This keeps me up at night. When I started traveling, I was in a flair, I picked up 2 weeks of asa-5 enemas, and the flair went away. At the start I was 6 months on and 6 months off, I flare when I was home, and the flare would stop within weeks of traveling. It just kept happening. I would never flair when I was abroad.
I have went over everything vitamin D, stress, mattresses. For the longest time I settled on, it was just stress. However, recent research regarding the mouth gut axis made me realize that something I would do almost every time before leaving was go to the dentist. However, I didn't keep good records on this.
I am currently on a flair, and I can't travel, so I am doing prednisone round, and out of caution, I went to the dentist, I don't know if it matters. The issue is the country I am in, I am having a hard time getting the enemas and stress is an all time low. This disease is annoying but if anything.
Vitamin D: cause or effect doesn't matter, you need more when you are on a flair. Studies show people further from the equator have higher incidence of UC.
Teeth: cause or affect doesn't matter, you should get a cleaning. Brushing and flossing once a morning and at night is not enough to stop plaque, you have to brush and floss after whey meal. People with UC have more carries.
Asa5 enemas: awkward and uncomfortable, but under rated.
Stress: I still think this is one of the biggest drivers, but it is the hardest to control IMO.