Are certain habits or behaviors—like smoking or skipping doctor appointments—making your inflammatory bowel disease (IBD) worse? With IBD, missteps in your day-to-day routine can take a toll on how well you’re managing your condition. We asked three IBD experts which habits you should nix—and what to do instead.

1. Skipping Doctor Appointments

Managing IBD is an ongoing process that may require adjustments to your treatment plan along the way. Be sure to keep up with scheduled check-ups, even when you’re feeling well. “IBD will only stay under control as long as you are proactive about treatments and visits,” says Alan Moss, MD, associate professor of medicine at Harvard Medical School and gastroenterologist at Beth Israel Deaconness Medical Center in Boston, Massachusetts.

2. Keeping Your Doctor in the Dark

If you’re not feeling well, speak up. “I completely understand that no one wants to talk about their poop—or any other IBD symptoms,” says Tasneem Ahmed, DO, assistant professor in the department of internal medicine at UT Southwestern Medical Center in Dallas, Texas. That’s why important to find a doctor that you can establish a good relationship with and feel comfortable talking to about your symptoms. “Please don’t be shy—the sooner you open up about your symptoms, the sooner we can get you on the right treatment plan.”

It can help to prepare ahead of time and bring notes to your appointments so you don’t forget what you want to discuss. “Make a list of 2 to 3 things to discuss for each visit, and bring them up at the beginning of the consultation to ensure your doctor is aware of what is on your mind,” adds Dr. Moss.

3. Missing Out on Essential Nutrients

You likely already know how important it is to watch what you eat and drink to avoid your personal trigger foods, and that you need to alter your diet when you’re in a flare. But depending on which type of IBD you have, you may want to focus on adding specific nutrients to your diet.

“With ulcerative colitis, vitamin D deficiency, anemia, and iron deficiency can be common,” says Laura Manning, MPH, RD, CDN, clinical nutrition coordinator at the Susan and Leonard Feinstein IBD Clinical Center at Mount Sinai Medical Center in New York City. “For Crohn’s, deficiencies in b12, folate, zinc, iron and vitamin D are common.”

Ask your doctor if you would benefit from taking a multivitamin to help ensure you’re getting the nutrients you need. 

Barman making cocktail at the counter

4. Hitting Up Happy Hour Regularly

Talk to your doctor about whether or not you should avoid alcohol altogether, or if it’s OK to indulge in the occasional drink. For some people with IBD, drinking in moderation might be tolerable. But if you do indulge, stick to Dietary Guidelines for Americans’ recommendation—one drink a day for women, two for men. And remember that alcohol can be dehydrating, so have a glass of water, too.

5. Smoking Cigarettes

Smoking affects ulcerative colitis and Crohn’s differently, but generally speaking, smoking can trigger flare-ups and impact the effectiveness of your IBD medication. The good news: Quitting can help improve your digestive health and your overall health.

“Quitting helps minimize the overall risk of cancer and other health problems like heart disease,” says Dr. Ahmed. Ask your doctor about smoking cessation aids, like gums, lozenges and patches, that can help you quit.

6. Letting Stress Take Over

Living with a chronic condition like IBD can take a toll, both physically and mentally, leading to stress. What’s more, stress can actually worsen IBD symptoms. “If you’re stressed, you may be avoiding self-care,” says Manning, “and self-care is really important.” Try practicing stress relief techniques like deep breathing, meditation, journaling or massage.

7. Skipping Exercise

“Exercise is another self-care tool we can use to help alleviate stress and create a healthy well-being,” says Manning. Staying active is important for your physical health, too, as exercising regularly can help you better manage IBD and lower your risk of related health complications.

Aim for 150 minutes of moderate-intensity exercise each week, and try to incorporate a mix of cardio, strength training, stretching and balance exercises. Just remember to scale back during a flare and let your body rest and recover.

8. Not Factoring in Seasonal Plans

It’s important to take steps to manage your IBD no matter what’s on your calendar—from holiday parties to summer vacations. “At these times, people are eating different foods than they’re used to and drinking more alcohol, and it could cause GI issues,” says Manning.

Anxiety can also come into play around the holidays, specifically, which can also be an IBD trigger. “It’s important to know your intolerances and plan accordingly.”

9. Forgetting to Track How You’re Doing

Taking note of your triggers, symptoms, and how you’re feeling with an app like Oshi can help you and your doctor spot patterns in how your lifestyle is affecting your IBD and make any necessary adjustments.

“Tracking helps in terms of being proactive,” says Ahmed. “The sooner you catch the beginning of a flare, the easier it is to control that flare.”


Author Kerry Weiss is an experienced writer, editor and content strategist based in New York City. Specializing in health and wellness content, her work has appeared on sites like WebMD, Everyday Health, Sharecare and MedPage Today. She holds a BA in Communication and Rhetoric with a double Minor in English and Journalism from the University at Albany in Albany, NY, and an MS in Publishing from Pace University in New York City. She enjoys spending quality time with her family and friends, and traveling the world.

Oshi is a tracking tool and content resource. It does not render medical advice or services, and it is not intended to diagnose, treat, cure, or prevent any disease. You should always review this information with your healthcare professionals.