When you’re experiencing a Crohn’s flare-upThe sudden intensification of disease symptoms or the return of symptoms suddenly., your gastrointestinal (GI) tract may be inflamed, and that may cause you to have frequent or urgent bowel movements, diarrhea, bloody stool, and/or abdominal pain. Other symptoms may include fatigue, lack of appetite, and weight loss. Crohn’s can be progressive, so over time, your symptoms could get worse. You should tell your doctor any time you are experiencing symptoms or worsening of symptoms, and because Crohn’s can affect the entire GI tract — from the mouth to the anus — you should bring up symptoms even if you don't think they are related to Crohn’s. Having a restroom request card on hand can be helpful when unexpected symptoms arise.
Crohn’s disease typically varies between periods when the disease is active, or flaring up, and when it is in remission (few or no symptoms). Crohn’s disease varies from person to person and may change over time.
What can affect Crohn’s disease flares?
There are several things that can affect Crohn’s disease symptoms, including:
Skipping doses or taking the wrong dose of your medication
If you experience flares and are taking your medications as prescribed, talk to your doctor about changing your dose, frequency, or type of medication.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs such as aspirin, naproxen, and ibuprofen may irritate the bowel, which can cause symptoms to flare up. Ask your doctor if you are able to take acetaminophen instead for fever or mild pain.
Antibiotics treat bacterial infections, but can also change the balance of bacteria that live in the intestines, which can cause diarrhea. Tell your gastroenterologist if you experience a flare while taking antibiotics.
Because stress can affect Crohn’s symptoms, it might be helpful to learn and incorporate stress-management techniques into your routine, such as yoga or meditation.
Foods that irritate your gastrointestinal (GI) tract
Even though there is no evidence that food causes Crohn's disease, certain foods can impact your symptoms. Keeping a food diary can help you determine which foods to avoid based on your experience—and consulting with your doctor and/or a dietitian can help you plan a diet that works for you.
Managing Crohn’s flares
Here are some ways you can help minimize flare-ups and maximize your health:
Take your treatment as prescribed
As your doctor has probably told you, it's very important to take your current treatment as prescribed even if you are feeling better. Although managing Crohn’s disease is more than just taking medicine, the best way to deal with Crohn’s disease symptoms and flare-ups is to find an effective treatment plan. Many people can keep Crohn’s in remission (few or no symptoms) with the medications that are right for them.
Corticosteroids (Steroids)Given orally, as an injection, rectally, or intravenously, these medications help reduce inflammation by suppressing the immune system and are usually given to help with moderate to severe Crohn’s and ulcerative colitis symptoms. Steroids are not intended for long-term use. are often prescribed to treat flare-ups. However, they are best suited for short-term control of symptoms, and should not be used for long periods of time. If not used appropriately, patients can become steroid dependent or resistant.
See your doctor on a regular basis
Your doctor will likely ask that you come in for check-ups on a regular basis, and you should also be able to contact your doctor when you have a question or to help you manage a Crohn’s flare. Establishing a good relationship with your doctor can help you be honest about your symptoms and how they affect you so that your gastroenterologist can determine which treatment is best for you.
Having a healthcare team (nurses, a nutritionist, a social worker or psychologist) that you can turn to for guidance can also help you manage Crohn’s flare-ups. Remember, your healthcare team is there to work with you on your overall well-being, not just your treatment.
Set up a support system
In addition to your healthcare team, educating your family and close friends about Crohn’s disease will help them understand what you may be going through. Don’t be afraid to ask for support when you need it.
Stay on track with your tests
Ask your doctor how often you should get diagnostic tests and/or procedures, which can help you identify many treatment side effects or signs of Crohn’s disease progression.
Maintain a healthy diet
There is no particular diet that is appropriate for all people with Crohn’s disease. However, getting proper nutrition is essential to help minimize the effects of Crohn’s. Ask your doctor or consult with a dietitian or nutritionist to help you figure out your own diet plan and whether you may need to take vitamin and/or mineral supplements.
Refocusing the mind
Brandi Chastain, world-renowned soccer player and IBD caregiver, talks to IBD psychiatrist Dr. Eva Szigethy about ways to enhance emotional wellness and the importance of having social support.
Eva Szigethy, Ph.D., M.D., M.S., is a Professor of Psychiatry, Medicine and Pediatrics at the University of Pittsburgh School of Medicine. She specializes in the psychological impact of chronic digestive diseases.
Here are a few other ways you can help minimize Crohn’s flares:
Get regular exercise:
Talk to your doctor about setting up an appropriate exercise plan.
Smoking can make symptoms worse and make Crohn’s disease more difficult to treat.
Manage your stress levels
Stress-management techniques can help you stay calm.