I used to think that the fall flare ups of my ulcerative colitis were mainly caused by stress. In my teens and early twenties, starting a new school year brought new routines, people, classes, teachers, roommates, and sometimes even a new place to live. Twice I was hospitalized for these relentless flares, and I came to dread the autumn season, even though I love the weather and the colors at this time of year. Curiously, after I was finished with college and in the work force, the trend still persisted. Only a few years ago I discovered that I was not alone in my seasonal downturn in health - there were many others with Inflammatory Bowel Disease (IBD) experiencing the same problems during both the fall and the spring. So what's going on?
Seasonal flare ups in people with IBD have been noticed by the medical community. Some people experience problems only in the spring or autumn seasons. One theory is that this is a IgE-mediated allergic response.
IgE is a type of immunoglobulin isotype, which is a special protein that helps inactivate organisms that may cause disease. The function of IgE is to bind itself to an antigen (a substance that activate the production of antibodies). By doing so, IgE will cause the inactivation or removal of the offending toxin, microbe, or foreign substance. However, IgE tends to attach itself to receptors on mast cells (cells that triggers allergy symptoms such as a runny nose). If an antigen binds itself to one of these IgE cells, the mast cells are activated, and release histamine, heparin, cytokines, leukotrines, and other chemicals.
The presense of leukotrines attracts a new type of cell called an eosinophil. These cells fight off the allergic response, but the chemicals that they use to do so are toxic to the body as well as to the invading infection.
Eosinophils have a connection to IBD. Three of the four toxic compounds that are released by eosinophil cells are found in greater amounts in the stool of people with active IBD than in controls.
It follows, then, that this series of events leading to the increased eosinophils in the stool of IBD patients is triggered by allergens in the environment. And as anyone with hay fever knows, the worst time for allergies is in the fall and the spring.
Unfortunately, attempts to prove this sort of direct relationship have been fruitless. It’s too bad that our guts don’t understand that this is only a theory.
Tips to prevent a flare-up- Avoid NSAIDs
- See your doctor regularly
- Stop smoking if you have Crohn's Disease
- Take your medication as prescribed
