Tips for recovering after an ulcerative colitis flare-up

After an ulcerative colitis flare-up, most people are eager to get back to their usual activities as quickly as possible. But it can take time for your body to heal. When the worst part of the flare is behind you and your symptoms improve, you may still struggle with fatigue, digestive issues and emotional stress.

During this time, it's important to be gentle with yourself while you begin to heal. The following tips can keep you on track to a full recovery as you ease back into daily life.

As the flare-up eases and your symptoms improve, take a moment to confirm that you have the right medicines for ongoing care. During the flare, your healthcare professional may have changed the type of medicine you take or altered the dosage of your current medicines.

Your care team usually coordinates changes to your prescription medicines with your pharmacy. But make sure that your pharmacy has preapproved prescriptions on file. This can help you get medicines quickly when needed. If you were hospitalized, check the status of your prescriptions before you go home. It's also a good idea to check that you have the nonprescription medicines at home that your care team recommends.

During a flare-up, your treatment might include corticosteroids. These medicines also are called steroids. They quickly control flares but are not safe for long-term use.

Take this medicine exactly as told by your healthcare professional. Don't stop using it without first checking with your care team. You will need to slowly decrease your dose before stopping it completely.

Taking a corticosteroid with food or milk can help prevent stomach upset, which is a common side effect of the medicine. Other side effects can include changes in mood or behavior, trouble sleeping, increased thirst, dizziness, and other complications. Quickly report any side effects or changes in your health to your care team. Long-term steroid use may weaken bones over time. Your healthcare professional may recommend calcium and vitamin D supplements to support bone strength.

It's important to stay in contact with your healthcare team and report new or worsening symptoms. This allows your care team to adjust your treatment and medicines if needed. Your care team also can answer questions, address concerns, and offer helpful information as you heal. In addition, make an appointment with your healthcare professional as soon as possible after a flare-up goes away — even if your symptoms were mild. Having regular check-ins helps prevent setbacks and ensures that you're on track to a full recovery.

Some of the medicines that treat ulcerative colitis can reduce your ability to fight infections. It's important to safeguard your health both during and after a flare-up. Washing your hands and disinfecting doorknobs and other surfaces can reduce your risk of picking up bacteria and viruses. Also, talk with your healthcare professional about the vaccines you might need and when it's safe for you to receive them. Staying up to date on recommended vaccines helps protect you from disease and infection. If you are underweight or not getting all the nutrients you need, you have a higher risk of infection. Your healthcare team can create a dietary plan to help you maintain a healthy weight and addresses your nutritional needs.

After a flare-up, your digestive system likely will be sensitive, even when your symptoms are improving. Eating smaller, more-frequent meals during this time is helpful.

In general, avoid foods that trigger your symptoms. You may want to steer clear of foods that are likely to cause gas, such as beans, broccoli and carbonated drinks. The alcohol in beer, wine and mixed drinks can stimulate your intestines and make diarrhea worse. The same is true of beverages that contain caffeine.

The key is to reintroduce foods slowly, one at a time, and notice how your body responds. Keep a diary to track what foods you can eat and what foods cause symptoms. Over several weeks, continue to gradually add different foods until you return to the healthy diet that your care team recommends.

As you recover from a flare-up, it's important to stay properly hydrated. Diarrhea can cause you to lose more fluids and electrolytes than you take in, which leads to dehydration.

Drinking water helps you stay hydrated — but water alone may not replace the electrolytes you've lost. Electrolytes are minerals like sodium, potassium, magnesium and calcium that help your body maintain the correct level of fluids and other vital body functions.

Drinks that contain electrolytes, such as sports drinks or oral rehydration solutions, help replenish lost electrolytes. Even when diarrhea improves, continue to drink enough fluid to stay well hydrated. The best way to monitor hydration is to check your urine. If it's clear or light yellow, you're probably well hydrated. If it's dark yellow or amber colored, you likely need to increase your fluid intake.

While the exact cause of ulcerative colitis remains unknown, stress can trigger flare-ups and make symptoms worse. When you're stressed, your body can release hormones that increase inflammation, making your gut even more inflamed. This leads to more-frequent and more-severe ulcerative colitis symptoms.

During a flare-up, you may feel worried or upset. This can worsen your symptoms and cause even more stress, creating a vicious cycle. Many people with ulcerative colitis have found that managing stress and addressing negative thoughts can break this cycle — calming both the mind and the gut.

There are several stress management and relaxation techniques that people use to find calm and maintain perspective. No one method has proved more effective than another. The best option is the one that works for you.

Here are some frequently used techniques for managing stress:

• Biofeedback.
• Breathing exercises.
• Cognitive behavioral therapy.
• Exercise.
• Hypnotherapy.
• Meditation and guided imagery.
• Spending time in nature.
• Tai chi.
• Yoga.

Try an approach that appeals to you and don't worry if it doesn't seem to work. Give yourself time to practice or try another technique.

Fatigue is common after a flare-up. Your strength and stamina may take time to return, especially if you were hospitalized or had to stay in bed. It's important to gradually resume activity and rebuild your strength. Start with gentle stretches or movement and short walks. Increase activity as you feel able. Listen to your body — pushing too hard too soon can make fatigue worse and interfere with recovery.

Recovery time varies depending on the severity of the flare-up. If you managed your symptoms at home, instead of being hospitalized, your return to usual activities may be faster but still gradual.

If you've had flares before, you probably have an idea of what to expect and how long it takes to recover. Let your employer or school know that you'll be absent during this time. If needed, ask your care team for a document explaining that an ulcerative colitis flare-up is causing your absence or that you need to temporarily reduce your responsibilities during recovery.

Living with ulcerative colitis can be emotionally challenging and isolating at times, but you don't have to feel alone. Patient advocacy groups, like the Crohn's & Colitis Foundation, provide education, guidance and a sense of community. They offer support for people adjusting to a new diagnosis and for those managing flare-ups over time.

If you're feeling anxious or down, reach out to your healthcare team or a mental health professional for helpful ways to cope.

Recovery is a process that takes time. By keeping these strategies in mind you'll be on your way to recovery and back to your daily life.