Does it feel like you will never escape your IBD? Even when your symptoms are not active, are you thinking about when those symptoms will rear their ugly heads and how will you deal with it? Knowing that you’re already doing your best to avoid triggering a flare-up may help you enjoy other aspects of your life.
When a flare comes unexpectedly, or with symptoms you are not used to, it can be a sign that your medication may need to be changed. Talk to your doctor about this.
Don’t sweat the small stuff
Physical and emotional stress do not cause IBD, but you may find that times of stress are shortly followed by a flare in your IBD symptoms. Even people without IBD can experience a difference in their digestion while dealing with stress. You can’t always control the situations in life that cause you stress, and you can’t always see them coming, which is one reason why they can be so stressful! One thing you do have power over is your reaction to what life throws at you, including your IBD.
Practicing stress management techniques can help you learn to take things in your stride and reduce your future stress levels. You may find that simple things like making the time to talk to friends, indulging in a hobby, or going for a walk can help you deal with the stresses in your life.
Stress is a personal experience and we all deal with it differently. So use whatever works for you.
Missing doses means you could miss out
Flares can be triggered by missing doses of your medicine, or by taking incorrect doses. It may even be with your doctor’s approval, when you are starting a new medication or are being weaned off a current one.
If you have trouble remembering to take any medication you are prescribed, talk to your doctor about it. This can happen in chronic conditions like IBD where you sometimes have to take medicine for a long period, even when you are free of symptoms. Your doctor may have another option which fits better with your lifestyle, or they may have some tips to help you stay the course.
If your symptoms flare after a change made by your doctor, let them know straight away. It will help them decide whether that change is the right one for you.
Antibiotics and NSAIDs
Two commonly used types of medicines can bring on a symptom flare-up – non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics.
NSAIDs are a family of pain killers, including ibuprofen, aspirin, and diclofenac. Talk to your doctor or pharmacist about alternatives the next time you experience mild pain or a fever.
You may be prescribed antibiotics to treat a bacterial infection. However, they can affect the native bacteria in your intestinal tract. There are many, many different types of bacteria which colonise your gut, and altering their balance can lead to symptoms like diarrhoea and inflammation. If you experience IBD symptoms during or after taking antibiotics, tell your doctor straight away.
You can help to prevent flares caused by medication by asking other healthcare professionals to consult your gastroenterologist before they prescribe you a medicine, and by talking to your gastroenterologist about any new medicines and supplements before you take them.
Food for thought?
Food can be a common trigger for a flare, although this will not be the case for every person with IBD, nor every flare. Because your diet can vary considerably, it may be hard to pinpoint whether something you ate contributed to a flare. Keeping a food diary can help you spot patterns in your intake that lead to a flare, so you can try to avoid them in the future.
There are a few different foods that are known to trigger IBD flares. Try to steer clear of greasy and fried foods, they have little nutritional value and can cause gas and diarrhoea. Other gas-inducing ingredients you should be mindful of include beans, cabbage, broccoli, caffeine, carbonated drinks and dairy foods. Alcohol should only be consumed in moderation. If you think food might be triggering your flares, eating smaller meals more often could help.
See a doctor or dietitian before eliminating any problematic foods from your diet.
Cigarettes are a known risk factor and potential flare trigger in Crohn’s disease. In fact, smokers with Crohn’s disease who’ve quit have reported fewer flares and reduced need for medication. Interestingly, ulcerative colitis is more common in non-smokers and ex-smokers, and smoking cessation can cause an ulcerative colitis flare. However, the general health risks associated with smoking offset any potential benefit in avoiding ulcerative colitis flares.
Managing a chronic condition like IBD is a long-term game. Set-backs happen, but they’re normal and they give you a chance to learn new coping strategies as well as better ways to help prevent future flares.