如何应对溃疡性结肠炎急性发作

Together with medications, diet and lifestyle changes may help reduce the severity of ulcerative colitis symptoms during flare-ups.  

Ulcerative colitis (UC) is a long-term condition. It causes inflammation and ulcers (sores) on the inner lining of the large intestine. While the exact cause is unclear, health experts believe a combination of genes, an abnormal immune response, and gut microbiome may play a role. 

UC symptoms typically worsen over time. However, in some people, the symptoms may improve or disappear temporarily. This period, when you experience minimal or no symptoms, is known as remission. 

What Are Ulcerative Colitis Flare-Ups?

An ulcerative colitis flare-up is a period when the symptoms reappear or worsen after remission. Flare-ups can cause mild or severe symptoms, which may last for hours, a few days, or months. Likewise, the gap between flares might be weeks or years. 

What Causes Ulcerative Colitis Flare-Ups?

Researchers have yet to find the exact cause of ulcerative colitis flare-ups. What they know is that diet and stress may trigger flare-ups.

You may be at a higher risk of developing recurrent UC flare-ups if you have [1]:

• Bowel incontinence (failure to control bowel movements)
• A family history of ulcerative colitis

Symptoms of Flare-Ups

Symptoms vary widely and may include:

• Diarrhea six or more times a day
• Blood or mucus in the stool
• Severe abdominal pain and cramps
• Urgency to pass stool
• 疲劳 
• 发烧 
• 体重减轻
• Anemia (low hemoglobin level or fewer red blood cells in the blood)
• 气促 
• 心律不齐 

Some people may have joint pain, mouth ulcers, and irritated eyes. 

How To Manage Ulcerative Colitis Flare-Ups

Because UC is a lifelong condition, you will need to visit your provider regularly. Regular visits are necessary even when you are in remission. When you first experience a flare-up, inform your provider. They will help you determine the cause and adjust medication if needed. 

To reduce irritation during a flare-up, replace your toilet paper with wipes. You may also take acetaminophen to relieve pain. 

Along with your prescribed medications, use the following tips to help manage symptoms. 

Identify the Triggers

Triggers can vary from one person to another. Common triggers include:

• Pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs like ibuprofen, naproxen, aspirin)
• Antibiotics (they can disrupt microbial balance in your gut)
• Foods, such as dairy products, high-fiber foods, greasy foods, caffeine, spices, sodas, and alcohol
• Stopping your UC medications without talking to your provider 
• Hormonal changes during periods and pregnancy
• Abnormal electrolyte levels 

管理压力

Stress does not cause ulcerative colitis, but it can trigger a flare-up or worsen symptoms. Try meditation, yoga, mindfulness, or exercise to reduce stress. 

Regular exercise may help boost your feeling of well-being and diminish some UC symptoms [2].

Watch What You Eat

Certain foods may trigger flare-ups. Avoid them if you know which foods are the culprit. Eat mindfully whenever possible. Instead of large meals, eat four or five small meals every day. 

根据 克罗恩病和结肠炎基金会, the following foods may help reduce discomfort during a flare-up [3]:

• Fruits like bananas and raspberries
• Cooked green vegetables 
• Healthy fats (fatty fish, walnut butter, flaxseed oil)
• Cooked or reheated starches (rice, potatoes, sweet potatoes, oatmeal)
• High-protein foods, such as chicken, tofu, fish, turkey, eggs, yogurt, beans, and chia seeds

Drink plenty of fluids every day to maintain electrolyte balance and prevent dehydration. Apart from water, which is the best for rehydration, you may take broth, smoothies, or oral rehydration solution. 

Keep a food journal to determine potential triggers. 

进一步阅读： 溃疡性结肠炎饮食计划：该吃什么和该避免什么

Stick to Your Treatment Regimen

Take your medications exactly as prescribed by your healthcare provider. Never discontinue your medication without talking to your provider. Abruptly discontinuing your medication may trigger a flare-up. 

When To Seek Medical Help

Talk to your healthcare provider immediately if you:

• Notice blood clots in your stool
• Have heavy and persistent diarrhea
• Have a high fever
• Have severe vomiting
• Have continuous pain

Probiotics for Ulcerative Colitis Flare-Ups: Do They Work?

Probiotics may be effective in preventing flare-ups and reducing symptom severity. However, more studies are needed to confirm these benefits, determine the beneficial bacterial species, and the dosage. 

Moreover, there’s insufficient evidence to recommend probiotics alone as the primary treatment for UC. 

常见问题

What are the new prescription treatments for ulcerative colitis?

The new prescription treatments for ulcerative colitis are:

• Interleukin-23 selective inhibitors (risankizumab-rzaa and mirikizumab-mrkz)
• Sphingosine 1-phosphate modulators (ozanimod and etrasimod)
• Janus kinase inhibitors (tofacitinib and upadacitinib)

What are the apps that track ulcerative colitis flare-ups and symptoms?

Examples of apps for tracking and managing UC are: mySymptoms Food Diary, Aila Health, LyfeMD, We Can’t Wait, and Trellus Health. 

How can I control ulcerative colitis?

No cure for ulcerative colitis is available. However, medications and lifestyle changes can help manage symptoms, reduce relapse, and prevent complications. Always take your medications as prescribed and never stop medical treatment without talking to your provider. 

Can coffee trigger ulcerative colitis flare-ups?

Coffee may trigger a flare-up in some people. The exact mechanism is unclear, but health experts think it might involve stimulation of colon contractions. Avoid or try small servings if you think coffee worsens your condition. 

What foods should I avoid during a flare-up?

Foods to avoid during a UC flare-up include:

• 酒精
• Sugary foods and drinks
• 咖啡因
• Dairy products (milk, cheese, cream)
• Greasy food
• Foods that cause gas, such as beans and carbonated beverages
• Heavily seasoned foods
• Foods rich in insoluble fiber (raw vegetables, some raw fruits)
• 红肉
• Spicy food

How can I prevent UC flare-ups?

The following may help lower your risk of flare-ups:

• Avoiding triggers
• Engaging in regular physical activity
• Managing stress 
• Seeing your healthcare provider regularly 
• Sticking to the treatment regimen 
• Avoiding pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs)