC. As the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains, you may alternate between times of remission and flare-ups, with symptoms that vary in intensity between people.
You may not be able to completely stop a flare once it starts, but some strategies may help ease symptoms.
You want to avoid foods that can cause irritation and inflammation in your digestive tract and aggravate your symptoms. Avoid:
- spicy foods
- fried and greasy foods
- carbonated drinks
- high fiber foods such as fresh vegetables
Instead, try eating bland food options, such as white rice or potatoes. Include some low fat foods and proteins, such as tuna, because these foods are easy to digest and are gentle on the gastrointestinal tract.
Find out the best and worst UC foods.
The word “diet” can have many meanings. This article uses “diet” to refer to an eating lifestyle rather than a temporary change in how you eat.
UC flare symptoms like diarrhea, vomiting, and lack of appetite can lead to dehydration. Staying hydrated also helps your body get rid of wastes that can lead to inflammation and irritation.
The Centers for Disease Control and Prevention (CDC) advises drinking water instead of sugary drinks. You also get fluids from the food you eat, including items from a bland diet, such as pudding, broth, and spinach.
3. Keep stress to a minimum.
With stress, your body produces higher cortisol levels, a stress hormone that can cause inflammation and UC flares.
While you may not be able to entirely stop your stressful days, there are some things you can do to help reduce your stress levels and keep yourself in a healthy state of mind. These include:
- getting enough sleep
- exercising
- meditating
Regular exercise reduces stress and has a calming effect, which is helpful during a flare. It may also boost your immune system, according to the Crohn’s & Colitis Foundation (CCF), an advocacy group.
Physical activity strengthens the heart and lungs. This, in turn, increases the amount of oxygen in your blood and keeps your organs — including your digestive tract — healthy.
You may not feel well enough to exercise during a UC flare. Remember that low intensity exercise like walking is a great choice. If you do not want to go out to exercise, try a gentle yoga routine a few times a week.
5. Reduce your alcohol consumption.
Alcohol consumption may lead to inflammation and other ulcerative colitis flare-up symptoms. If you drink alcohol, stopping may ease your symptoms and help prevent flares.
Learn more tips for managing UC flares.
Warning signs of an ulcerative colitis flare-up
UC flare-up symptoms can be painful and uncomfortable, but they do not always indicate a serious illness.
The most common symptoms, per NIDDK, include:
- diarrhea
- blood, mucus, or pus in your stools or stool that appears black or tarry in texture
- rectal bleeding
- tenesmus, which is a painful urge to defecate even though your bowel may be empty
- bowel movement urgency
- abdominal pain or cramps
- feeling tired
The duration of a flare-up varies depending on how much inflammation is present and how severe it is. Flare-ups can last from a few days to several weeks.
If you are having a flare-up, contact your doctor as soon as possible because prolonged symptoms can lead to serious complications, such as bowel perforation.
Contact your doctor if:
- You have been experiencing diarrhea for more than 3 days in a row.
- Your symptoms worsen when you eat something new such as foods made with nuts.
- You have a high fever.
- You have severe abdominal pains with more blood or blood clots in your stool.
- You are unable to pass gas or stool.
- You are vomiting.
- You have unexplained weight loss.
With a clinical evaluation, your care team may:
- identify an underlying condition, such as infection, that could be causing your symptoms
- prescribe or modify your medications to:
- ease your symptoms
- shorten the duration of the flare
- reduce the likelihood of another flare
- recommend or modify your diet to include certain foods that can help you recover
Read How Severe Is Your Ulcerative Colitis?
CCF notes a variety of factors that may bring on a flare-up or exacerbate your symptoms, including:
- stress
- certain foods like spicy foods
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- antibiotics
- missing or not taking prescription medications
- smoking tobacco
A small 2014 study in the World Journal of Gastroenterology found that medication nonadherence was the most significant risk factor for flares.
Preventing ulcerative colitis flares
The following tips for preventing and managing UC flares are based on CCF and a 2020 review of dietary supplements for UC and other inflammatory bowel diseases.
Self-care at home, complementary therapies, and medications include:
- self-care:
- drink plenty of water
- eat a well-balanced and nutritious diet
- keep your stress levels low
- exercise regularly
- eat smaller portions more frequently
- reduce alcohol consumption
- avoid smoking
- dietary supplements:
- fish oils
- vitamin D
- probiotics
- take medications as prescribed, which may include:
- aminosalicylates like mesalamine
- corticosteroids
- antibiotics
- antidiarrheals
- immune modulators to suppress the body’s immune response
If your medicines are not managing your flares or you develop serious complications from UC, you may need surgery to remove your colon.
The procedure is called a proctocolectomy with ileostomy or an ileoanal reservoir to help you in passing stool.
Learn about UC surgery.
Frequently asked questions
Kelsey Trull, PA-C, reviewed the following questions.
How long do ulcerative colitis flare-ups last?
Each flare-up varies between people. It may last for days or weeks.
What foods heal ulcerative colitis?
Foods that are nutritious and easy for the body to digest may help heal your intestinal lining, but they do not heal, cure, or prevent UC flares. These types of foods include:
- low fiber vegetables and fruits like ripe bananas and watermelons
- low fiber and bland carbohydrates like rice and potatoes
- low fat foods
- proteins such as salmon and eggs
UC is a chronic disease that causes inflammation of the lining of the colon, the rectum, or both. A flare-up can cause diarrhea, blood in stool, fever, and abdominal pain.
Bland foods, fluids, and relaxation techniques may help ease flare symptoms. You may need prescription medication to stop a flare.
UC flare symptoms can be severe. Seek medical treatment for severe symptoms or if your symptoms persist for more than a few days.