March 31, 2023
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Photography by Lyndon Stratford/Stocksy United
Even if you’ve lived with Crohn’s disease or ulcerative colitis for a while and have your diet dialed in, other factors can affect your symptoms.
For many of us, living with IBD is something we’ve almost gotten used to. When a flare strikes, we might feel like we know the drill about how to deal with it, whether that means instantly calling the doctor, heading to the store to grab our safe foods, or knowing what yoga pose works the best for trapped gas.
But even if you’ve been living with the condition for years, you still might be making some IBD mistakes. After all, even though we often become experts in our own bodies, we can’t be expected to know everything about our condition through and through.
Let’s take a look at five common IBD mistakes you could still be making, along with how to best modify your actions to improve your quality of life.
If you’re not getting enough Zzz’s, it’s probably not for lack of trying. A 2013 study found that 75% of people with active IBD experience sleep disturbances. It’s not surprising — I’ve personally experienced tossing and turning due to pain, being woken up by an urgent need to use the toilet, or just not feeling relaxed enough to drift off.
But sleep is really powerful and is one of the simplest things you can do to support your health. Not only did that 2013 study show that poor sleep quality can lead to IBD relapses, but a more recent study suggests that people with IBD with poor sleep quality are at higher risk for hospitalization and surgery.
That’s why it’s so important to actively support your sleep quality as well as just resting. If you’re waking with pain and urgency, it could be worth keeping a diary to see if it’s linked to any particular triggers, such as eating close to bedtime.
I personally find larger meals that are high in fat can lead to stomach pain that wakes me up during the night.
We know all about our IBD medications, but do we always check side effects and interactions for over-the-counter medications, like cold remedies or headache pills? For example, NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen and naproxen, can make symptoms worse. It’s important to check the label: In my experience, these types of medications can be hiding in things like cold remedies.
Speaking of cold remedies, I also try to avoid these when possible as I found they often contain caffeine. While the effect of caffeine on IBD is uncertain, I personally can’t tolerate caffeine. Not only does it irritate my gut but it really impairs my sleep. Caffeine is also known to increase the contractions and movements in the colon and potentially cause diarrhea.
How often have you grabbed low fat, low sugar foods thinking they’re healthier? Even if we’re trying to eat with the best intentions, diet foods don’t always equal IBD-friendly.
Common additions to lots of diet and sugar-free foods are alternative sweeteners like aspartame and sucralose. This is another personal trigger of mine — every time I drink a sugar-free fruit juice or eat jelly made with aspartame, I experience diarrhea and cramping. Now, studies suggest these sweeteners may worsen inflammation in the digestive tract and/or negatively affect the gut microbiome.
Another common thing to do when trying to eat healthier is to order salads. Greens and raw foods are, of course, healthy, but these can sometimes worsen IBD symptoms, due to their high fiber content.
I personally cannot eat raw “roughage” like cucumber, celery, and lettuce but have more success with cooked vegetables, since cooking can break down fiber and make it easier to digest. While I can’t avoid fiber completely, I do try to eat in smaller quantities.
Foods high in insoluble fiber (an indigestible type of carbohydrate that bulks out our stool) are one of the possible trigger foods when in a flare-up, according to the Crohn’s and Colitis Foundation.
It’s always important to speak with your medical team before making any diet changes.
We’re so used to reaching out for help with our physical health that we may not realize that addressing our mental health is just as important.
Living with a chronic illness can make so many aspects of life difficult, adding stress to our lives. No wonder depression rates are higher in people with IBD, and anxiety is also common.
Yet, talking about our mental health isn’t often part of conversations with our IBD doctors. Don’t be afraid to initiate the conversation and ask your doctor what support is out there for your mental health — whether that be medication or talking therapies.
Sometimes, if we’re lucky enough, our IBD can quiet down for long enough that we almost forget how bad it can get. So, we might skip a doctor’s visit, forget to grab a prescription refill or indulge in some of our previous triggers, like alcohol.
So many times, after my IBD has been quiet for some time, I’ve wondered: “What if I actually can eat fried food now?” or “Maybe I don’t need to schedule in so many rest days anymore.” Then, wham! It’s flare-central.
While being in remission may mean you don’t need to be as strict with certain lifestyle factors (like watching what you eat), it’s important to still keep up with any doctor’s appointments and be prepared for flare-ups. Almost 50% of people with IBD have at least one flare a year. Looking out for any potential signs means your doctor can support you faster.
While we can’t guarantee that avoiding these five mistakes will prevent an IBD flare-up, you can use this insight to make sure you give your body the best chance of living well with the condition.
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