Question:
What can be done to reduce flare-ups of ulcerative colitis?
Answer:
The usual recommendation to protect against flare-ups of ulcerative colitis is for patients to remain on one of the salicylate-based drugs (such as Asacol or Azulfidine) once their colitis is in remission. Their dosage can be lower than that used to treat active disease. Agents that suppress the immune system such as azathioprine (Imuran) and 6-mercaptopurine (Purinethol) are also used to protect against flare-ups in patients whose disease has been severe. However, these drugs carry more risk than the salicylate-based drugs. Doctors try to avoid the long-term use of corticosteroids such as prednisone.
Another way to help avoid flare-ups is stress avoidance, since anxiety can trigger increased symptoms in someone with ulcerative colitis. Some physicians will recommend a mild tranquillizer for patients prone to stress.
The daily intake of a fermentable fiber supplement, specifically plantago ovata seed, has been reported to be beneficial in sustaining remissions from ulcerative colitis. However, there is not a lot of evidence to support this approach.
It would be wise to avoid non-steroidal anti-inflammatory drugs (NSAIDs), which are known to activate colitis in a small number of patients. Examples of NSAIDs include ibuprofen and naproxen.
Are there any dietary changes you can make to try to avoid flares of ulcerative colitis? One study looking at the food intake of patients found that those whose diets were high in red meat or those who drank alcohol were more prone to relapses of colitis, but it would be premature to make any recommendations based on this single report.
