Medically Reviewed by Jenny Blair, MD
Living with inflammatory bowel disease (IBD), whether it’s Crohn’s or ulcerative colitis (UC), isn’t just painful—symptoms like bloating and gas, as well as frequent doctor’s appointments, bathroom emergencies and concerns about treatment can be disruptive to daily life, too.
“Once you’re diagnosed with Crohn’s or UC, it’s a complete change of your lifestyle. Not only are you going to frequent doctor’s appointments, you’re having colonoscopies every year or two years,” says Katherine Freeman, MD, gastroenterologist at Mount Sinai Hospital in Manhasset, New York. “You have to be very diligent with your diet and get to know your body.”
Researchers still don’t know the exact cause of inflammatory bowel disease, but there are a number of ways to better manage the condition on a day-to-day basis—and reduce your risk of a flare.
“Triggers, for me, are usually lifestyle related,” says Joe Hinksman, 30, Vancouver Island, British Columbia, (Instagram: @you.look.fine.to.me). Hinksman, who has Crohn’s disease, adds: “If I’m not eating well, sleeping well and doing what I can to reduce my stress, I find my symptoms can be worse.”
It’s true that no two people with IBD have exactly the same set of symptoms or triggers and treatment plans can vary, but making these healthy choices can offer some relief.
1. Control your stress.
Stress has been linked to myriad health conditions—from insomnia, to high blood pressure, to heart attack—and inflammatory bowel disease is no different. “We do believe stress, anxiety and mood destruction can magnify symptoms,” says Richa Shukla, MD, gastroenterologist and assistant professor at Baylor College of Medicine in Houston, Texas.
Numerous studies have pointed to stress as a trigger for IBD. Rates of psychiatric issues like anxiety and depression are higher in people with Crohn’s and UC than in the general population—making stress management vital to those living with the condition. If you’re feeling stressed or anxious, simple coping techniques like yoga, meditation, journaling or listening to music may help. “Mindfulness practice is really helpful. Being very aware of you, your symptoms and how your symptoms affect your quality of life, and how you can cope, is humongous in helping patients,” Dr. Shukla adds.
2. Track your symptoms daily.
Self-management may help keep IBD symptoms in check—and that’s why it’s so important to track your symptoms, triggers, diet, and stress levels every day. Tracking may help you identify patterns in your symptoms or triggers, so you can better self-manage your IBD. It may also provide valuable insights to your doctor.
Oshi makes it easy to track the health factors that contribute to IBD, like diet, stress, sleep and physical activity, as well as any symptoms you experience on a day-to-day basis. All you have to do is answer a few simple questions in each category. Other apps we love are Bathroom Scout, which can help you locate the nearest bathroom, and Headspace for stress-busting, guided meditation sessions.
3. Stay hydrated.
We all know hydration is vital to our health and bodily functions, but extended periods of diarrhea or vomiting (or both) can often lead to dehydration. Although dehydration is typically treatable at home, significant loss of fluids can be dangerous. For those who have recently undergone a diverting ileostomy, dehydration is a common cause for hospital readmission following the surgery.
Some ways to avoid dehydration include:
• Drinking plenty of water each day—about 2 ½ liters for women and about 3 ½ liters for men
• Eating foods with high water content like cucumbers, watermelon, or oranges
• Avoiding alcoholic or caffeinated drinks
Like we said: Most cases of dehydration can be managed at home. But if you have ongoing diarrhea or vomiting or experience symptoms like cramping, dark-colored urine or light-headedness, seek medical care ASAP.
4. Watch your diet.
Because people with IBD have different triggers and symptoms, there isn’t a single diet that doctors recommend for condition management. Rather, it’s important to closely monitor your diet and determine what’s good—and what isn’t—for your body.
Christine Jordan, 32, London, England, (Instagram: @ibdfit) was diagnosed with Crohn’s at age 13 and has had major success with a vegan diet. “Going vegan was the best thing I’ve ever done for my Crohn’s disease. I was on double doses of adalimumab and steroids, and had another surgery scheduled. Going vegan has me on single doses of adalimumab, no steroids, and [I don’t have] surgery in sight.”
Hinksman, on the other hand, found cutting fiber and sugar from his diet helped reduce uncomfortable symptoms and flares.
Remember: Every person is different and will react to foods in different ways. If you want to try adding or eliminating certain foods, talk to your doctor. She’ll be able to advise on nutrition and any potential risks.
5. Avoid vitamin deficiencies.
Inflammation, diet, treatments that block the absorption of nutrients and persistent diarrhea often lead to micronutrient deficiencies in people with IBD. In fact, one study showed found that more than half of people with IBD have deficiencies in iron, vitamins D and K, and folic acid, among other micronutrients. Vitamin deficiencies may result in prolonged, further complicated cases of IBD; anemia, due to iron deficiency; loss of bone density; and increased inflammation, due to deficiencies in vitamins D and K.
Dr. Freeman recommends calcium and vitamin D supplements, as well as multivitamins to her patents with micronutrient deficiencies. If they don’t trigger symptoms, foods rich in calcium, vitamin D, and iron may help, too. Think: Dark, leafy greens; fatty fish, like salmon; and eggs.
6. Give your body rest.
When you have a chronic condition, it’s important to listen to your body—and give it the rest it needs. “Lack of sleep is my biggest trigger, so I make sure I rest as much as possible and keep good sleep hygiene to ensure a deep sleep,” says Jordan.
If you’re having trouble getting enough sleep, try to:
• Go to bed at the same time every night and wake up at the same time every morning—even weekends
• Keep electronics, like TVs, laptops and smartphones, out of the bedroom
• Avoid caffeine and alcohol before bedtime
“Rest” can also mean practicing self-care, avoiding exercise for a few days, or eating a smoothie or pureed diet that’s easily digested. It’s important to determine what works for you (and your body), so you can feel better.
7. Stick to your treatment plan.
“The best thing is to treat the disease itself,” says Freeman. If you’re on a daily medication for IBD, practicing medication compliance and sticking to your doctor’s prescribed treatment plan can help keep your IBD—and its uncomfortable symptoms—in check.
Finding the right treatment can feel like trial and error, and it may take several attempts (or combinations of medications) to find what works for you. If you’re interested in trying a new treatment or your current treatment isn’t effective, be sure to talk to your doctor.
Remember: No two people experience IBD the same way, so it’s important to listen to your body and determine what works (and what doesn’t) for you.
“There’s no one-size-fits-all management plan for any chronic illness, but there sure are a lot of suggestions to try. Find what fits and roll with it. We’re all unique, dynamic and amazing warriors,” says Hinksman.