Last Updated on June 15, 2023 by Steven Root


This article aims to provide a comprehensive exploration of ulcerative colitis and its connection to stress, and will cover the following:

  • Defining Ulcerative Colitis
  • The Role of Stress
  • Stress as a Trigger
  • Coping Techniques
  • Treatment Options
  • Lifestyle Changes

Ulcerative colitis, an inflammatory bowel disease, has an unexpected accomplice – stress. What ties the mind to the gut? How can we break free from this alliance or perhaps use it to our advantage? Let’s discuss ulcerative colitis and stress.

Defining Ulcerative Colitis

Ulcerative colitis targets the colon and rectum. This condition manifests through symptoms like abdominal pain, diarrhea, and bloody stools.

The disease varies in severity. Some may experience mild symptoms, while others face significant pain and discomfort for extended periods of time. The unpredictability of the disease itself can be stressful, which feeds into the self perpetuating cycle of ulcerative colitis -> stress -> ulcerative colitis.

The Role of Stress

Stress: The Unseen Adversary

Stress often operates in the shadows. It can add fuel to the ‘flames’ of inflammation and yet goes unseen and unrecognized by so many. An increased awareness of what drives our stress is necessary to be able to take action.

Deciphering The Gut-Brain Axis

The gut and brain are intimately connected and the gut-brain axis is the line they communicate on, and it’s not just idle chit-chat. The brain can influence gut health, and stress can disrupt the messages being sent.

A review article published in The Journal of Physiology and Pharmacology dives into how stress affects the gut. For instance, stress can alter the contractions of the muscles in your gut, affect mucus secretion, your ability to guard against harmful bacteria, and more.

Immune Response and Stress

Stress hormones such as cortisol can alter your immune response. In ulcerative colitis, the immune system is already misfiring and attacking healthy tissue. Stress hormones can be seen as a bad influence in this case, encouraging more chaos and leading to greater inflammation.

Stress as a Trigger

Symptom Flare-Ups: A Closer Look

Ulcerative colitis can be unpredictable and stress plays a significant role in the activation of the disease. Flare-ups are often described as having come from ‘nowhere’, but often the reality is that there has been a trigger.. and that trigger is stress.

Microbial Mayhem

Our gut is home to a community of microbes known as the microbiome. Like any community, balance is key. Stress can disrupt the peace and change the microbial landscape. This disruption is linked strongly to an increase in inflammation in the case of those diagnosed with ulcerative colitis.

The Domino Effect

It’s not just about flare-ups; it’s also about quality of life. Stress-triggered symptoms can impact work, relationships, and mental health. It’s a domino effect, with each aspect of life influencing the other.

Managing Stress

Letting Go – The Ultimate Strategy

Suppressed and repressed emotions such as fear and anger (stress in a nutshell) are causative of not only ulcerative colitis symptoms but of many disease processes. Releasing these emotions in a constructive way can have a major positive impact on the likelihood of experiencing symptoms. This is why seeing a counselor and certain texts such as “Letting go” by David Hawkins and “Untethered Soul” by Michael Singer are often described as particularly useful by many of those diagnosed with the illness.

Mindfulness: The Anchor

Where stress is the storm, mindfulness practices can be the anchor. Mindfulness roots you in the present moment. It’s a break from worries about the future or regrets about the past. For someone with ulcerative colitis, it’s a pause button on the constant stresses of life that are so often driving inflammation. Incorporating mindfulness practices into your life can be very useful in mitigating against symptoms.

Meditation: The Stress-Diffuser

Meditation and mindfulness are closely related. Where mindfulness can be applied to any moment, meditation is a dedicated time to cultivate this awareness. It has been shown to reduce the production of stress hormones, which as we know, play a significant role in ulcerative colitis flare ups.

Engaging in Hobbies: A Necessary Distraction

What do you love to do? Painting, reading, cooking? Engaging in hobbies can be a pleasant and necessary diversion from stress. It’s also a way to build competence and confidence, which can be empowering when living with a chronic illness.

So many people are avoidant of the things they love for fear of their symptoms interfering.. things such as exercise, socializing, traveling etc. However these things can be incredibly helpful in healing from and staying healed from ulcerative colitis. Whilst running a marathon and backpacking through South East Asia may not be smart, you should be doing what you can. Engaging in “normal” life can be a tremendous source of healing.

Social Connections: Strength in Numbers

Having a support system is like having a safety net. It’s knowing that if you fall, someone will be there. Engaging with friends, lovers, interest groups etc, even virtually, can foster a sense of belonging and reduce stress. Feeling disconnected can be incredibly painful, and the associated apathy is detrimental to your health. Stay connected.

Treatment Options

Holistic Healing

Dietary and lifestyle changes are underused modalities of healing and can be incredibly effective both in getting rid of symptoms and keeping symptoms away and in fact, should be the first thing that people focus on as a means of healing. Some people will choose to pursue this route and avoid taking medication. If this is the path you wish to take, you can enquire here to get help in building a dietary & lifestyle strategy that works for you.

Medications: Tailored Approaches

There is an array of medications available, including anti-inflammatories, immunosuppressants, or biologics. If you choose to go down this route, the key is to be aware of the risks, and find what works for you. This might entail some trial and error, and it’s about tailoring the approach to your unique needs. Your doctor will be able to discuss these with you in depth.

Surgical Intervention: A Last Resort

For some, surgery might be the best option. This can mean removing part or all of the colon. It’s a tough decision to make, but for some, it’s a path to a better quality of life. Always do what feels right for you.

Lifestyle Changes

Nutritional Navigation

Diet plays a starring role in healing and staying healed from ulcerative colitis. But there’s no one-size-fits-all diet. Again for help in navigating the nutritional landscape and finding what helps or hinders your specific condition, you can enquire here.

Exercise: The Endorphin Boost

We can’t talk about lifestyle changes without mentioning exercise. It’s not just about physical health; it’s a mental boost. The endorphins released during exercise can reduce stress and improve mood. And perhaps even most importantly, exercise can make you feel ‘normal’. It can make you feel like you.. just.. CAN. As before, no need to run a marathon.. but do what you can.

Sleep Well: Recharge and Reset

Good sleep is giving your body the downtime it needs to fight back. It’s a time for repair and resetting, which is essential if you’re going to be effective in managing both your ulcerative colitis and stress.

Learning and Adapting

Managing ulcerative colitis is an ongoing process. It’s about learning, adapting, and finding what works for you. This might change over time, and that’s okay. It’s about building a toolkit to manage ulcerative colitis and stress effectively.


We have discussed that:

  • Ulcerative colitis involves inflammation in the colon and rectum.
  • Stress can exacerbate ulcerative colitis symptoms via the gut-brain axis.
  • Lifestyle changes, including diet, exercise, and sleep, are critical when it comes to ulcerative colitis and stress.
  • Letting go, mindfulness and social connection can mitigate stress.
  • Treatment options range from holistic therapies through to medication and surgery.