Medications That May Trigger Ulcerative Colitis Flare-Ups: What to Know

Ulcerative colitis (UC) is a chronic inflammatory condition of the colon that can flare unexpectedly—often due to environmental triggers, stress, or certain medications. While the condition is primarily autoimmune, some drugs have been linked to triggering or worsening symptoms.

If you or someone you love has UC, it’s important to know which common medications may cause trouble—and what treatment options exist if symptoms return.

5 Medications That May Worsen or Trigger Ulcerative Colitis

1. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) – Medications like ibuprofen (Advil) or naproxen (Aleve) can irritate the gut lining and increase inflammation, making UC symptoms worse.
2. Antibiotics – Some antibiotics may alter the gut microbiome, potentially triggering flares by disrupting the balance of beneficial bacteria in the colon.
3. Oral Contraceptives – While not a trigger for everyone, some research suggests that hormonal birth control pills may increase the risk of developing or exacerbating inflammatory bowel conditions.
4. Isotretinoin (Accutane) – This acne medication has been controversially linked to gastrointestinal inflammation, including cases of UC onset in certain individuals.
5. Chemotherapy Drugs – Some cancer treatments can inflame the digestive tract or suppress immune function, which may either trigger a flare or complicate treatment of existing colitis.

If you're taking any of these medications and notice gastrointestinal issues like abdominal pain, bloody stool, or urgency, speak with your healthcare provider immediately.

Treatment Options for Ulcerative Colitis Flares

Managing ulcerative colitis involves a combination of long-term control medications and flare-up treatments. Common therapies include anti-inflammatory drugs such as mesalamine, corticosteroids for short-term relief, immunosuppressants, and biologic therapies that target immune system pathways. In more severe cases, surgical options may be considered, such as colectomy.

Lifestyle changes—including stress management, dietary adjustments, and avoiding trigger medications—can also make a meaningful difference. Some patients benefit from probiotics, guided nutrition plans, or complementary therapies like acupuncture.

If your UC is worsening despite treatment, a specialist such as a gastroenterologist can evaluate new biologic options or review whether any current prescriptions may be playing a role.

Conclusion

While medications are meant to help, some can unintentionally trigger or aggravate ulcerative colitis. Knowing which drugs to be cautious with—and staying proactive with treatment—can help you manage symptoms and prevent long-term complications. Always talk to your doctor before stopping or switching any medications. Early awareness and careful coordination with your healthcare team can lead to better outcomes and fewer flares.

Sources

Crohn’s & Colitis Foundation – https://www.crohnscolitisfoundation.org

National Institute of Diabetes and Digestive and Kidney Diseases – https://www.niddk.nih.gov

Mayo Clinic – https://www.mayoclinic.org

American Gastroenterological Association – https://www.gastro.org

Cleveland Clinic – https://my.clevelandclinic.org