Treatment Precautions Background
Treatment Guidelines

The Fundamentals of Treatment,
Essential Principles to Follow

A promise for patients with ulcerative colitis and Crohn's disease
to prevent recurrence and move toward full recovery.

"If you do not follow these 5 rules,
treatment may fail or the condition may recur."

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.

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 a recurrence.

The use of chemical drugs such as antibiotics, painkillers, cold medicine, anesthetics, vaccinations, and surgeries can worsen the condition. In particular, many patients report a worsening of symptoms after using antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs). Antibiotics do not just kill bacteria at the site of injury; they indiscriminately kill bacteria in the microbiome within our large intestine.

Antibiotics and the Microbiome

The microbiome, the resident bacteria in the large intestine, consists of about 38 trillion bacteria and has a significant impact on our body's immune system. The administration of antibiotics destroys this microbiome, causing immune system disruption and diarrhea. There are research reports indicating that even after just 4 days of using a 3-type combination antibiotic, 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 tendency to use antibiotics in 80% of cold medications, and antibiotics are prescribed to ulcerative colitis and Crohn's disease patients without much concern. Therefore, the use of unnecessary antibiotics must be avoided, and if they must be used due to unavoidable circumstances, you should double or triple your intake of probiotics and use them with caution. Remember that your symptoms may worsen when using antibiotics, and if they do, please contact the clinic immediately.

Eating food with chemical seasonings once or twice will not stop treatment from working or cause symptoms to recur immediately. However, poor eating habits hinder treatment and prolong the recovery period, and consistent consumption of instant food can lead to a recurrence of symptoms.

In particular, if you frequently consume sugar, fructose, and refined carbohydrates, you may see that symptoms do not improve quickly and actually worsen. Avoid the following foods:

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

Cold food: For patients who are sensitive to cold food, it is important to be careful about eating cold food during the initial stages of treatment. Once treatment progresses, the hypersensitivity to cold food will be treated and disappear, and after treatment, there will be no problems with eating cold food.

Spicy food: Reactions to spicy food vary greatly depending on 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, abdominal pain, diarrhea, and anal burning sensation. Such reactions have large variations 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 the thickness of healthy individuals. Therefore, they are much more susceptible to infection than the general population. Because of this, there are cases where one shares 'the same food' but 'only I (the patient with ulcerative colitis or Crohn's disease)' get sick.

[Forbidden and Recommended Foods] The safest food for patients with ulcerative colitis and Crohn's disease is food that has been freshly heated and cooked right before eating, or food that has been sterilized. You should never eat raw foods, such as raw fish, sushi, beef tartare, or ice cream, because there is a high possibility of bacteria in these foods. Also, ready-made buffet food or food that has been stored before sale is high-risk.

[Lifestyle Rules] Eating food with dirty hands, nail-biting habits, or thumb-sucking increase the risk of infection. Especially in summer, these infections occur frequently, 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. Recovery can take as short as 1-2 weeks, or as long as 1-2 months.

[If conditions suddenly worsen after improvement with Korean medicine treatment] There are cases where symptoms improve with Korean medicine treatment and then suddenly worsen rapidly. Generally, such sudden worsening after improvement is rare. However, sometimes toxic bacterial infections such as Cytomegalovirus (CMV) or Clostridium difficile occur, causing symptoms to worsen. In cases with such viral or bacterial infections, it may look like the symptoms of ulcerative colitis or Crohn's disease are worsening, but in fact, it is often an infection unrelated to the conditions. If your symptoms worsen rapidly during treatment, please contact the clinic immediately, and you should visit a hospital for endoscopies, PCR tests, and bacterial toxin tests to differentiate it from an infection.

It is highly recommended to strictly follow these prohibitions.
It is not that difficult if you think carefully and follow them.

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 a significant issue because they do not cause rapid immune responses. However, for patients with dermatitis such as atopy and psoriasis, or intestinal diseases such as ulcerative colitis and Crohn's disease, inflammation worsens depending on the food, so it is recommended to filter out foods that trigger allergies through a delayed immune response test.

Immediate vs. Delayed Immune Response

Comparison of response time

Why should you 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. On some days, they may have diarrhea 5 times, and on other days, 8 times. Why does this difference occur? This difference occurs depending on the food consumed 1-2 days prior.

Since the reaction appears from a minimum of 5-6 hours to a maximum of 2-3 days after food intake, it is very difficult to think of a direct connection to food on your own. Delayed immune reactions to food occur more frequently in younger people (teens to 20s) and less frequently as you get older (50s-60s). This is because as we live our lives, we are continuously exposed to food, which decreases allergy reactions.

Treatment Strategy and Application

It is recommended to check for allergies to specific foods (rice, tofu, beans, oranges, flour, milk, etc.) and avoid these allergenic foods until the middle of treatment when symptoms have significantly improved. Blocking foods you are allergic to through an allergy test will significantly reduce exacerbation reactions during treatment. After symptoms have improved and treatment is completed, you can eat all foods again.

Lifestyle Guide

General Lifestyle Precautions

Dietary Habits and Nutritional Management

  • Nutritional 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 you take it.
  • Probiotics: It is recommended to take 2 or more different types of probiotic products. It is better to take products in capsules than powdered ones. Sometimes probiotic products can cause diarrhea, so if you experience diarrhea after taking a specific probiotic, try changing the product.
  • Chew slowly: Always chew thoroughly and do not eat in a hurry.
  • Meat consumption: There is no problem with meat consumption if there is no allergy. However, it is better to avoid processed meats such as ham and sausages, and avoid eating fried meat. Even if there is no allergy to meat, eating meat that is too fatty can cause diarrhea. Boiled meat is the safest.
  • Be careful with 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 and improves the gut environment. However, do not eat them raw (salads); it is better to steam or blanch them slightly.
  • Hydration: It is better to drink water than beverages. Recommended amounts vary by body weight, but it is recommended to drink at least 1L or more per day.
  • No Milk: Many Koreans and Asians have lactose intolerance. Therefore, avoid drinking milk.

Lifestyle and Medical Management

  • Be careful of other illnesses: Symptoms worsen if you contract other illnesses such as a cold. If you have ulcerative colitis or Crohn's disease and contract an additional illness, symptoms worsen, so be careful to prevent infection.
  • Endoscopy: It is best not to undergo endoscopy during treatment. Endoscopy is an invasive procedure, and depending on the skill of the examiner, it can scratch the intestinal wall or, in severe cases, cause perforation and worsen inflammation. It is essential when treatment is completed, but do not do it too often.
  • Aerobic exercise: Aerobic exercise suitable for your physical strength is recommended. It is good to do light exercise without overexerting yourself.
  • Proper bowel movement posture: When having a bowel movement, use a footstool so that your knees are higher than your hip joints and lean slightly forward to create a proper posture.
  • Anal hygiene: Always keep the anal area clean. Don't just wipe with toilet paper; it is better to use a shower, bidet, or wet wipes to clean thoroughly.
  • Anal itching: Occasionally, if there is itching around the anus, it may be caused by a fungal infection. Antifungal medication may be required, so if you experience itching, be sure to consult medical staff.
Inquiry AI