Could food and stress trigger ulcerative colitis flares?

Question

Hi doctor,

I’m a 35-year-old woman. I have ulcerative colitis mostly on the left side. Mostly, lifestyle is my question. I get loose stools with a little mucus the next day every time I eat out, especially spicy or fried food. But then sometimes even simple home-cooked food will set my symptoms off, so I don’t know what the triggers are.

I’m currently on Mesalamine 2.4 grams daily, and I’m not on steroids. Diet is the main trigger, but can inflammation occur by itself? Should I think about going gluten-free or dairy-free for good?

Also, stress is a big factor; if I have a disagreement with somebody or if I am under stress at work, I can instantly feel stomach discomfort. I have a mind-gut connection. I don't know how much of this is true.

Help please.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concerns.

This is common in people with ulcerative colitis, especially when the disease involves the left side of the colon. Food does not cause ulcerative colitis. But some foods can make symptoms worse for a while if your bowel is sore or inflamed.

Common offenders are spicy, fried, and restaurant foods. These foods can be high in fat, spices, and additives that stimulate the bowel and increase the frequency of stools.

But flare-ups can also occur with simple, home-cooked meals because the inflammation in ulcerative colitis can come and go without any special reason. Diet can provoke symptoms, but it does not cause disease activity.

Most patients who have ulcerative colitis do not need to avoid gluten and dairy permanently unless they develop specific symptoms after eating them. Some people are lactose intolerant, and this can cause bloating or loose stools. It’s better to find the foods that trigger you and eat them in moderation rather than put strict rules on yourself for the rest of your life.

You are presently on Mesalamine, an effective maintenance medication for controlling inflammation.

Your comment on stress is correct too; the gut-brain connection is well known. Emotional stress may increase bowel sensitivity, change gut motility, and worsen symptoms. Stress doesn’t cause ulcerative colitis, but it can worsen abdominal pain and the urgency to have a bowel movement.

Here are some lifestyle tips:

Have simple, balanced meals.
Maintain a symptom and food diary.
Stress can be handled with exercise, meditation, or relaxation techniques.
Don’t forget to make appointments with your gastroenterologist for regular follow-ups.

Many patients can have long periods of remission and stable symptoms with good medication adherence and a healthy lifestyle.

Hope this helps.

Thanks.