There are a few things you can do to help keep symptoms under control and reduce your risk of complications.

Dietary advice

Although particular diets are not thought to play a role in causing ulcerative colitis, some changes to your diet can help control the condition.

For example, you may find it useful to:

• eat small meals – eating five or six smaller meals a day, rather than three main meals, may help control your symptoms
• drink plenty of fluids – it is easy to become dehydrated 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 alcohol – as these will make your diarrhoea worse – and fizzy drinks, which can cause flatulence (gas)
• take food supplements – ask 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

Keeping a 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 from your diet.

However, you should not 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 are designed 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 are considering trying a low-residue diet, make sure you talk to your care team first.

Stress relief

Although stress does not 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 team can 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 and 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. A good resource is the Crohn's and Colitis UK website, which has details of local support groups and contains a large range of useful information on ulcerative colitis and related issues.

You may also find it useful to read the NHS guide to long-term conditions and self-care.

Fertility

The chances of a woman with ulcerative colitis becoming pregnant are not 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).

Certain types of aminosalicylate (ASA) medication can lead to a temporary loss of fertility in men, but alternative medications are available.

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 are pregnant or planning a pregnancy you should discuss it with your care team. If you become pregnant during a flare-up, or have a flare-up while pregnant, there is a risk you could give 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 be taken during pregnancy, including corticosteroids, most ASAs and some types of immunosuppressant medication.

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

In some cases, you may be advised to take a medication that is not normally recommended during pregnancy if your doctors think the risks of taking the medication outweigh the risks of having a flare-up.