Comment by thrwwXZTYE | Hacker News Reader

Comment by thrwwXZTYE | Hacker News Reader

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It's pretty obvious to me that asthma and colitis ulcerosa are stress-related. I had asthma for as long as I remember. I'm allergic to pollen and dust, but one of the triggers is high stress situations as well.

I started having symptoms of colitis ulcerosa when I was 18 and had final high school exams. I was under tons of stress. I started to care much less about such things and had years-long remission. There were only 2 other flare-ups - when I was passing driving licence test, and when I had the first big series of exams at university.

Basically every time I drove myself very hard I had another episode. And it's not fun to suddenly shit yourself in public transport let me tell you :/

It's been over 20 years since last time I had colitis ulcerosa flare-up. But, in the meantime I was also diagnosed with autoimmune liver disease (PSC), and I'm not sure this one is stress-related. It seems to me it just ticks away at my liver and even very relaxed lifestyle doesn't help. I'm very hopeful about new drugs for this, as the only alternative seems to be to wait for inevitable liver transplant later in life.

As a counter-example (and not at all to doubt your story), I had my first (and worst) UC flare when I was literally the happiest and most content I've ever been in my life. I had my second, a few years later, when I was on a religious retreat, and under absolutely no stress whatsoever!

My UC is entirely diet related.

A doctor friend and I think we have - as amateurs, mind: his specialty is very far from GI, but he reads and shares with me every UC paper that's published; I have no medical training, but am a motivated auto-didact on this subject - identified three or maybe four etiologies which are lumped together as "UC". The best gastro doc I've seen kinda shrugged, and said (roughly) "probably so, but they all respond to the same drugs in the same ways, so there's not much motivation to draw distinctions".

I'm not quite sure what to think about that answer. I do think it's good for patients to identify their own triggers.

There's definitely a lot of autoimmune type diseases that have mental and/or physical components.

Your endocrine system, sympathetic nervous system and central nervous system are all wired up together so of course changes/disfunctions in one can cause symptoms in another.

And there's lots of pathogens that cause "flu-like" symptoms, so it makes sense there could be multiple things that cause "UC-like" symptoms.

As mentioned in another comment my step moms UC is likely stress related. My crohns doesnt seem to be; but sport helps me a ton. Something thats interesting is that even with MC and also PSC there are multiple "forms" of it.

My doc says my crohns is inflaming the whole end part of my colon somewhat consistently; my small intestines are fine. Many other patients of hers have inflammations at specific parts that are more severe, and also sometiumes the small intestines are affected.

And then my PSC seems to (so far) only affect my small ducts; which doesnt mean it cant get more severe but so far is "less damaging" then "normal" PSC. No one seems to really know if these are the same disease, related or entirely different. Its kinda crazy tbh

Practicing yoga seems to help my UC. Aerobic exercise and weight training don't (although are obviously good in and of themselves). You can call it "woo", if you like, but I believe there's something to integrative practice that aligns the endocrine and sympathetic / para-sympathetic nervous systems. It at least seems to damp down my particular inflammation reactions in ways that other kinds of exercise do not.

Oh, also nicotine. I don't like being addicted to my vape pen, but a steady dose of nicotine gives me a much wider margin for error with my diet. Curiously, this connection was pointed out by my first, and best, gastro doctor: the two groups who present UC much less frequently than others are smokers and Ashkenazi jews. He told me that (prefaced by "I'm a doctor, so I can't really recommend this, but...) some of his patients found cigars helpful, and are fairly low-risk, as smoking goes. I used cigars for years to kill sub-clinical flares, before getting tired of the smell, and the time-commitment and hassle, and worried about the blood-pressure spikes they induce. Vaping is superior in every way, and I have made the cost-benefit wager that whatever (fairly low, so far as we can tell) health risk that comes with vaping is less than the risk and consequence of colon cancer from less-controlled UC.

That is, by the way, one of the big clues to varying etiologies: some people's UC is exacerbated, not helped, by nicotine. (My understanding is that Crohn's is always exacerbated.) My doctor friend and I believe we understand the mechanism behind why it works for my particular case.

I'm very sceptical of "stress related" explanations. They're convenient in the sense they explain nothing.

Stomach ulcers were "stress related" until whoops: turns out it's H. Pylori infections, and can be cured easily with antibiotics.

I appreciate what you’re saying, but when the time-linear correlation between a stress event and a GI reaction is very direct and reliable (and often bidirectional) it’s hard not to recognize a connection.

My (non-bio) mom has UC and her one big flare up in life was high school exam time she said (she still has nightmares about that time). Since then only small episodes easily treated with prednisolone, but often easily attributed to stress as well. Like days before an important work event: problems. Team members being ill and she has to cover: problems.

I personally have Crohns and PSC as well, and I think less stress helped; but I am on Rinvoq (INN-Upadacitinib) and eat psyllium husks and still have occasional diarrhea, what helps A TON however is sport. I skateboard (and whenever I find the time I go HARD), and 1-2 days after I am always good, colon wise. When I dont skate for a week and eat slightly fatty i have problems, but when skate on a friday and then order opne of those disguting cheap pizzas from that greek place i am still good (i dont do this often but it happens).

Why I have these autoimmun diseases is also an interesting question. My biological parents are both good in that regard, so is my extended family. However I do know my bio-mom smoked while pregnant, and i passively smoked in the household up until I was 12 (and then started smoking at 14, quit with 18)

So maybe thats part of it too

Its very interetsing all that, also scary

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