The sunshine is well and truly here. While for the first day or two, we happily embraced beer gardens and flip flops, it’s becoming more and more annoying. In fact, it’s more than being a bit hot and sweaty- it’s actually making us feel terrible. But why? Is there anything tangible that proves that hot weather makes IBD worse? Can soaring temperatures really make our Crohn’s and Ulcerative colitis flare up? And what on earth should we do about it? Let’s find out.
Why is my IBD worse in the hot weather?
First of all, hot weather can put a strain on our bodies in a number of ways. We sweat more which means we lose more fluids and are therefore more prone to dehydration. We might struggle with keeping hydrated, eating patterns and sleep- all of which can impact on our health. At this time of year, we might also drink and eat differently- with cider in the beer garden, BBQs, and salads. All of this, can alter our gut bacteria and put us at risk of a flare (it’s thought hot weather can actually change our gut bacteria too!) Changes in gut bacteria can cause a change in bowel habits and is also linked to Inflammatory Bowel Disease (more and more research is considering this relationship). However, we should remember ‘summer diarrhea’ is also more prevalent in the general population because of all these things. So if you’re reading this and you have IBS- this may well explain your flare ups.But is IBD any different? well, yes…
Can the heat actually cause IBD to flare up?
Surprisingly, the answer to this is an overwhelming yes! This study found that IBD flare up risks increase by 4.6% for each day of a heatwave. The team behind the study stated: “We found a substantial increase in hospital admissions because of flares of IBD”. They noted that flare-ups of gastroenteritis also occurred. but while “the effect on gastroenteritis is strongest with a delay of 7 days, the effect on IBD flares is immediate, suggesting different mechanisms.” In other words, more of the general population might get food poisoning or diarrhea at this time of the year, but with those of us with Inflammatory Bowel Disease, the heat seems to impact us in a different way AND much more quickly. Another study in Switzerland found that IBD admissions were much more common during long stretches of hot days. They again found a similar percentage to the first study: 5%
Some doctors are still skeptical of this and claim that as IBD is such a complex disease, it seems unlikely those in remission could suddenly find themselves in a flare-up a day or two after reaching for the sun cream. However, you might recall when I wrote my blog post: Does your period make IBD worse? while I struggled to find lots of substantial evidence, what I did find was tons of personal experience. Today, I have seen these kinds of discussions all over Facebook, which back up the studies I’ve mentioned.
If you seem to be on the opposite end of the spectrum, perhaps vitamin D plays a role in your disease activity. More on vitamin D+IBD activity here.
How Can I Deal with my IBD in the hot weather?
1.Keep hydrated. Now obviously the key here is to prevent dehydration by drinking water. However, in times of extreme heat, our sodium/potassium pump can be disrupted and we lose these in great quantities too; along with other electrolytes. So, therefore, those who are struggling to stay hydrated or particularly those who have had an ileostomy may lose large quantities of these electrolytes and water will continue to flood them out (as those with an ileostomy have a greater risk of an electrolyte imbalance)
2.So how can we keep this electrolyte balance? Well, that’s what things like dioralyte sachets (which can be purchased in most supermarkets) offer. However, you can also make your own and St Mark’s Hospital has a simple recipe here. The key is to add a balance of salt and sugar to the water.
Coconut water can help with hydration as it provides potassium to replace that which has been lost. However, if you are already dehydrated, it is not able to help as it doesn’t contain enough sodium. You could try to combat this by adding salt to the coconut water- I’ve seen lots of ‘healthier’ versions of electrolyte balance drinks online which combine coconut water, salt and sugar. However, in times of severe dehydration, I would always advise sticking to medical advice and proven rehydration solutions.
3. Drink slowly to avoid a sudden rush of electrolyte loss.
4. Avoid other diuretics. Tea, coffee and alcohol are all diuretics. This means they increase water loss and you’ll need to increase the amount of fluids you drink to compensate for them.
5. Be mindful of air con- it actually increases dehydration risk as it lowers the water content in the air.
6. Add a Magnesium spray. I mentioned in my best supplements for IBD blog post that Magnesium is often beneficial for IBD. It too is an electrolyte that can be lost in Dehydration so if you suspect that is an issue, I always recommend a Magnesium spray rather than supplement. Better You do a range of Magnesium sprays and lotions.
7. Rest the gut if needed. If heat is making your IBD worse, then the first thing to do is obviously talk to your medical team. However, if you are just looking for ways to prevent this from happening then simple recipes and nutrient dense drinks may help. Take a look at my latest easy digest recipes here. Things like bone broth and juicing may provide a temporary rest and relief. However, the key is not to change your diet dramatically but instead rely on simple, easy to digest foods.
8. SUNCREAM! Remember many medications both increase the risk of skin cancer and the rate at which we burn. Be cautious!
9. Probiotics may help somewhat in the short-term. Especially if you’ve travelled abroad or changed your diet dramatic. I’d focus on naturally probiotic rich foods. More on these here.
10.Finally, Stoma in A Teacup has a fantastic Facebook post for Ostomates looking for specific advice.