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Ulcerative Colitis Advice

#1

Hiya, im looking for advice on Ulcerative Colitis.

I’m currently in hospital after a particularly bad flare up of UC, i had chronic diarrhoea for a week and ended up so severely dehydrated my blood pressure was 60/40 and my heart rate 158… big mistake thinking i could avoid hospital and deal with it at home…
this is my second flare up requiring hospitalisation in 3 weeks despite being on a decreasing dose of prednisolone from 40mg (this week im on 25mg) and i was also started on mesalizine 4800mg.
since this is the second flare up my doctor has seriously recommend i quit smoking/vaping. i have cut down to 2 or 3 cigarettes a day and mostly vape 3mg of nicotine. i was wondering if anyone has any experience or knowledge as to if quitting smoking completely and starting to vape nicotine free would be as beneficial as quitting vaping and smoking completely.
i ask this seemingly obvious question ‘should i quit’ because i have spoken in depth with my therapist about quitting as i know it’s bad for my physical health, but she believes the negative physical impacts are less significant than the benefits it provides. i have severe anxiety and have been in psychiatric units to help deal with it and i find smoking has always been a big help. it allows me time outside to calm down and just take a minute to breathe, i also find that the deep breathing associated with smoking/vaping helps the anxiety and the nicotine is obviously helpful with stress.
however, after two hospitalisations in 3 weeks, if quitting both would improve my symptoms i will give it my best shot. im just wondering if its the nicotine that could be worsening the UC or if its simply the act of vaping that will aggravate it.
Thank you,
Emily

#2

Emily, I am not sure I can help. One thing recommended for those w/ UC is to reduce their stress. I think that is hilarious, as UC is stressful just in having a flare!
Aside from that, recommending no smoking/vaping sounds like a good idea for anyone. But I understand it helps with your anxiety.

Do you have any other ways that can help? Stress balls help, especially when you throw it at the person who is causing your stress. Just as smoking was a learned activity, other methods of stress reduction can be learned.

#3

Hi Emily, I also don’t think I can speak to whether quitting smoking will help with your UC. You already know that smoking is very bad for your overall health, but a quick Google search tells me that a few studies suggest there might actually be some benefit to UC from nicotine itself. Go figure.

That said, I can speak more to the impact of smoking on anxiety. Like you pointed out, the deep breathing associated with smoking/vaping helps with anxiety, but that’s a property of breathing, not of nicotine. Nicotine itself is a stimulant - it increases blood pressure and heart rate, and contributes to stress rather than decreases it. Despite its stimulant properties, the feeling of relief that comes from getting rid of that craving, combined with deep breathing and allowing yourself a break, is a really powerful negative reinforcer that makes it seem as though smoking is helping with your anxiety.

The real kicker is that nicotine withdrawal also causes anxiety, and smoking does legitimately help with that anxiety, even though it wouldn’t be present if you didn’t use nicotine in the first place. So the “benefit” of smoking on anxiety is usually just avoiding the consequences of nicotine withdrawal. The upside to this is that the “bonus” anxiety of withdrawal is temporary (a few weeks to a few months), and then you’re essentially back to baseline. Knowing all that doesn’t make quitting suck any less, but if you’re in a solid enough place in your life and your doctor recommends it, doing so might be a good idea.

One option to consider might be nicotine replacement therapy. This can be nicotine patches, gum or lozenges, or preferably a combination of the patch and one of the other two. The patch gives a steady release of nicotine throughout the day, while the gum/lozenges can help with “breakthrough” cravings, which can be especially important if you smoke in response to anxiety. Going this route would let you keep the nicotine without the carcinogens, which is the real danger of smoking. Quitting altogether can potentially help a lot of things over time, but the most important thing is to stop putting those carcinogens in your body (about 2000 chemicals per cigarette, about 70 of which are known to cause cancer). UC increases risk for colon cancer enough by itself. Vaping could be better, but it could also be bad in different ways, we just don’t know enough yet.

Well that was a bit of an essay! Hope it was helpful. One thing that I struggle with in dealing with PSC/UC is trying to balance taking steps to stay healthy and manage the symptoms without falling into the trap of trying to control something that’s out of my control. For me, diet is a big struggle, since food is my favorite coping mechanism. So regardless of what you decide, I hope you don’t place too much blame on yourself for continuing to smoke right now. We’re all just struggling through this as best we can.

#4

Hey Emily-Great questions!

First off, I am not a doctor…so this is my best advice from our personal experiences and much research. I just returned from the Integrative Mental Health Conference in Dallas Texas-It was amazing. They talked about so much…main thing…nutrition does make a difference (Omega 3 and zinc, tryptophan ect) I personally take buspirone and some counseling:)

On smoking…there actually is research on smoking making you less likely to get PSC…but you already have it…so…

I used to smoke organic cigarettes…did some research there. Regular tabacco was smoked by the indians to kill off intestinal parasites. It is still not good for the lungs though.

I have anxiety too. I noted in research that some crazy number (like 50%) of people that smoke have anxiety or other mental illness. Yup…I used smoking to “take deep breaths” and that is what I figured out was the reason I enjoyed it so much.

Fast forward. I know vape essential oils and do meditation. The essential oil pen I use is the Kinin. It is so relaxing and the essential oils are flavorful and healthier (they are in glycerin.)
https://mykinin.com/shop/ email them for a discount code.

I really hope that you find a way to cope with your anxiety.

And on UC. My husband had great luck getting off gluten and dairy and changing his diet. He did a whole food (Smoothie) diet for 6 months and took days off to fast. He read Jordan Rubins book 13 years ago and it changed his life. He has been UC free since them. (His dr could not believe his colonoscopy 10 years apart…severe UC to Absentia UC) Got bit by a tick and PSC hit him within 2 months. Liver failed quickly.

I personally work for an integrative laboratory that does Food Allergy testing and think it is a must have!!! Inflammatory foods are not good for the gut. PSC can be an IGG4 mediated immune response.
I will keep you in my prayers. This is a judgement free zone. I am so thankful that you were able to share your struggles. Please know that we are all here to support you and walk this, share our struggles and triumphs with one another.

I will pray for the best for you!

M

#5

Emily.
Not a smoker but had to have a total colectomy due to UC.

I was diaganosed with Crohns/UC with Coeliac (gluten free) at the same time. So I immediatly went gluten free and moderated my diet. Unfortunatly I was not like Mommymoses partner who recovered in the UC department. Mine just kept getting worse until I had emergency surgery when I got a sever infection and had toxic mega colon.

Anyway long story short as can be seen from the commentary each persons bodily system deals with things slightly different. What I take from these discussions is to do what you think is right and if the deep breathing is what relieves the anxiety then try yoga while trying to give the “darts” away (Aussie slang for cigarettes).

Good luck with your journey