Lifestyle matters

Taking medication is just one part of managing inflammatory bowel disease (IBD). Both Ulcerative Colitis and Crohn’s disease will react well to positive changes in lifestyle; leading to better symptom control and less complications.

These include:

• Diet and nutrition
• Exercise
• Emotional well-being
• Smoking and alcohol intake

Emotional Wellbeing

Although emotional upset does not cause IBD itself, in some people, stressful situations or strong emotions may lead to flare-ups of symptoms. This doesn’t mean that everyone who has stress will experience a flare-up, but if you are someone with IBD, who knows that stress can be problematic, it is helpful to be prepared and to learn some stress-management techniques.

Stress can be a constant presence in life: changing jobs, getting married, moving, a death in the family, raising children, or caring for elderly parents can all cause stress. Simply having a chronic condition can cause IBD. Even minor annoyances of life can be stressful. You can’t completely eliminate stress-producing events, but it may be possible to change your reaction to them.

Examples of stress management include:

• Listening to relaxing music
• Taking a walk somewhere peaceful
• Meditation or lying down in a dark room for a few minutes
• Talking to a friend or therapist
• Having a long bath
• Reading
• Biofeedback
• Relaxation and breathing exercises
• Practicing yoga or tai chi
• Hypnotherapy

If you find it really hard to deal with stress and find yourself quite anxious or on edge a lot of the time you might want to consider structured stress relief techniques such as cognitive behavioural therapy (CBT) or neuro linguistic programming (NLP).

Smoking

As well as having an impact on your lungs and heart, smoking can also:

• Increase the risk for developing Crohn’s disease
• Trigger flare-ups
• Increase the risk of developing abscesses and/or fistulas in people with Crohn’s disease

People who smoke have:

• More recurrences of their condition – this can be between 50-100% in patients with Crohn’s disease¹
• Increased need for surgery
• Greater need for immune-system-suppressing medications

Remember the more you smoke, the more likely IBD is to come back again.

In contrast, Crohn’s disease patients who have quit smoking report:

• Having 65% fewer flare-ups than continuing smokers²
• Reduced need for medications to control the disease

Ulcerative colitis tends to occur more in non-smokers and ex-smokers. However, in people with ulcerative colitis, smoking cessation can cause a flare-up of the disease; it is unclear why smoking may have this protective effect. However, since smoking carries many health risks, including lung cancer and heart disease, any protective effect is outweighed by the other health risks.

Alcohol

Although you are able to drink alcohol when you have IBD, you need to be sensible about it. Speak with your IBD health team about what is reasonable in your situation, or take a look at your national guidelines for more information.

Other medication

As well as taking maintenance medication to manage your IBD, patients with both ulcerative colitis and Crohn’s disease need also be to careful about other medications they may be prescribed or buy over the counter to make sure they don’t cause a flare-up. These include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, naproxen and ibuprofen can trigger flare-ups. For mild pain or to reduce a fever, take paracetamol or speak to your doctor
• Antibiotics can cause an inbalance in the bacteria that live in the intestine. Such changes can cause diarrhoea (antibiotic-associated diarrhoea) or may lead to excessive growth of specific bacteria that can cause inflammation. If you are taking an antibiotic and experience a flare-up of your IBD symptoms, it is important to inform your healthcare provider. You should also inform your provider if you have recently taken antibiotics, even if for non-gastrointestinal infections

Always tell your doctor or pharmacist that you have inflammatory bowel disease (IBD) when you are buying medication over-the-counter or getting a prescription, so they can double check the medicines are okay for you to take.

References:
1: Smoking and Crohns Disease. Available at: http://www.crohnsandcolitis.com.au/smoking-and-crohns.php Accessed May 2014
2: Johnson, G.J., Cosnes, J., and Mansfield, J.C. (2005). Review article: smoking cessation as primary therapy to modify the course of Crohn’s disease. Aliment. Pharmacol. Ther. 21, 921–931.