Crohn’s disease is a chronic inflammation of the gastrointestinal (GI) tract that currently affects as many as 780,000 Americans. It’s a type of inflammatory bowel disease (IBD), along with ulcerative colitis and microscopic colitis.

It’s hard for anyone who doesn’t have Crohn’s disease to understand what it’s like to experience a flare-up (when the symptoms suddenly intensify or return).

The symptoms of a Crohn’s disease flare-up can vary, depending on which portion of the GI tract is affected. Some common symptoms include:

  • diarrhea
  • fatigue
  • rectal bleeding
  • abdominal cramps
  • constipation
  • nausea
  • loss of appetite
  • feeling like your bowel movements are incomplete

Even though Crohn’s mostly affects the GI tract, it can sometimes cause inflammation in other places. For example, you may also experience:

  • joint pain
  • eye inflammation
  • skin inflammation
  • fatigue

If you have Crohn’s disease, these symptoms may make it hard for you to function comfortably in a work or social setting. In more severe cases, symptoms can make it difficult to keep a job or a long-term relationship.

People may experience different symptoms and different degrees of severity, but it’s common to find it difficult to cope with the challenges of this disease.

Crohn’s takes an emotional toll

If you have Crohn’s disease, you may experience feelings of guilt and sadness during a flare-up.

Due to the sensitive nature of Crohn’s symptoms, it can be hard to explain to friends and colleagues why you have to cancel plans or make an abrupt exit. At times, you may also feel like a burden to others, which could intensify feelings of guilt.

Symptoms, like bleeding and cramps, are frightening and may lead to increased levels of stress and anxiety. This, in turn, can contribute to flare-ups.

Other symptoms, like diarrhea and constipation, are often embarrassing to talk about and may make experiencing a flare-up a lonely and isolating experience.

Crohn’s can be unpredictable

For many people with Crohn’s disease, the unpredictable nature of flare-ups can also be extremely frustrating. There’s no way to know when one might happen, and the symptoms are often so bad that you’re forced to stop whatever you’re doing (no matter how important it is).

Whether you’re in the middle of a presentation at work or out celebrating a friend’s birthday, if you experience a flare-up, it immediately becomes your top priority. Since there’s currently no cure for Crohn’s, you might also feel helpless or hopeless.

The good news

Just because there’s no cure, it doesn’t mean there’s no hope.

Crohn’s research is always advancing, and researchers are developing more knowledge about how this disease develops in the body.

These days, there are a number of immune-suppressive therapies that may even lead to disease remission. It’s also now common knowledge that certain medications and lifestyle choices can help you to lessen the intensity of your flare-ups.

Before you look for the best strategies to manage your Crohn’s flare-ups, the first thing you may wish to do is to see your doctor.

Your doctor will be able to tell you how severe your symptoms are and where you need to manage them in a medical setting — or if you can do it at home.

To determine with certainty that you have Crohn’s disease, and to evaluate the severity of your symptoms, your doctor will do a physical exam and ask you questions. In addition, the doctor may:

  • run blood tests
  • refer you to an endoscopy or colonoscopy, and, in some cases, take a tissue sample (This is called a biopsy.)
  • run imaging tests, like an x-ray, CT, or MRI

Based on the results of these tests, your doctor may decide you need treatment that may consist of prescription medications.

There are different types of medications offered for various needs. In certain severe cases, you may need surgery.

Lifestyle changes

In other cases, you may be able to manage your symptoms naturally or by making lifestyle changes in combination with other therapies.

According to the Crohn’s and Colitis Foundation (CCF), there’s a number of things you can do to keep Crohn’s flare-ups at bay. These include both physical and lifestyle strategies.

Here are some physical lifestyle strategies:

  • Practice good anal hygiene. This includes showering with a hand shower, cleansing the anal area with wet wipes instead of toilet paper, applying appropriate skin protectants to the skin around the anus, and taking a bath in warm salt water to reduce soreness.
  • Take over-the-counter medications. This includes taking diarrhea medications, such as Imodium or Pepto-Bismol, medicinal mouth washers for canker sores, and analgesics for general symptoms of pain. Consult your doctor for the best options for you.
  • Reduce joint pain. This includes resting the affected joints, applying heat on the painful area, and doing physical therapy exercises.

Here are other lifestyle strategies:

  • Take multivitamins. Crohn’s disease may interfere with your body’s ability to absorb important nutrients. Consider asking your doctor to get a test for vitamin deficiencies and a recommendation for the right multivitamins for you.
  • Eat a healthy diet. Eating a balanced diet will also help your body get the nutrients it needs. It may also help reduce canker sores.
  • Have regular medical checkups. Making sure you see your doctor regularly, even when your symptoms are in remission, will help you avoid an unexpected return of symptoms that get out of control.
  • Track your symptoms. In between appointments, it’s helpful to record your symptoms so that your doctor can see how they’re progressing and how they’re impacting your life.
  • Exercise. Regular physical activity, even if it’s low intensity, may improve your health and boost your immune system. It can also improve bone strength and reduce stress.
  • Limit smoking. If you’re a smoker, quitting can be difficult. Finding support for the process is important, because smoking can make your symptoms worse. Resources for quitting are available at smokefree.gov.
  • Reduce stress. Stress may exacerbate symptoms. Ways that may help you reduce stress include meditation, yoga, cognitive behavioral therapy, hypnotherapy, biofeedback, and guided imagery.
  • Build a support system. Talking to someone you trust about your symptoms may help alleviate the sense of isolation that comes with a flare-up. Support groups and discussion forums are also available (both online and in person) if you’re looking for a community outside your immediate social circle. Try looking for the local chapter of CCF in your area, as well as local support groups in your area.

We asked people with Crohn’s disease to describe their Crohn’s flare-ups in three words. Here’s what they said:

“Diarrhea, nausea, pain” — @emilyt804

“Scary, isolating, tiring” — @paigejoanna

“Debilitating, unpredictable, frustrating” — @bakerstreetjedi

“Guilt, sadness, pain” — @adelaidejuliette

As you can see, living with Crohn’s disease can be challenging, frustrating, and stressful. If you’re one of the thousands of Americans with Crohn’s disease, know that you’re not alone — and you’ve got nothing to be embarrassed about.

Crohn’s disease isn’t the result of something you did wrong, nor is it something you should feel ashamed of or guilty about. Living with the condition requires a lot of strength, so don’t waste your energy on what others might think.

If you sense that someone is judging you for your Crohn’s disease, it’s likely that they’re either uneducated about the condition or compensating for their insecurities.

It may surprise you how understanding people are once they learn about what you’re going through. Don’t be afraid to open up to your support system, and don’t feel bad if your flare-ups require you to alter your schedule.

Remember: Crohn’s disease may delay you, but it does not define you. For more information about how to manage Crohn’s disease flare-ups, consult your doctor or healthcare professional.

JPeei Clinic