How to act in case of an outbreak of ulcerative colitis?

July 12, 2022


Outbreak of ulcerative colitis

To what extent can an outbreak of ulcerative colitis interfere with my future plans? Will those outbreaks have implications for my social and family relationships? What about my professional achievements? What can I do when they show up? These are some of the questions that concern people who are diagnosed with ulcerative colitis. And that is because, although today these patients can have a good quality of life, it is inevitable that they worry about the moments when the symptoms of their illness are activated. That is because their expectations and quality of life will be altered.

To understand what an outbreak is, it is important to know that ulcerative colitis will be silent at many times. In other words, the patient will have remission periods1. However, at other times, the patient will experience abdominal pain, diarrhea, blood in the stools or a sense of urgency.These symptoms warn of a possible outbreak of ulcerative colitis. Depending on the intensity of the outbreak, other systemic symptoms, also called extraintestinal manifestations (EIM), that affect organs and tissues throughout the body, may appear.

Knowing how to act in case of an outbreak of ulcerative colitis is very important to stop the intensity and duration of the episode. The first step will always be to follow the recommendations of our healthcare professionals at all times. They will ensure to handle our case in an effective and personalized way. In addition, we will be conveyed the recommendations at the level of hydration, nutrition, physical exercise, stress and medication that we need. Below we provide some of these tips.

Hydration in outbreaks of ulcerative colitis

Diarrhea is an intestinal disorder that alerts the patient to possible dehydration. This is when we can suspect that the patient is suffering a relapse. In this situation, it is essential to act calmly so as not to increase the intensity of the outbreak.

Some tips for treating diarrhea are:

  • Increase water intake: it can be bottled, boiled or treated.
  • If diarrhea persists for more than one day, it is recommended to take oral rehydration salts (ORS) or, otherwise, a substitute made from 1 liter of bottled water, 6 tablespoons of sugar and 1 tablespoon of salt.
  • If the diarrhea lasts for more than three days and is accompanied by fever, vomiting and blood in the stool, the patient should see a doctor or visit the appropriate inflammatory bowel disease unit.
  • Under no circumstances should medications to stop diarrhea be taken without medical supervision.

Stress influences outbreaks of ulcerative colitis

Stress is not considered a cause of ulcerative colitis, but it can be the trigger for more serious psychological disorders such as depression and anxiety. In fact, these are identified as two of the most prevalent psychological disorders among patients with Inflammatory Bowel Disease (IBD). Some studies have shown that stressful situations or traumatic life events can exacerbate an ulcerative colitis that is in remission. In other words, stress increases the chances of an outbreak2.

In particular, some of the concerns the patients have are: fecal incontinence and the feeling of urgency, fear of having a new crisis, anticipative anxiety of experiencing some episode in public or not performing well at work or academically, among others.

The reverse can happen too: an outbreak of ulcerative colitis may lead to depression or anxiety. In particular, it is estimated that, in active periods (outbreaks) of the disease, these problems can affect 80% of patients3.

In these cases psychological intervention is one of the pillars in the treatment of ulcerative colitis4. By offering tools to adapt to the disease and the new situation, adherence to pharmacological treatment and assistance to controls is favored. Thus, professionals positively influence the reduction of stress and the improvement of the quality of life of patients with ulcerative colitis.

Physical exercise and ulcerative colitis

Leading a healthy lifestyle helps reduce the stress and anxiety caused by the illness itself. They are also important in order to maintain a good functioning of the intestines, and to strengthen bones and muscles. For this reason, walking, swimming, cycling, practicing pilates or yoga, and even doing exercises at home are more than advisable, both in a situation of remission and relapse.

Diet to follow in case of outbreak

For patients with ulcerative colitis in remission, the diet should be as varied and balanced as possible. However, those who suffer an outbreak must modify their diet5 by reducing the intake of:

  • Fiber: whole grains and fresh fruits and vegetables. They should not be completely removed from the diet. They can be consumed baked, steamed or roasted. Basically, the goal is to reduce the chance of having diarrhea and stomach cramps.
  • Saturated fats and sugar.
  • Lactose-containing foods, mainly milk. Its use can be a cause of worsening of symptoms in periods of inflammatory activity. Nevertheless, it is advisable to maintain the intake of dairy products such as yoghurts, which are better tolerated because the milk is fermented.

On the other hand, for patients with weight loss or who suffer from growth and pubertal development retardation it is advisable to lead a hypercaloric diet.

  1. Remission of inflammatory diseases – Adacyte
  5. Five keys to a proper diet if you have ulcerative colitis – Adacyte

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