Managing UC symptoms is an important part of maintaining quality of life, but common mistakes can derail progress.

Ulcerative colitis (UC) is a condition that causes chronic inflammation and sores, or ulcers, in the lining of the large intestine. Along with Crohn’s disease, it’s one of two primary conditions that fall under the term inflammatory bowel disease (IBD).

The exact cause of UC is unknown, but unusual immune activity, genetics, your gut microbiome, and the environment are all thought to play a role.

UC can bring about gastrointestinal (GI) symptoms like bowel urgency, abdominal cramping, and diarrhea. In addition, the condition is characterized by times of disease inactivity (called remission) mixed with periods of new or worsening symptoms, known as flares.

UC flares aren’t always predictable or preventable. But avoiding these common mistakes can help reduce the frequency of these episodes.

Doctors typically prescribe immunosuppressants or disease-modifying medications to keep inflammation down and calm overactive immune processes. When UC symptoms go into remission, it can be tempting to skip your medications or decrease the dosage without input from your doctor.

However, skipping medications, forgetting doses, and altering your prescription without medical guidance can cause your symptoms to return full force. But continuing to take your medication exactly as prescribed — even when you’re feeling well — helps ensure your treatment continues to work.

The longer you live with IBD and the more familiar you become with your individual symptoms, the less important it may feel to visit your doctor on a regular schedule.

While it’s true that you may go years without many noticeable changes, UC can be a progressive condition, meaning the damage it causes to the large intestine may worsen over time.

Regular visits to your doctor can help catch any changes in your condition early and ensure your current treatment strategies are working to prevent disease progression.

Skipping appointments increases the chance that flare-ups will become more frequent due to undetected, advancing, or uncontrolled IBD. Getting regular lab work also helps monitor for treatment side effects like anemia and liver or kidney damage. If you’re taking a biologic, you’ll also need annual skin cancer screenings.

Currently, there’s no evidence that any specific food should be universally avoided if you have IBD. That said, some people notice certain foods aggravate their symptoms, like high fiber foods which can lead to bloating.

Another noticeable UC symptom trigger? Eating too much in one sitting. Large meals can overwhelm your body’s ability to process food efficiently, leading to an uncomfortably full sensation, indigestion, gas, and bloating.

For some people, this sudden, large influx of food may bring on a UC flare-up by demanding too much from an already impaired digestive system.

Eating smaller, more frequent meals is recommended instead.

The relationship between UC and dehydration is complex.

Inflammation from UC can prevent your intestines from absorbing enough water, which is why watery bowel movements are a common symptom. And expelling too much water in bowel movements can cause dehydration.

Additionally, dehydration can contribute to malnutrition in UC, which can cause worsening of symptoms such as:

  • muscle loss
  • fatigue and low energy
  • muscle weakness
  • decreased bone strength
  • weight loss
  • intestinal blockage
  • growth delays in children

The best way to stay hydrated? Keep a water bottle on hand to ensure you’re drinking enough throughout the day.

Stress doesn’t cause UC, but it can worsen your symptoms.

Your brain and your digestive system are linked by the gut-brain axis, a communication pathway that affects functions related to mood, digestion, immunity, and cognitive function.

When you’re stressed, the brain relays those feelings to your gut as part of the stress response. As a result, stress can lead to symptoms of irritable bowel syndrome, which can co-occur in people with IBD.

Need to nip stress in the bud? Try practicing relaxation techniques or breathing exercises.

Smoking cigarettes is never recommended, but sudden smoking cessation may trigger a UC flare-up. In fact, UC is more common among non-smokers compared to people who smoke.

The reasons for this aren’t clear, but continuing to smoke is not recommended as a way to ward off UC flare-ups. Any protective features of cigarette smoking are considered insignificant compared to the long list of major health risks associated with the habit.

Once you’re ready to quit, work with your doctor to create a plan to do so successfully without worsening UC symptoms.

Keeping track of your UC symptoms, their frequency, and severity can help you spot patterns and changes in your condition.

Forgetting to log your symptoms won’t directly cause a flare-up, but it may contribute to a lack of awareness around subtle changes.

If it seems like you’re experiencing sudden flare-ups without warning, it could be the culmination of minor changes that went unnoticed for too long due to a lack of proper tracking.

Having UC increases your risk of developing other health conditions, such as:

  • psoriasis
  • psoriatic arthritis
  • ankylosing spondylitis
  • osteoporosis
  • erythema nodosum
  • primary sclerosing cholangitis

It’s important to get regular checkups and screenings to monitor for the development of any new conditions and symptoms. In general, managing all aspects of your health may, in turn, help you stay on top of UC.

Antibiotics work by eliminating bacterial infections — but they can also affect the balance of bacteria in your GI tract, otherwise known as your gut microbiome. They can also cause GI symptoms and increase the risk of developing an infection like that caused by C. difficile, which is already an increased risk for people living with UC.

Since many people see doctors other than their GI specialist for general concerns, having a conversation about UC is important any time you’re being prescribed a new medication.

If an antibiotic is necessary, your doctor can then make an informed decision on the type of medication, dose, and additional treatments to help prevent a UC flare.

Ulcerative colitis often has periods of remission followed by episodes where GI symptoms flare up. While there’s no way to completely prevent a UC flare, avoiding common pitfalls can help reduce their frequency.

Staying hydrated, managing stress, and keeping up with regular doctor visits, as well as prescribed medications, are just a few ways you can avoid aggravating UC symptoms.