If you live with Crohn’s disease or ulcerative colitis, the holidays bring travel, rich food, late nights and family obligations all at once. A 2025 review of 58 studies found that psychological stress, poor sleep, smoking and diet were among the modifiable factors linked to inflammatory bowel disease (IBD) flares.[1] You cannot control the calendar, but you can build a plan before it starts.
What the research says about stress and flares
The 2025 review in the Journal of Clinical Medicine pulled together studies on what predicts IBD relapse. Poor sleep quality and poor mental health were linked to higher flare risk, and stress and nutrition showed up as key predictors.[1] An earlier review in The American Journal of Gastroenterology adds a useful detail: perceived stress, meaning how stressed you feel, appears to matter more than major life events. It also notes that stress’s effect on inflammation itself is still unclear.[2]
Those are associations, not proof that a busy December causes a flare. The second review also points out that few interventional trials exist. Trials of structured exercise and psychological therapies have not consistently improved measured disease activity, although they may improve quality of life.[2] That is a reason to treat these steps as support for your treatment plan, not a replacement for it.
Six steps to protect your routine
- Protect your sleep first. Poor sleep is one of the better-supported flare links.[1] Set a fixed wind-down time and swap late-night scrolling for a paper book, a warm bath or light stretching.
- Keep meals on schedule. Skipped meals set up overeating at the party. Eat at regular intervals and build most meals around foods you already know you tolerate.
- Move gently every day. Recreational exercise is associated with lower flare risk and less fatigue in people with IBD.[2] A morning walk counts.
- Schedule mini-breaks. Practice slow belly breathing or a five-minute walk before a stressful moment, so the tool is familiar when you need it.
- Plan the food ahead of the event. Ask the host what is on the menu, bring a dish you can eat, or look up a restaurant menu in advance. Eating a snack beforehand removes the worry about not having enough.
- Have a plan B. Know where the nearest restroom is, carry your medications, pick one person you can quietly tell, and give yourself permission to leave early. A small kit with wipes, a change of clothes and resealable bags makes this easier.
These steps follow the practical tips in a recent Everyday Health guide to holiday stress and IBD, which quotes gastroenterologists and a GI psychologist.
Do not skip the conversation with your care team
If your symptoms are changing, or you are about to travel, talk to your gastroenterologist about a flare plan. Do not start, stop or change a medication on your own.
References
[1] Koppelman LJM, Oyugi A, Maljaars PWJ, van der Meulen-de Jong AE. Modifiable factors influencing disease flares in inflammatory bowel disease: a literature overview of lifestyle, psychological, and environmental risk factors. Journal of Clinical Medicine, 2025;14(7):2296. Population: literature review of 58 articles (PubMed, 2012 to 2024). DOI: https://doi.org/10.3390/jcm14072296. Finding as used: psychological stress, sleep disturbances, smoking and nutrition were identified as modifiable factors influencing flares, and poor sleep quality and mental health were linked to increased flare risk. ↑︎
[2] Rozich JJ, Holmer A, Singh S. Effect of lifestyle factors on outcomes in patients with inflammatory bowel diseases. American Journal of Gastroenterology, 2020;115(6):832-840. Population: narrative review. DOI: https://doi.org/10.14309/ajg.0000000000000608. Finding as used: recreational exercise decreases the risk of flare and fatigue; perceived stress rather than major life events may trigger symptomatic flare, though its impact on inflammation is unclear; trials of structured exercise and psychological therapy have not consistently shown benefit in disease activity but may improve quality of life. ↑︎
Kurt Greiner
Kurt is a digital strategist and IT professional blending emerging technology with practical application to help businesses and individuals streamline their digital presence. His current work focuses on the intersection of intentional living and technological resilience, exploring how individuals can leverage modern tools to navigate the second half of life with purpose.
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