All About Telehealth for Ulcerative Colitis Telehealth allows doctors to care for people virtually over a phone call, text message, or most commonly, video chat. Although some situations require an in-person visit, telehealth is a great option when you can't get to the doctor's office for your ulcerative colitis. If you're new to telehealth, here's what you need to know. Medicare will cover telehealth visits just like in-person visits, but state Medicaid programs and private insurers vary, so confirm your coverage in advance. With telehealth, even though you're not in the doctor's office, your private health information is still covered by HIPAA, so it will remain confidential and secure. Although your gastroenterologist can't give you a physical exam via telehealth, they can write prescriptions and offer quality care, especially if you prepare in advance. Before your telehealth appointment:- Ask if there's anything you should do ahead of time, like adjust your diet- List any ulcerative colitis symptoms, including dates and severity- Report any pain, changes in stool, rectal bleeding, fever, or fatigue- Note any side effects from your ulcerative colitis medications- Document any new stresses or recent life changes- Keep track of what you've been eating and drinking- Compile a list of your health conditions and medications, including herbs and supplements- Record your weight, as well as your vital signs if you own a thermometer, blood pressure monitor, or another device- Charge your computer or phone- Make sure your internet is reliable- Download any telehealth apps your specific provider may require- Write down questions you have for your gastroenterologist- Find a quiet, private space to conduct the call- Be prepared with pen and paper or a note-taking app Turn to Healthgrades to connect with the right gastroenterologist to treat your ulcerative colitis via telehealth. And share this video to spread the word!

I'm Steph and I have ulcerative colitis. One dramatic experience that I've had living with ulcerative colitis was before I was on the right medication. The doctors were trying everything, kind of working from the ground up, trying not to start with the really Herculean drugs with me. I would have flare ups every four to six weeks that would leave me completely weak and not able to really think straight as well as being in a lot of pain and being really uncomfortable and not really able to leave the house. So the worst episode, the worst flare-up that I experienced, it did have me in the hospital for about a week, which did result in me getting on biologic medications, which has absolutely changed my life. The thing that scares me the most about living with ulcerative colitis is not having access to a healthcare plan in the future. Everything seems incredibly tenuous, especially with the economy and healthcare and the way that it's structured today in the United States and, if I don't have decent health coverage, my medication will not be possible for me to afford. So it is a genuine fear. Thinking about a silver lining for living with a chronic illness is a really difficult question. But for me really what it is is feeling more connected to my body and knowing when I'm feeling something that's off and advocating for myself for it being off and how off it feels. We're often asked if it's from one to 10, where's your pain? Well, I've gotten better at knowing my 10s and my fives. I feel like I know when I'm having a really good day and that I don't take that for granted.

Mick: It feels like being stabbed or something. Cody: Like someone was stabbing me in the guts and dragging the knife across. Lisa: You feel like knives are going in your stomach. John: It reached to a point where one day the pain was so bad that I went to the emergency room. Lisa: I was on a trip in the Caribbean. I ate something, and I thought that it just upset my stomach. Cody: I was actually training to be a circus performer in Vermont, and I started having pretty intense stomach cramping. Mick: Diarrhea, urgency, and eventually bloody diarrhea. Dana: I had to wear diapers. I couldn't leave my house going more than a five-mile radius. I was walking around scared. Cody: I would be in rehearsals and just hoping that I wouldn't, all of a sudden, have an urge to use the restroom. Or, I would not eat for a day if I had to perform because I was worried of what might happen if I did. John: You're hurting, and you can't put your finger on it. For me, it would get so severe that I would have to take days off of work. Lisa: I was losing weight. I was bleeding. I started to become incontinent where I couldn't keep my bowels together. I was having accidents in the car, and things like that. Dana: I was going to the bathroom about 20 to 30 times a day. Mick: I actually had to be hospitalized because I had lost a lot of blood. Lisa: It was probably maybe two months in that I decided that this was not just something bad I ate on vacation. Dana: I finally went to the doctor. Lisa: They had suggested that I get a colonoscopy right away. Mick: After doing a few tests, ruling out some things, they pretty quickly came to the conclusion that it was ulcerative colitis. Cody: Be hopeful. There's so much research going on right now. There's constantly new treatments coming out. Lisa: The mental part of the disease is sometimes a lot worse than the physical part of the disease. The number one thing I would say is, you have to be positive. Mick: I feel almost like I'm maybe kind of lucky, even, that I don't have a worse condition. Cody: I like to have some humor with this sort of thing. John: Because the last thing you want to do is die from a pain in the butt. Dana: I know it sounds silly, but sometimes I feel to myself like maybe I was the person who was meant to get this because I found a way to be able to manage it, control it my way, and still put a smile on my face, and still be able to live my life, because you can still live your life even with the ulcerative colitis.

Dr. Hunt: Ulcerative colitis is a chronic inflammatory condition that affects primarily the colon and the rectum. Dr. Wolff: But it can also cause symptoms outside of the gut. We call these extra-intestinal manifestations of ulcerative colitis, and so it can involve the eyes, the spine, the liver. Dr. Vrabie: We don't really know what causes ulcerative colitis. Currently, we think it's a combination of genetic predisposition, the micro environment that lives inside your GI tract, and maybe some environmental triggers. Dr. Wolff: This disease can certainly take you down and you can have debilitating symptoms with ulcerative colitis: rectal bleeding, weight loss, abdominal pain, fatigue. Dr. Vrabie: The gold standard for diagnosing ulcerative colitis is a biopsy. Dr. Wolff: There is typically blood work and stool analysis to look for infection and maybe look for clues of inflammation, and typically a gastroenterologist will perform a colonoscopy, which is an exam of the large intestine where we look for signs that would indicate inflammation in the colon. Dr. Hunt: The goals of treatment are to manage the disease, improve your lifestyle, to maintain remission and to minimize the risk of cancer. So most patients can be managed successfully without the need for surgery. Dr. Wolff: For patients with mild or limited disease, there is a category of medications called mesalamines, or 5-ASA preparations. Dr. Vrabie: The next iteration up would be immunomodulators, which are somewhat immunosuppressant and come with several side effects which require some monitoring. Dr. Wolff: Another category are biologics, which act as a laser beam on certain inflammatory molecules in the body and are generally used for more moderate to severe cases of ulcerative colitis. We talk about the risk of infection, hypersensitivity, potentially the risk of some very rare forms of cancer with those medications, but we're weighing those risks against the risks of untreated or undertreated ulcerative colitis. It can lead to hospitalization and may increase the risk of colon cancer. Dr. Vrabie: I want to make sure that a patient feels that they have, in their provider team, an ally. Dr. Wolff: I think it's really important to be positive. Many patients can achieve a state of remission where they're not thinking about their symptoms and their colon all day long, and that's really the goal.

Cody: Food is an interesting topic for me. I've run the gamut. Name a diet, I've probably tried it to manage my ulcerative colitis. Lisa: There is no set regimen of food that you can eat. You have to find out what's good for you. Dr. Wolff: I tell my patients to just live a healthy, balanced life. It's more about what to avoid, so avoid processed meat. Red meat consumption has been linked to, potentially, inflammation and colon cancer risk. Avoid certain additives to food, processed foods, refined sugars. John: Use a lot of ginger and coconut oil because it helps with the inflammation. Cody: Humans are really individual, and what causes inflammation for one person could not for another person. So there are certain things that I've discovered throughout the years that I really don't do well with--gluten, dairy, sugar. Dana: But it was trial and error. I had to learn. I had to teach myself and learn what foods were okay for me and what foods were not okay for me. Lisa: Alcohol, I completely avoid. Spicy foods, I avoid. Vegetables that don't break down easily, I avoid. Dana: When I'm having a flare-up, the best foods that I could eat would be breads, carbs. Simple starches would help bind me. Cody: No raw foods and no salads. No cheese. Lisa: Unfortunately, I don't think there is any food that will prevent the flare-up, but it's better to get some nutrition in than none at all. John: So I'd eat a lot of oatmeal throughout the day. Cody: Just trying to stick with soups and stews and potatoes and things that are mushy. Dr. Vrabie: The management of a flare is very individualized, so I have patients that will automatically switch to a liquid diet. For other people, that only makes the stool more liquid and increases their symptoms. Cody: It's a very, very, very individualized process of just really paying attention to your body and learning what works for you and what doesn't work for you.

Dana: Having ulcerative colitis is very much trial and error. You go from certain times that you feel amazing and then when you have flare-ups, it's just... It's the worst. Lisa: You become a prisoner of your own home. Linda: Everywhere you go, you make sure you know where the bathroom is. And people think you look great and you're fine, but you're not and you make believe you are. Cody: First and foremost, engage with other people that have this disease. Dana: People who have UC always feel like they're alone because it's a stigma. You don't talk about that type of sickness. So support that we get is so important. John: Sharing is how I heal. I talk about what I'm going through. Mick: You're going to get times when you can't really help yourself just because you're in pain and you don't want to move around. It's great to have people who could help do things for you. John: When I go through a flare-up, I look at, "What have I been doing wrong?" It's usually a sign that I'm slipping in my diet and I will actually go through a fast. Start heavy again with the detox waters and I'll even take a dose of coconut oil down and usually in about two days, the irritation is gone. Cody: Specific foods and drinks that I avoid in flares would be... All foods. I'm sort of joking, but you know, anything harsh. Lisa: So alcohol, I completely avoid. Spicy foods, I avoid. Vegetables that don't break down easily, I avoid. Dana: The best foods that I could eat would be breads, carbs. Simple starches would help bind me. Linda: If it's very bad, I have quite a few medications that I can use. Mick: If you're going out somewhere, make sure you bring some kind of toilet paper with you. Cody: Just a nitty-gritty tip. There's a couple of different products that are all natural wipes that can help relieve any soreness. Lisa: Stress plays such a role with the flare-ups that I think that it's important to try to manage it the best way you can by taking some time out for yourself. Linda: Going to the gym does relax me. Cody: Making sure I meditate every morning. Making sure I get enough sleep when I can. Lisa: Maybe even taking some anti-anxiety medication. That's really helped me tremendously. Dana: You can do this. You can live with this. It is not a death sentence. John: It does get better. Lisa: Eventually the flare will end and you'll be able to go about your life.

The first time I felt, I guess, the symptoms of heartburn and just an incredible burning sensation, it felt like breathing fire and persistent. There's nothing really that you could do. I tried to drink water to take care of it, but that wouldn't really douse it. Before I started taking medication, there really wasn't any food that I would avoid. But I would find out pretty quickly which foods would give me heartburn. Things that caused it would be, like, barbecue pork, which I love. Sometimes if I would have wine, in particular white wine, in conjunction with something that I would eat, I would seem to notice I would have acid reflux more often. I guess my heartburn was more frequent, then I would take antacids. But I started to have a pain in the middle of my back, kind of a dull pain. And it didn't seem like heartburn. And then I was sent to have a test, an upper GI test, where you drink a barium solution along with, I don't know how you'd call it, pop rocks or whatever. It fills your esophagus with air, and you have to swallow something. Then they film the barium going down your throat, and they can see if there's any acid reflux. And it turned out I had a hiatal hernia and acid reflux. Now if I get an attack, it's... Almost it feels like you need to burp, but you can't. It's very mild. It's not the burning sensation. I'm going to try and modify my diet when I can. I'm not going to give up the stuff that I love, but I'm going to try and be a little bit better during the week, I think.

At least by 13 years old, I most definitely had some issues. My mom is how I was able to let someone know what was going on. Of course, I didn't know what they were at the time, and so I asked her. She actually has had problems with hemorrhoids as well. So, as soon as I asked her, she said, "I think you've got hemorrhoids," which of course she was surprised because I was so young. But hereditary reasons, the doctor had said, could contribute to why I would have them as well. They could be internal or external. So, a lot of times when they were internal, there was nothing I could actually feel when I wiped after a bowel movement or something like that, but still I knew something was itchy. And then sometimes they were external, so I could actually see them when I looked in the mirror or when I wiped. Sometimes it was even, I knew because of blood. And so, I would have either chronic diarrhea or chronic constipation. We really couldn't pinpoint what was causing the constipation or what was causing the diarrhea. No certain food group. However, the doctor did instruct me, and I remember getting the sheet of paper that showed me foods that were rich in fiber. The creams did help, but most of the time it was over time. I would say what helped more than anything is just watching my diet more. Drinking the water. An exercise regimen definitely has helped so much. However, there's a good balance when it comes to my bowel, and I could do too much working out. I've noticed that on extremely long runs or times that I've been training for a race, the hemorrhoids can flare up because I'm pounding that pavement over and over. A piece of advice that I would offer for people with hemorrhoids is that after a bowel movement ,it's hard to get as clean as you would like to get with just a normal piece of toilet paper. And so, I think carrying wet wipes or something that you can cleanse yourself better. Making sure, please, to avoid the ones with alcohol, because if you're already sore, wiping with something that isn't a sensitive skin wipe can be painful. Definitely tell your doctor. For your primary care doctor at your annual physical or your OB/GYN when you're going in for your annual, it is always on the sheets that you have to fill out. Circle it. Tell your doctor that you're suffering with these because they do get worse, they definitely get worse over time. The itching, the burning, just not feeling comfortable sitting down, those are things that can be prevented by a healthy diet, exercise for some, and you don't have to live with it.

I had my first IBS attack at age nine. All of a sudden, without warning, I had the worst pain I had ever experienced in my life, just like this lower abdominal... I thought I was dying. It felt like somebody had just plunged their hand inside me and was trying to rip out my guts. And I couldn't breathe, I couldn't talk. I came to and was facedown in the dirt, and the pain was gone, but I was very cold. I was very shaky. I was sort of in a cold sweat, and I went to go see my pediatrician, who was just absolutely horrible, who listened to what had happened and said, "Your symptoms don't fit anything I've ever heard of, so there's nothing wrong with you." And her exact words to me were, "Quit whining." So for seven years I just lived with it. When I finally did see the gastroenterologist, he said, "You have diverticulosis, and here's some prescription anti-spasmodics and you'll be fine. It won't kill you." When I was about 29, then I went to see a different GI doctor and said, "I don't think I have diverticulosis. I don't think I've ever been properly tested for other disorders, and I think I have IBS. But I would sure like someone who's a gastroenterologist and a professional in this field to second that opinion, what do you think? I don't want to just decide this on my own and self-diagnose after 20 years." It was a great guy. He was a great doc, and he listened and he said, "Well, you certainly don't have diverticulosis. There isn't a nine-year-old in the world that would have that. You should have been tested for celiac, so we'll do the blood screen for that now. You should have been tested for inflammatory bowel disease like Crohn's and ulcerative colitis." And he said, "At this point, honestly, since you have no red flag symptoms and nothing has progressed in the past 20 years, the odds are overwhelming that it is IBS." Finally, 20 years later, I was officially diagnosed with IBS. IBS in general is diagnosed by symptoms, and you have to have lower abdominal pain or discomfort in association with bowel dysfunction, which can be diarrhea or constipation, or alternating. People really run the spectrum, both with the pain part of it, whether it's extreme pain like mine, I found out later I'm a pretty extreme case. If I do get hit by that pain, there's usually diarrhea as a part of it. Sometimes in the aftermath of a severe attack, the next day it'll flip to constipation. I think it's just my gut is so out of whack at that point. I think when people are dealing with doctors, the most important thing is that they get a proper diagnosis. You can't self-diagnose IBS. You have to have tests to rule out disorders that can mimic IBS, plus your symptoms have to fit the Rome Criteria. So learn about that yourself, learn what this is, and if you don't think you've been properly diagnosed, see another doctor. Find one of the good doctors out there, there are plenty of them. There's great GI docs. It might take a while to find one, but it's worth it. Once you have a diagnosis, there's not a lot doctors can do for you. You can self manage it, you have to self manage it and self control it, but you can't self-diagnose it.

I started having pain in my side and so I started going to the emergency room, trying to figure out what it was. And it turns out my appendix had ruptured and I ended up needing surgery for that and they did a biopsy, and that's when they found the Crohn's. I was in such shock, I don't know if I really understood how much of an impact it would have and how serious the symptoms could be. I started just having severe pain out of the blue and then it kind of dawned on me--okay, so this is what Crohn's is. This is what it really feels like to have a flare. You'll find that most Crohn's disease patients has diarrhea when they're going to the bathroom 20 or 30 times a day. I don't really have that. I usually just have the severe pain, I have a lot of fatigue and I have ulcers. So sometimes I get the burning from my ulcers. But other then that, I usually don't have signs unless I'm in pain. The sharp pains can get pretty strong and there have been times where I would say I couldn't function because I would be in the bed, laying down, balled up and unable to stretch out because it hurts. When you're actually having a flare and it's affecting everything you do, you don't feel like going to work, you don't feel like being a mom, you don't feel like being a spouse. I had insomnia, mood swings where you're depressed and just all over the place emotionally. So for me, it's been a mental thing of just forcing myself to get through the day. You have to do it. You have to get up, you can't let yourself get so tired and depressed that you can't function. So even with family support, friends, if they don't have the disease and they still don't always get it. Support groups and stuff like that is the only outlet you have sometimes. When I get really stressed out, that will bring a flare on. So I have to find ways to reduce stress. So my favorite thing to do is read. I read anything from vampire novels to mysteries. And so I always take time, if only 30 minutes a day, to read something that relaxes me. So I think right now, I'd say I'm in a good place and hopefully it will get better.

In seventh grade, I remember after lunch, every day, I had English and I would just sit in my desk and hunch over because my stomach was in so much pain. It just was unbearable, and I had to try to be invested in class and just couldn't, because I was in so much pain. My mom and I were trying to figure it out and she said, "Okay, let's just take things out of your diet and just figure it out, because it just seems like you're sensitive to something. The first thing she suggested I take out was cheese and I love cheese, but after I cut out cheese from my diet for about a week, I did not have any more stomachaches. I felt so much better. My mom made an appointment with an allergist, and I went there to take a hydrogen breath test. I blew into a tube to check the hydrogen levels in my breath, because if you're lactose intolerant, you'll have more hydrogen in your breath. I think I had record levels. She'd never seen it that high. That was my official diagnosis with lactose intolerance. Since I turned out to be lactose intolerant, that means that my small intestine doesn't produce this enzyme called lactase which digests lactose. So since I don't have this enzyme, my body doesn't know what to do with this lactose and it just hurts; I get gas and I get bloated, and it's just super unpleasant. Since my body doesn't create this enzyme that digests dairy, they've created an enzyme in the form of a pill that I can just take with my meals. So that saves me a lot, but I am so sensitive that sometimes I just stay away from it. But if I really, really want to drink hot cocoa or have a tiny bite of cake, I know I can take a lactase pill and I will be fine. The problem with lactose is that it's hidden in a lot of processed foods, so it's in some deli meats, it's in a lot of medications, it's in some breads, some cereals, they just stick it in places as a filler. If you're lactose intolerant, it's best to just obsess about the ingredients list on whatever you're eating. At first it was really hard to just be that girl with the complications and to have to ask at restaurants if there's lactose in anything, or to make sure that I wasn't getting a ranch dressing with the salad. I had to be that girl at the party that couldn't eat the pizza. My advice would be to always be prepared with a lactase enzyme, because you can enjoy food with dairy in it if you eat one or two. I'd also advise people to make sure they know what they can handle and what they can't, because there's no reason to limit things that your body actually might be okay with. I wish someone had told me that there is no lactose in very aged cheddar cheeses, because cheddar cheese is my favorite food and I avoided it for the last 10 years because I thought I couldn't have it. I want people to know that lactose intolerance is just not a big deal. It hasn't really affected my life negatively because I control it.

5 Myths About Digestive Health Myth #1: Spicy foods and stress cause ulcers.Spicy foods and stress don’t cause ulcers, but they can worsen symptoms. Myth #2: Drinking milk cures ulcers.Drinking milk may temporarily relieve pain, but it can also increase stomach acid and make symptoms worse in the long run. Myth #3: Heartburn is nothing to worry about.Untreated, heartburn can cause serious complications over time, such as bleeding or ulcers in the esophagus. Myth #4: People with lactose intolerance can’t eat dairy.Most people with lactose intolerance can handle some amount of lactose. Over-the-counter lactase replacement products help many people enjoy dairy. Myth #5: More fiber is always better.Dietary fiber is healthy and can ease symptoms of digestive conditions like irritable bowel syndrome (IBS). But don’t bulk up your diet all at once; fiber can cause gas. Share this video to help educate others about digestive health!

Crohn's disease is a chronic disease of the intestines that causes inflammation in the digestive tract. For those with Crohn's, following a healthy diet is especially important, because symptoms can prevent you from getting vital nutrition. Plus, certain foods can make Crohn's worse or better, so paying attention to your diet is key to limiting the impact Crohn's can have on your good health. 1. Common symptoms of Crohn's disease, like poor vitamin and mineral absorption, decreased appetite, and bouts of diarrhea, prevent your body from getting the nutrients it needs. Figuring out which nutrient-rich foods keep your symptoms at bay can help you get the vitamins and minerals essential to healthy living. 2. Specific foods groups can wreak havoc on your digestive system, so it's important to avoid them, especially during a Crohn's flare-up. Bulky grains, high fiber foods, hot spices, fried or greasy foods, alcohol, and dairy products may increase stomach pain and diarrhea in someone with Crohn's disease. 3. You may not feel like you want to eat anything when your Crohn's flares up, but try foods that go easy on your tummy. Although everyone's body is different, low fiber foods like cooked vegetables, white breads, and lean meats can be easily digested and slow down bowel movements. And protein-rich foods like fish and eggs, plus fermented items like kimchi, pickled cabbage, are generally easy to digest and high in nutrition. 4. It's important to have the best health care team for you and your Crohn's disease. By using Healthgrades' Guided Physician Search, it's easy to find a doctor who's the right fit. 5. Instead of eating the usual three means, try eating five small dishes a day to help your body digest better. Eating small meals every three to four hours can prevent abdominal cramping and discomfort. Everyone with Crohn's is different, so your diet should be tailored just for you. Talk to your doctor about how to find the best eating strategy for you and your condition. You can find the right doctor to treat your Crohn's disease at Healthgrades.