Download Triggers for IBD

Some Common IBD Triggers
The main goal of current medical therapy for IBD is to keep in remission and avoid any disease
flare. Taking your medications on a regular basis is the best way to ensure remission and avoid
flares. However, you can still get flares and disease can become active. Certain drugs, food or
environmental factors can be the culprit to increase your symptoms. Even stress and poor sleep
can cause flare. Having knowledge about these triggers can help you stay in remission and
avoid disease flare
Medications
Anti-inflammatories: This includes over the counter medications like Ibuprofen and naproxen.
These medications are also known as non-steroidal anti-inflammatory drugs (NSAIDs). They can
cause ulcers in your stomach and intestines which can worsen your Crohn’s disease or
ulcerative colitis. You should talk to your doctor before taking any NSAIDs
Antibiotics: Some antibiotics are good to manage your Crohn’s or colitis, like ciprofloxacin
(Cipro) or metronidazole (Flagyl). However, taking antibiotics can increase your chances of
developing Clostridium difficile, an infection in the colon. If you have recently taken any
antibiotics and are experiencing flare, you must inform your doctor about it.
Accutane: This medication is used to treat acne. There is a possible association between this
medication and the development of Crohn’s and colitis, though the data is not very clear at this
time.
Oral contraceptives: Some studies have shown there is an increased risk of Crohn’s and colitis
among women taking oral contraceptives. However, there is not good enough evidence to say
this is true at this time.
Food
Artificial sweeteners: Sugar substitutes like aspartame (Equal), saccharin (Sweet ‘N Low), and
sucralose (Splenda) are common ingredients in sugar free or diet products. They are also used
in a lot of processed foods such as candies, jams, dairy, and baked goods. Small studies have
been done showing an association with Crohn’s and colitis and increased artificial sweetener
use. This has not been confirmed by a large trial. Sugar substitutes are large molecules. This
causes them to not be absorbed in the intestines. When this occurs, water is sucked through
the intestinal cells into the stool (by the process of osmosis), which causes diarrhea. This can
make your symptoms worse.
High-fat foods: During active disease, fat malabsorption can occur. Inflamed intestines cannot
absorb fat, causing it to be excreted in the stool. This is why you may experience large volume,
stinky diarrhea after consuming large fat meal.
High-fiber foods: Consuming high fiber food such as beans and legumes can cause you to have
abdominal distension and pain. Fiber also makes your stools bulkier and the rough surface
scrapes the tissue of the intestines. If your intestines are inflamed, this can cause pain and
more damage. If there is any kind of narrowing in your intestines, a high fiber diet can also
cause a blockage.
Caffeine: Caffeine is a stimulant chemical found in naturally in foods and added to many drinks.
Caffeine does produce a laxative effect. This can cause more frequent trips to the bathroom.
Because of this, it may be wise to avoid caffeine during active disease.
Dairy products: Many patients with Crohn’s disease and ulcerative colitis have sensitivity to
dairy products. After consuming milk or other dairy, they will experience bloating, gas, and
diarrhea. Lactose is the primary sugar in cow’s milk and casein is the primary protein in cow’s
milk. Both can cause these symptoms and both are found in a variety of foods including
cereals, salad dressings, whipped toppings, and processed meats
Alcohol: Consuming alcohol can irritate the intestines and worsen your diarrhea. It can also
interfere with certain medications you may take for your disease such as metronidazole.
Smoking and Nicotine
Nicotine affects intestinal inflammation, suppresses the immune system, decreases the blood
flow to your intestines and alters mucus production, a protective layer inside your intestines. If
you have Crohn’s disease, smoking is your worst enemy and your number one goal should be
smoking cessation. Smoking has been shown to increase your chances of needing surgery and
can cause your medications to not work as well. Secondhand smoke can also negatively impact
your disease. Studies show children exposed to secondhand smoke have a higher risk of
developing Crohn’s disease. On the other hand, smoking may actually be protective for those
with ulcerative colitis. It is common to begin experiencing active disease if you ever try to quit.
However, due to harmful health consequences of smoking, it is not recommended to resume
smoking in ulcerative colitis.
Stress
Stress may also play a role in disease flare. Some get into a vicious cycle of stress causing
symptoms and increased symptoms causing stress. Stress can also weakening your immune
system, putting your body at an increased risk for developing an infection. Try to avoid stress.
Exercise and meditation are good sources to keep stress away.
Sleep
Sleep has an important associating with the immune system. Our center has recently
performed a study showing that poor sleepers have more active disease and more
inflammation in the colon. Not only will sleep deprivation cause increased IBD symptoms, it
can also lead to heart disease, weight gain, and memory and learning problems.