Other symptoms may include diarrhea, nausea, a loss of appetite, and fatigue, according to the Crohn’s and Colitis Foundation. These symptoms may come on suddenly or slowly, the Foundation says. You can have one or more of these symptoms early on or as your flare progresses. Other warning signs of a flare, like bloating, vomiting, rectal bleeding, or incontinence, are possible, but less common, says James F. Marion, MD, director of education and outreach at the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai Hospital in New York City.
Nonadherence: Not taking your medications as instructedMedications: Taking non-steroidal anti-inflammatory medicines (NSAIDs) such as aspirin, naproxen, or ibuprofenDiet: Eating too much of a food that the bowel can’t process or handle
Other possible causes of flares include:
SmokingAlcoholStressAntibiotics, which can alter the amount and type of bacteria that normally live in your gut, triggering diarrhea or inflammation, the Foundation says.
There are other possible causes of flares: disease complications like fissure, fistula, stricture, or abscess. Fissures are often the result of straining during bowel movements or passing hard stools, the Mayo Clinic says. Call your doctor if you notice drainage of mucus or stool from your anus or from an area near your anus (a sign of a fistula); nausea, vomiting, or constipation (possible signs of a stricture, or narrowing of a section of the intestine); or severe abdominal pain, painful bowel movements, discharge of pus, fever, or a lump at the edge of your rectum that’s swollen, red, or tender (signs of abscess). All of these complications may require immediate attention. A flare can last several days and go away on its own. Or you can have a flare that gets progressively worse and requires surgery, says Ashkan Farhadi, MD, a gastroenterologist and the director of the Digestive Disease Center at MemorialCare Medical Group in Fountain Valley, California. Preventing flares before they occur with an effective medical maintenance regimen can change the path of your Crohn’s disease, Marion says. “With intervention, we can prevent a severe flare and avoid having to admit you to the hospital or perform surgery,” Dr. Farhadi adds.
What to Do When You’re Experiencing a Flare
As soon as you suspect a flare is occurring, it’s important that you take steps to control it. That’s because each flare can produce an injury to the bowel, Marion says. Frequent Crohn’s flares can trigger complications like intestinal obstruction, or systemic problems like anemia, bone loss, or clotting issues), he says. Alan Segal, 69, who lives near Atlanta, has had Crohn’s disease for more than 40 years. “I’ve had it long enough that I can recognize when I’m having a routine flare-up or it’s something different,” he says. If it’s a flare, Segal explains, he is careful to avoid foods that he knows cause him trouble and to stay near bathrooms. He might take acetaminophen, if necessary, for the pain. No diet can prevent or reduce discomfort from flares, but there are a few general principles that may help. If your Crohn’s symptoms are mild, a bland diet — bananas, white bread, white rice, applesauce, smooth peanut butter, potatoes without skin, and steamed fish — will be easier on your digestive tract, according to the Foundation. Avoiding caffeine, fresh fruits, and uncooked vegetables also may help; greasy and fried foods can also trigger a flare in some people with Crohn’s. Reducing stress is another smart strategy, Farhadi says. Make sure you’re getting adequate sleep and doing calming activities like yoga, meditation, and mindfulness, he says. The Foundation says that light aerobic exercise, journaling, biofeedback, and therapy can also help people with inflammatory bowel diseases such as Crohn’s better manage some of their bowel symptoms. Over-the-counter medications may also help relieve some symptoms of flares. For example, anti-diarrheal medications can reduce the frequency of diarrhea episodes, while acetaminophen is generally a safe medication that can ease the pain. Just be sure to ask your doctor before taking these or other medications to ensure that they are safe for you. Finally, your doctor may need to adjust your medications during your flare, Farhadi says. That’s why when you have Crohn’s, it’s important to have good communication with your gastroenterologist. “Your doctor can help you navigate and recognize the relapsing and remitting symptoms of your disease,” Marion says. And always let your doctor know if you have a change in symptoms, he adds.
