Treatment Precautions Background
Treatment Guidelines

The Fundamentals of Treatment,
Essential Principles to Follow

A promise for ulcerative colitis and Crohn's disease patients to prevent relapse
and move toward complete recovery.

"Failure to follow these 5 rules
may prevent treatment or lead to relapse."

These are non-negotiable, essential lifestyle rules
for treating ulcerative colitis and Crohn's disease.

5 Mandatory Rules

5 Essential
Compliance Rules

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

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

The use of chemical drugs such as antibiotics, painkillers, cold medicine, anesthetics, vaccinations, and surgeries can cause deterioration. Many patients report worsening symptoms, especially after the use of antibiotics and anti-inflammatory painkillers. Antibiotics do not just kill bacteria at the site of infection; they indiscriminately kill the bacteria of the microbiome in our colon.

Antibiotics and the Microbiome

The colonic microbiome consists of approximately 38 trillion bacteria and has a close impact on our body's immune system. The administration of antibiotics destroys this microbiome, causing immune system disruption and triggering diarrhea. There are research reports indicating that even after 4 days of triple combination antibiotic use, it takes more than 6 months for the destroyed microbiome to recover. (Recovery of gut microbiota of healthy adults following antibiotic exposure - PubMed)

[Countermeasures] Indiscriminate abuse of antibiotics must be avoided. In South Korea, there is a tendency to use antibiotics in 80% of cold medicines, and antibiotics are often prescribed to patients with ulcerative colitis and Crohn's disease without much caution. Therefore, you must avoid unnecessary use of antibiotics. If you have no choice but to use them, increase your intake of probiotics by 2-3 times and proceed with caution. Please remember that using antibiotics can aggravate symptoms; if your symptoms worsen, contact the clinic immediately.

Eating food with artificial seasonings once or twice will not prevent treatment or cause symptoms to relapse. However, poor dietary habits hinder treatment, making the treatment period longer, and continuous consumption of instant foods can lead to symptom relapse.

In particular, frequent consumption of sugar, fructose, and refined carbohydrates can lead to a failure in rapid improvement and even worsening of symptoms. Avoid eating the following foods:

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

Cold food: Patients who are sensitive to cold food should be careful about eating cold food at the beginning of treatment. Once treatment progresses, hypersensitivity to cold food will be cured and disappear, and after treatment, you will have no particular issues with eating cold food.

Spicy food: Reactions to spicy food vary greatly by country, culture, and individual. However, patients with ulcerative colitis or Crohn's disease tend to have a notable hypersensitivity to spicy food. When consuming spicy food (even if it doesn't feel spicy in the mouth), it can cause heartburn or abdominal pain, diarrhea, and anal burning sensation. These reactions have significant variances based on individual and cultural differences and are not treatment targets that can be corrected with 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 1/3 as thin as that of a healthy person. Therefore, they are much more vulnerable to infection. This is why sometimes, when sharing the 'same food', 'only me' (the patient) ends up getting sick.

[Prohibited and Recommended Foods] The safest foods for ulcerative colitis and Crohn's disease patients are those that are cooked and heated just before eating, or foods that are sterilized. Raw foods, raw fish (sashimi), sushi, raw beef (yukhoe), and ice cream should never be eaten because they are highly likely to contain bacteria. Also, ready-made buffet foods or foods stored for a long time are high-risk.

[Lifestyle Rules] Eating with dirty hands, nail-biting habits, or finger-sucking increase the risk of infection. Such infections occur frequently, especially in summer, so be sure to wash your hands thoroughly and frequently with soap. If a patient with ulcerative colitis or Crohn's disease develops food poisoning or enteritis, abdominal pain and diarrhea worsen, and bloody stools increase. It can take anywhere from 1-2 weeks to 1-2 months to recover.

[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 that you follow the above prohibitions.
If you think carefully and follow them, it is not that difficult.

Food Allergy Test

Delayed Food
Allergy Test (IgG)

While some patients have allergies to immediate immune responses that cause shock, allergies to delayed immune responses are something everyone has. For healthy individuals, these delayed allergies do not cause significant immune reactions and are not a problem at all. However, for patients with dermatitis such as atopic dermatitis or psoriasis, or patients with enteritis such as ulcerative colitis or Crohn's disease, inflammation can worsen depending on the food. Therefore, it is recommended to identify and avoid allergy-triggering foods through a delayed immune response test.

Immediate vs. Delayed Immune Response

Reaction Time Comparison

Why should we know about delayed allergies?

For example, for patients with ulcerative colitis and Crohn's disease, the frequency of diarrhea varies slightly from day to day even for the same patient. Some days they have 5 bowel movements, other days 8. Why does this difference occur? It happens depending on the food consumed 1-2 days prior.

Since the reaction appears after a minimum of 5-6 hours to a maximum of 2-3 days after consuming food, it is very difficult to recognize the direct correlation with food on your own. Delayed food immune responses occur more frequently in teenagers and those in their 20s, and decrease as people get older (50s-60s). This is because as we live our 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, flour, milk, etc.) and avoid those foods until the middle of treatment when symptoms have significantly improved. Blocking allergy-triggering foods through allergy testing will greatly reduce aggravating reactions to food during treatment. Once symptoms have improved and treatment is completed, you may eat all foods again.

Lifestyle Guide

General Lifestyle Precautions

Dietary Habits and Nutritional Management

  • Supplements: You may take them. Vitamin D, in particular, is often reported to be deficient in patients with ulcerative colitis and Crohn's disease, so it is good to take it.
  • Probiotics: We recommend taking two or more different types of probiotic products. It is better to consume capsule products than powdered ones. Sometimes probiotic preparations can cause diarrhea, so if you experience diarrhea after taking a certain probiotic, try changing the product.
  • Chew slowly: Always chew thoroughly and do not eat in a hurry.
  • Meat consumption: If you have no allergies, there is no problem with consuming meat. However, it is best to avoid processed meats like ham and sausage, and do not eat fried meat. Even if you are not allergic to meat, eating meat with too much fat can trigger diarrhea. Boiled meat is the safest.
  • Watch out for fat: Avoid fried foods, trans fats, and foods high in saturated fat.
  • Vegetable consumption: It is good to eat plenty of vegetables. The fiber in vegetables acts as food for beneficial bacteria in the gut, improving the intestinal environment. However, avoid eating them raw (salad); it is better to slightly steam or blanch them.
  • Hydration: It is better to drink water than beverages. Although the recommended amount depends on body weight, we recommend drinking at least 1L or more per day.
  • No Milk: Many Koreans and Asians have lactose intolerance. Therefore, do not drink milk.

Lifestyle Habits and Medical Management

  • Caution with other illnesses: Even if you catch other diseases like a cold, symptoms will worsen. If you have ulcerative colitis or Crohn's disease and catch additional illnesses, symptoms will worsen, so be careful to prevent infection.
  • Endoscopy: It is not recommended to undergo endoscopic examinations during treatment. Endoscopy is an invasive procedure that, depending on the skill of the examiner, can cause damage to the intestinal wall or, in severe cases, perforation and worsen inflammation. While it is essential when concluding treatment, do not do it too often.
  • Aerobic exercise: We recommend aerobic exercise suitable for your physical strength. It is good to do it lightly without overdoing it.
  • Proper defecation posture: When having a bowel movement, it is recommended to use a footstool so that your knees are higher than your hip joints and lean forward slightly.
  • Anal hygiene: Always keep the anal area clean. Do not finish by only using toilet paper; it is recommended to wipe clean using a shower head, bidet, or wet wipes.
  • Anal itching: Occasionally, you may experience itching around the anus, which is sometimes caused by a fungal infection. You may need to use antifungals, so if it itches, be sure to consult medical staff.

F.A.Q

Frequently Asked Questions

Loading FAQ data...
Inquiry AI