Living With Ulcerative Colitis

When ulcerative colitis symptoms flare up, you may find yourself planning life around your disease. A flare can disrupt your plans and drain your energy.

During remission, ulcerative colitis continues to affect your lifestyle in other ways. Daily challenges include taking medications, avoiding certain foods, managing stress, and staying close to a bathroom.¹ Because symptoms are unpredictable, you may avoid certain activities or have to cancel plans.

The main goals of treatment are to find medications that relieve symptoms, produce remission, and keep you in remission.² In addition to medical treatment, making some lifestyle changes and surrounding yourself with supportive people may improve your quality of life.

Diet and nutrition with ulcerative colitis

Ulcerative colitis is different for each person. No single diet has been proven to prevent or cure ulcerative colitis.³ Yet for each individual, certain foods may trigger more symptoms than others. A food diary can help you to track your symptoms and identify your own triggers. You may also find that you can eat differently during remission than during a flare.

Some general tips for eating during a flare are:³

• Eat small, frequent meals.
• Limit greasy or fried foods.
• Hydrate with water, diluted fruit juice, or a low-sugar electrolyte drink.

Insoluble fiber comes from the skin of fruit, vegetables, and beans, leafy vegetables, whole grains, whole nuts, and seeds. Insoluble fiber adds bulk to stool. Bulky stool moves through the body more quickly. Eating foods high in insoluble fiber can also increase gas. Therefore, it may help to limit insoluble fiber during a flare. Instead, choose foods that are easier to digest. Examples include well-cooked starchy vegetables (eg, potatoes), peeled fruits (applesauce, melon), or breads made with refined grain.³

Other foods that may be hard to tolerate include:³

• Lactose, the sugar found in milk and milk products
• Gluten, a protein found in wheat products
• Sugar alcohols, such as sorbitol and mannitol
• Other hard-to-digest sugars called FODMAPs

Stress and symptom flares

Many people with ulcerative colitis notice that stress is linked to symptom flares. Some preliminary scientific research supports this connection as well, although it far from proven.⁴ Certainly, many aspects of having ulcerative colitis contribute to feeling stressed: never knowing when symptoms will flare, having to constantly remain close to a bathroom, missing time from work and school, paying for expensive medications.¹

There are many different ways to manage stress, including:

• Breathing techniques
• Yoga
• Exercise
• Meditation
• Journaling

Mindfulness-based stress reduction has been shown in one small study to improve quality of life during a flare, even when it does not prevent a flare.⁵

Smoking and risk of symptoms

Surprisingly, current smokers have a lower risk of ulcerative colitis than never smokers.⁶ Smokers who have ulcerative colitis tend to have less severe disease.⁶ Nevertheless, the numerous harmful effect of smoking outweigh any benefits in ulcerative colitis.

Conversely, smoking increases the risk of developing Crohn’s disease, the frequency of Crohn’s disease flare ups, and the likelihood of needing surgical treatment of Crohn’s disease.

Working and employment with UC

Although many people with inflammatory bowel disease do work, managing ulcerative colitis and a job can be challenging. You are not required to tell your employer about your disease, either during the interview or once you have the job.⁷ However, you may decide to share some information with your supervisor or colleagues in order to get the support you need.

Certain laws may protect employees with inflammatory bowel disease.⁷ The Americans with Disabilities Act is a law that prohibits discrimination against individuals with disabilities. Under this law, you may be entitled to reasonable accommodations so that you can perform your job. The Family and Medical Leave Act entitles certain employees to unpaid, job-protected leave for specified family and medical reasons. If you request accommodations under either law, you must disclose your health condition.⁷ Your employer may have specific policies about how to request accommodations or provide notice of leave.

If you are unable to work, you may consider applying for Social Security disability benefits.

Getting support when living with ulcerative colitis

Managing ulcerative colitis may feel overwhelming, and it can be hard to talk about the disease with other people. However, many people with inflammatory bowel disease find that their partners, family, and friends are very supportive. Support comes in many forms. Caregivers may help by keeping track of medications, speaking with doctors, or dealing with insurers. They can help with chores such as cooking, laundry, or cleaning when you are fatigued. Finding people who you can talk with about the disease—in person or online—may help you to feel less isolated.