Living with ulcerative colitis

There are a few things you can do to help keep symptoms of ulcerative colitis under control andreduce your risk of complications.

Dietary advice

Although a specific dietisn't thought to play a role in causing ulcerative colitis, some changes to your dietcan help control the condition.

For example, you may find it useful to:

• eat small mealseating five or six smaller meals a day, rather than three main meals, may help control your symptoms
• drink plenty of fluidsit's easy to become Dehydration when you have ulcerative colitis, as you can lose a lot of fluid through diarrhoea. Water is the best source of fluids. Avoid caffeine and alcoholas these will make your diarrhoea worse and fizzy drinks, which can cause flatulence (gas)
• take food supplementsask your GP or gastroenterologist if you need food supplements, as you might not be getting enough vitamins and minerals in your diet

Keep a food diary

Keepinga food diary that documents what you eat can also be helpful.You may find you can tolerate some foods while others make your symptoms worse. By keeping a record of what and when you eat, you should be able to identify problem foods and eliminate them fromyour diet.

However, you shouldn't eliminate entire food groups (such as dairy products) from your diet without speaking to your care team, because you may not get enough of certain vitamins and minerals .

If you want to try a new food, it's best to only try one type a day, as it's then easier to spot foods that cause problems.

Low-residue diet

Temporarily eating a low-residue or low-fibre diet can sometimes help improve symptoms of ulcerative colitis during a flare-up. These diets aredesigned to reduce the amount and frequency of the stools you pass.

Examples of foods that can be eaten as part of a low-residue diet include:

• white bread
• refined (non-wholegrain)breakfast cereals, such as cornflakes
• white rice, refined pasta and noodles
• cooked vegetables (but not the peel, seeds or stalks)
• lean meat and fish
• eggs

If you're considering trying a low-residue diet, make sure you talk to your care team first.

Stress relief

Although stress doesn't cause ulcerative colitis, successfully managing stress levels may reduce the frequency of symptoms. The following advice may help:

• exercise this has been proven to reduce stress and boost your mood; your GP or care teamcan advise on a suitable exercise plan
• relaxation techniques breathing exercises, meditation and yoga are good ways of teaching yourself to relax
• communication living with ulcerative colitis can be frustrating and isolating; talking to others with the condition can help (see below)

For more information and advice, see:

• exercise to relieve stress
• relaxation tips

Emotional impact

Living with a long-term condition that is as unpredictable and potentially debilitating as ulcerative colitis can have a significant emotional impact.

In some cases, anxiety and stress caused by ulcerative colitis can lead to depression . Signs of depression include feeling very down, hopeless and no longer taking pleasure in activities you used to enjoy. If you think you might be depressed, contact your GP for advice.

You may also find it useful to talk to others affected by ulcerative colitis, either face-to-face or via the internet. Crohn's and Colitis UK is a good resource, with details of local support groups and a large range of useful information on ulcerative colitis and related issues.

Read Tony's real life story of living with ulcerative colitis

Fertility

The chances of a woman with ulcerative colitis becoming pregnant aren't usually affected by the condition. However, infertility can be a complication of surgery carried out to create an ileo-anal pouch.

This risk is much lower if you have surgery to divert the small intestine through an opening in your abdomen (an ileostomy ).

Pregnancy

The majority of women with ulcerative colitis who decide to have children will have a normal pregnancy and a healthy baby.

However, if you're pregnant or planning a pregnancy you should discuss it with your care team. If youbecome pregnant during a flare-up, or havea flare-up while pregnant, there's a risk you couldgive birth early ( premature birth ) or have a baby with a low birthweight.

For this reason, doctors usually recommend trying to get ulcerative colitis under control before getting pregnant.

Most ulcerative colitis medications can betaken during pregnancy, including corticosteroids, most 5-ASAs and some types of immunosuppressant medication.

However,there are certain medications (such assome types of immunosuppressant) that may need to be avoided as they're associated with an increased risk of birth defects.

In some cases, your doctorsmay advise you to take a medicine that isn't normally recommended during pregnancy. This might happenifthey think the risks of having a flare-up outweigh the risks associated with the medicine.