Abdominal pain or crampsBloatingLack of appetiteFatigue
Your specific Crohn’s flare symptoms depend on the section of your gastrointestinal tract affected, says Richard P. Rood, MD, a professor of medicine at Washington University School of Medicine in St. Louis. Symptoms also vary depending on how much inflammation is present in the body. “For example, if the colon is involved, there is an influx of inflammatory cells that release chemicals that destroy the colon’s lining, which leads to diarrhea,” Dr. Rood says. For this reason, it’s important to work with your doctor on the best treatment option and follow the treatment schedule. “Sometimes patients get better and then they think they’re cured and they stop the treatment without communicating with their doctor,” says Madalina Butnariu, MD, a gastroenterologist at the Ohio State University Wexner Medical Center in Columbus. Stopping treatment on your own can lead to another flare up or may interfere with the efficacy of a medication.
How to Keep Your Disease in Remission
You can’t completely prevent disease flare-ups from happening. But there are things you can do to manage your disease. Effective medication helps with the management of Crohn’s disease. “These medications treat inflammation and prevent complications,” Dr. Lee says. Other steps to managing your disease include:
Preventing and Reducing Stress During times of emotional stress, people tend to report more flare-ups. According to a study published in May 2020 in PLOS ONE, roughly 75 percent of people with IBD believed that stress and other mental health conditions could trigger flare-ups. And the more people worried about a flare-up, the worse it got: Feeling stressed about IBD was associated with more active disease. According to the Crohn’s & Colitis Foundation, changes in the GI tract and decreased resistance to inflammation may be felt after a stressful event. Taking care of your mental health improves your quality of life and also helps to manage Crohn’s disease symptoms. Some small studies have shown that relaxation exercises and rest can sometimes help alleviate Crohn’s symptoms, Lee says. A review published in 2019 in Frontiers in Pediatrics reported stress to be a major trigger for flare-ups in both adolescents and adults with IBD. But stress reduction techniques such as mindfulness, cognitive behavioral therapy, and yoga were effective in alleviating gastrointestinal pain. For people with Crohn’s who have anxiety and depression, relaxation techniques might also work, in addition to antidepressant medication if your doctor deems it necessary. A study published in 2018 in the Journal of Psychosomatic Research found meditation beneficial in reducing depression and anxiety in people with Crohn’s disease. This also improved their overall quality of life.Exercising Exercising benefits everyone — and people with Crohn’s disease are no exception. According to the Crohn’s & Colitis Foundation, exercise helps to manage anxiety and depressive symptoms that can emerge after a diagnosis. Walking for as little as 10 to 20 minutes per day can make a huge difference in lowering stress levels and reducing Crohn’s disease symptoms. For people in remission, a 2020 review published in Intestinal Research reported on the benefits of resistance training, including increased muscle strength and improvements in their quality of life. Make sure to let your body rest when it’s too tired to work out or during a flare-up. Consider speaking with a doctor about what exercise works best for you during remission and in times of a flare-up.Eating Healthy You are what you eat. Your diet can help manage Crohn’s disease symptoms and keep you healthy overall. On the other hand, there are some foods you may want to skip to avoid complications such as weight loss and malnutrition. The American College of Gastroenterology recommends a nutrition plan that avoids high-fiber foods such as vegetable skin and fried foods. It’s also important to stay hydrated with beverages including water, broth, or tomato juice. If you’re excluding foods, there might be a risk of vitamin deficiency. Talk to your doctor about taking vitamin D or B12 as needed.Monitoring Your Symptoms Keeping a close eye on your everyday symptoms will make it easier to predict when a flare-up is about to happen. Mobile apps such as GI Monitor and myIBD easily track your symptoms and gives you a snapshot of how you’re doing.Being Prepared Although flares tend to come on gradually, there is a chance that you will develop a flare quickly. And since you don’t know when the urge to go or abdominal pain will strike — at home, in the car, at the office — you should always make sure that you are ready to act. “If you have Crohn’s disease, you should be prepared at all times by noting where the restrooms are and keeping a spare set of clothes in the car or nearby, just in case,” Rood says.
Tips for Managing Discomfort During a Flare
Reach for an OTC. Over-the-counter medication is also a good option to relieve pain associated with a Crohn’s flare. “If you have pain related to Crohn’s disease, take Tylenol only,” Lee says, “since ibuprofen and NSAIDs (nonsteroidal anti-inflammatory drugs) can worsen inflammation.”Use ointment. You might experience anal irritation during a flare-up. Instead of toilet paper, use a moist towelette or soft baby wipe. At night, consider applying an all-purpose skin protectant such as Desitin around the surrounding anus area.Maintain a healthy diet. Sticking to a nutritious IBD diet helps in alleviating flare-up symptoms. If you’re lacking in a specific nutrient, consider taking a multivitamin as a supplement.Switch to medicinal mouthwashes. Severe flare-ups occasionally create canker sores around the mouth. Canker sores tend to go away once the flare-up is under control, but medicinal mouthwashes can help in the meantime to alleviate discomfort.Take a bath. To relieve painful bowel movements, take care of your bottom by bathing in warm water.Stretch your joints. About one in three people with Crohn’s disease will experience painful and swollen joints, according to Crohn’s & Colitis UK. While flare-ups can bring back joint pain, it can be managed through a combination of medication, exercise, and physical therapy. Your doctor may recommend a physiotherapist or physical therapist to work on stretching to reduce stiffness. They might also recommend walking, swimming, or cycling to keep you moving your back and neck muscles. Pilates can also help with stretching and strengthening your posture.
The Bottom Line
The better you’re prepared for a flare and how it will affect your routine, the better you’ll be at dealing with it when it occurs. Above all, befriend your gastroenterologist. You should tell your doctor about any changes in your disease and stay on track with all medical appointments for tests and procedures. “Management of Crohn’s disease with medications and close follow-up with a gastroenterologist can help prevent Crohn’s flares in the first place,” Lee says. Additional reporting by Jocelyn Solis-Moreira.
