Treatment Precautions Background
Treatment Guidelines

The Standards of Treatment,
Principles That Must Be Followed

Our promise to prevent the recurrence of ulcerative colitis and Crohn's disease
and guide you toward complete recovery.

"Failure to follow these 5 rules
may result in treatment failure or recurrence."

These are essential lifestyle rules that cannot be compromised
when 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 efficacy and protect the intestinal mucosa.

Alcohol consumption, in particular, 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 recurrence.

The use of chemical drugs such as antibiotics, painkillers, cold medicine, anesthetics, vaccinations, and surgeries can worsen your condition. Many patients report worsening symptoms especially after using antibiotics and non-steroidal anti-inflammatory drugs. Antibiotics do not just kill bacteria at the site of the wound; they indiscriminately kill the bacteria of the gut microbiome located in our colon.

Antibiotics and the Microbiome

The gut microbiome, consisting of about 38 trillion bacteria, is closely linked to our immune system. Administration of antibiotics destroys this microbiome, causing immune system disturbance and diarrhea. Research reports indicate that even after just 4 days of triple combination antibiotic use, it takes more than 6 months for the destroyed microbiome to return to normal. (Recovery of gut microbiota of healthy adults following antibiotic exposure - PubMed)

[Management] Indiscriminate abuse of antibiotics must be avoided. In South Korea, there is a tendency to use antibiotics in 80% of cold medications, 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 absolutely must use antibiotics, you should increase your probiotic intake by 2-3 times and proceed with caution. Always remember that using antibiotics may worsen your symptoms, and if they do, please contact the clinic immediately.

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

In particular, frequent consumption of sugar, fructose, and refined carbohydrates can delay improvement and worsen symptoms. Avoid 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 during the early stages of treatment. Once treatment progresses, the hypersensitivity to cold food will be cured and disappear; after treatment, you will be able to eat cold foods without any issues.

Spicy foods: Reactions to spicy food vary greatly depending on country and culture. However, patients with ulcerative colitis or Crohn's disease tend to be highly sensitive to spicy food. When consuming spicy food (even if it does not feel spicy in the mouth), it can cause heartburn, abdominal pain, diarrhea, and in some cases, anal burning. These reactions vary greatly due to individual and cultural differences and are not something that can be corrected with medication. Therefore, sensitivity 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 healthy individuals. Therefore, they are much more vulnerable to infection. This is why sometimes, when sharing the 'same food', 'only the patient' gets sick.

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

[Lifestyle Rules] Picking up food with dirty hands, nail-biting, or thumb-sucking increases the risk of infection. Such infections occur frequently, especially in summer, so be sure to 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.

[Sudden worsening after improvement from herbal treatment] Sometimes, symptoms that were improving during herbal treatment can suddenly and rapidly worsen. Generally, sudden worsening after improvement is rare. However, occasionally, toxic bacterial infections such as Cytomegalovirus (CMV) or Clostridium difficile occur, worsening the symptoms. In cases of such viral or bacterial infections, it may look like ulcerative colitis or Crohn's disease are worsening, but in fact, it is often an infection unrelated to the underlying condition. If symptoms worsen rapidly during treatment, you must consult the clinic, and tests such as endoscopy, PCR, or bacterial toxin tests should be conducted at a hospital to rule out an infection.

It is highly recommended to strictly 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 can cause shock, but allergies to delayed immune responses are something everyone has. For healthy individuals, these delayed allergies are not a serious issue as they do not trigger drastic immune responses. However, for patients with dermatitis such as atopic dermatitis or psoriasis, or enteritis such as ulcerative colitis or Crohn's disease, inflammation can worsen depending on the food. Therefore, it is recommended to identify and avoid allergic foods through a delayed immune response test.

Immediate vs. Delayed Immune Response

Comparison of Response Time

Why should you know about delayed allergies?

For example, the frequency of diarrhea in ulcerative colitis and Crohn's disease patients varies daily, even for the same patient. On some days it might be 5 times, on others 8 times. Why does this difference occur? It happens depending on the food consumed 1-2 days prior.

Since the reaction appears anywhere from a minimum of 5-6 hours to a maximum of 2-3 days after food intake, it is very difficult to recognize the direct link yourself. Delayed food immune responses occur more frequently in teenagers and people in their 20s, and decrease as one ages into their 50s and 60s, because constant exposure to food throughout life reduces allergic reactions.

Treatment Strategy and Application

It is recommended to identify allergies to specific foods (rice, tofu, beans, oranges, wheat, milk, etc.) and avoid them until the mid-stages of treatment when symptoms have significantly improved. Blocking allergic foods through allergy testing will greatly reduce worsening reactions to food during treatment. Once symptoms have improved and treatment has concluded, 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 ulcerative colitis and Crohn's disease patients, so it is recommended to take it.
  • Probiotics: We recommend taking two or more different probiotic products. Capsules are better than powder forms. Occasionally, probiotics can cause diarrhea, so if you experience diarrhea after taking a specific one, try switching to a different product.
  • Chew slowly: Always chew thoroughly and do not eat in a hurry.
  • Meat consumption: If there is no allergy, meat consumption is fine. However, processed meats like ham and sausages should be avoided, and fried meats should be avoided. Even if you are not allergic to meat, consuming meat with too much fat can trigger diarrhea. Boiled meat is the safest.
  • Caution with fat: Avoid deep-fried foods, trans fats, and foods high in saturated fats.
  • Vegetable consumption: Vegetables are recommended. The fiber in vegetables serves as food for beneficial gut bacteria and improves the intestinal environment. However, do not eat them raw (salads); lightly steaming or blanching them is better.
  • Hydration: Drinking water is better than other beverages. While recommended daily intake depends on weight, we recommend drinking at least 1L or more per day.
  • No Milk: Many Koreans and Asians have lactose intolerance. Therefore, avoid drinking milk.

Lifestyle Habits and Medical Management

  • Other illnesses: Symptoms can worsen if you catch other illnesses such as a cold. If you have ulcerative colitis or Crohn's disease, any additional illness will worsen symptoms, so take care to prevent infections.
  • Endoscopy: It is best not to undergo endoscopic examinations during treatment. Endoscopy is an invasive procedure that can scratch the intestinal wall depending on the practitioner's skill level, and in severe cases, cause perforation or exacerbate inflammation. While necessary at the end of treatment, avoid doing it too frequently.
  • Aerobic exercise: Aerobic exercise suited to your fitness level is encouraged. It is best to do it lightly without overexerting yourself.
  • Proper defecation posture: When passing stool, using a footstool to keep your knees higher than your hip joints and leaning forward slightly creates a better posture for defecation.
  • Anal hygiene: Keep the anal area clean at all times. Do not rely solely on toilet paper; it is better to clean thoroughly using a showerhead, bidet, or wet wipes.
  • Anal itching: Occasionally, itching around the anus can occur, sometimes caused by fungal infections. You may need to use antifungal medication, so please consult medical staff if you experience itching.
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