Treatment Precautions Background
Treatment Guidelines

The Standards of Treatment,
Principles That Must Be Followed

These are commitments to prevent the recurrence of ulcerative colitis and Crohn's disease,
and to move toward complete recovery.

"If you cannot follow these 5 rules,
treatment may fail or the disease may recur."

These are essential lifestyle rules that cannot be compromised
when treating ulcerative colitis and Crohn's disease.

5 Mandatory Rules

5 Essential
Guidelines

These are items that must be absolutely followed to enhance treatment effectiveness and protect the intestinal mucosa.

In particular, drinking alcohol is a major factor in the recurrence and worsening of ulcerative colitis and Crohn's disease. You must refrain from drinking during treatment, and even after treatment, consuming alcohol can lead to recurrence.

The use of chemical drugs such as antibiotics, painkillers, cold medicine, anesthetics, vaccinations, and surgeries can worsen the condition. Many patients report a worsening of symptoms, especially after using antibiotics and non-steroidal anti-inflammatory drugs. Antibiotics do not just kill bacteria at the site of the wound, but they indiscriminately kill the bacteria in our body's microbiome within the large intestine.

Antibiotics and the Microbiome

The microbiome, the symbiotic bacteria in the large intestine, consists of approximately 38 trillion bacteria and is closely related to our body's immune system. The administration of antibiotics destroys this microbiome, causing disruption to the immune system and inducing diarrhea. There are research reports indicating that even after 4 days of using 3 types of combined antibiotics, it takes more than 6 months for the destroyed microbiome to recover. (Recovery of gut microbiota of healthy adults following antibiotic exposure - PubMed)

[Countermeasures] The indiscriminate abuse of antibiotics must be avoided. In South Korea, there is a reckless trend where antibiotics are used in 80% of cold medicines, and antibiotics are often prescribed to patients with ulcerative colitis and Crohn's disease without much caution. Therefore, the use of unnecessary antibiotics must be avoided. If you must use antibiotics due to unavoidable circumstances, you should increase your probiotic intake by 2-3 times and use them very cautiously. Please remember that using antibiotics can worsen your symptoms, and if your symptoms worsen, contact the clinic immediately.

Eating food with chemical seasonings once or twice will not necessarily stop the treatment or cause symptoms to recur. However, poor dietary habits interfere with treatment, prolonging the recovery period, and continuous consumption of instant food can lead to a recurrence of symptoms.

In particular, frequent consumption of sugar, fructose, and refined carbohydrates can prevent symptoms from improving quickly and lead to worsening. Please avoid eating the following foods:

  • Sweet foods containing sugar
  • All beverages containing fructose, and fruits high in fructose
  • Refined carbohydrates such as wheat flour

Cold foods: Patients sensitive to cold foods should be cautious about eating them early in treatment. As treatment progresses, the hypersensitivity to cold foods will be resolved and disappear; after treatment, eating cold foods will not cause any particular issues.

Spicy foods: Reactions to spicy food vary greatly by country and culture. However, patients with ulcerative colitis or Crohn's disease tend to be hypersensitive to spicy food. When consuming spicy food (even if it doesn't taste spicy in the mouth), it can cause heartburn or abdominal pain, diarrhea, and anal burning sensations. These reactions vary due to personal and cultural differences and are not targeted for correction by medication. Therefore, hypersensitivity to spicy food often remains even after treatment.

The intestinal mucosa of patients with ulcerative colitis and Crohn's disease is about one-third as thin as that of the average person. Therefore, they are much more vulnerable to infections. Because of this, there are times when people share the 'same food,' but 'only I (the patient with ulcerative colitis or Crohn's disease)' get sick.

[Prohibited and Recommended Foods] The safest foods for patients with ulcerative colitis and Crohn's disease are those that are heated and cooked just before eating, or foods that have been sterilized. Raw foods, sashimi, sushi, raw beef, ice cream, etc., have a high possibility of containing bacteria and should absolutely not be eaten. Ready-made buffet food or food that has been stored before sale is also high-risk.

[Lifestyle Rules] Habits like picking up food with dirty hands, nail biting, or thumb sucking increase the risk of infection. Especially in summer, these infections occur frequently, so please wash your hands thoroughly with soap often. If a patient with ulcerative colitis or Crohn's disease develops food poisoning or enteritis, abdominal pain and diarrhea will worsen, and bloody stools will increase. Recovery can take anywhere from 1-2 weeks to 1-2 months.

[Case of rapid deterioration after improvement with Korean medicine treatment] Occasionally, there are cases where symptoms improve after Korean medicine treatment but suddenly worsen. Generally, it is rare for symptoms to worsen suddenly after such improvements. However, sometimes toxic bacterial infections such as Cytomegalovirus (CMV) or Clostridium difficile occur, leading to symptom worsening. In such cases, while it may appear as though the symptoms of ulcerative colitis or Crohn's disease are worsening, it is often an infection unrelated to the disease. If you experience rapid deterioration during treatment, please contact the clinic immediately, and ensure to differentiate the condition through endoscopic examination, PCR testing, and bacterial toxin testing at a hospital.

It is highly recommended to follow these prohibitions.
If you think carefully and follow them, it is not that difficult.

Food Allergy Test

Delayed Food Allergy Test
(IgG)

Some patients have allergies to immediate immune responses that cause shock, but allergies to delayed immune responses are something everyone has. For healthy individuals, these delayed allergies are not an important issue because they do not trigger drastic immune responses. However, for dermatitis patients (atopy, psoriasis) or enteritis patients (ulcerative colitis, Crohn's disease), inflammation worsens depending on the food, so it is recommended to identify foods that cause allergies through a delayed immune response test.

Immediate vs. Delayed Immune Response

Response Time Comparison

Why should you know about delayed allergies?

For example, for patients with ulcerative colitis and Crohn's disease, even the same patient will have a slightly different number of bowel movements each day. One day it might be 5 times, another day 8 times. Why do these differences occur? This happens depending on the food consumed 1-2 days prior.

Since the reaction appears between 5-6 hours and up to 2-3 days after food consumption, it is very difficult for patients to realize the direct correlation with food on their own. Delayed immune responses to food are more common in younger people (teens to 20s) and less common as we age (50s-60s). This is because as we live our daily lives, we are continuously exposed to food, which decreases the allergic response.

Treatment Strategy and Application

It is recommended to identify allergies to specific foods (rice, tofu, beans, oranges, wheat flour, milk, etc.) and avoid these foods until mid-treatment when symptoms are almost improved. Blocking allergic foods through allergy testing will significantly reduce worsening reactions to food during treatment. After symptoms have improved and treatment has ended, you may eat all foods again.

Lifestyle Guide

General Lifestyle Precautions

Dietary and Nutritional Management

  • Supplements: You may take them. In particular, Vitamin D deficiency is frequently reported in patients with ulcerative colitis and Crohn's disease, so it is good to make sure to take it.
  • Probiotics: It is recommended to take 2 or more different types of probiotic products. It is better to take products in capsules rather than powder. Occasionally, probiotics can induce diarrhea, so if you experience diarrhea after taking a specific probiotic, try switching products.
  • Chew slowly: Always chew thoroughly and do not eat in a hurry.
  • Meat consumption: There is no problem with consuming meat if there is no allergy. However, it is best to avoid processed meats such as ham and sausages, and avoid eating fried meat. Even if you are not allergic to meat, consuming meat with too much fat can induce diarrhea. Boiled meat is the safest.
  • Watch out for fat: Try to avoid fried foods, trans fats, and foods high in saturated fats.
  • Vegetable consumption: It is good to eat plenty of vegetables. The fiber in vegetables serves as food for beneficial gut bacteria, improving the intestinal environment. However, avoid eating them raw (salads) and it is better to steam or blanch them slightly.
  • Water intake: It is better to drink water than other beverages. While recommended intake varies by body weight, we recommend at least 1L or more per day.
  • No milk: Many Koreans and Asians have lactose intolerance. Therefore, do not drink milk.

Lifestyle and Treatment Management

  • Caution with other illnesses: Even if you catch other illnesses such as a cold, your symptoms will worsen. If you have ulcerative colitis or Crohn's disease, getting additional illnesses will worsen your symptoms, so be careful about preventing infections.
  • Endoscopy: It is best not to undergo endoscopy during treatment. Endoscopy is an invasive procedure and, depending on the operator's skill, can cause injury to the intestinal wall, or in severe cases, cause perforation and worsen inflammation. It is essential when treatment ends, but do not do it too often.
  • Aerobic exercise: We recommend aerobic exercise suitable for your fitness level. It is good to do light exercise without overdoing it.
  • Proper bowel movement posture: It is good to use a footstool when having a bowel movement so that the knees are higher than the hip joints and you lean forward slightly to create a proper posture.
  • Anal hygiene: Always keep the anal area clean. Do not finish by only using toilet paper; it is better to clean thoroughly using a showerhead, bidet, or wet wipes.
  • Anal itching: Occasionally, you may experience itching around the anus, which can sometimes be caused by a fungal infection. You may need to use antifungals, so if you have itching, be sure to ask the medical staff.

F.A.Q

Frequently Asked Questions

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