7 Tips for Managing a Crohn's Disease Flare-Up
A flare-up of Crohn’s disease can be a real letdown, especially after you’ve been symptom-free for a while. But rest assured there are many steps you can take to ease distress and speed up healing.
1. Check In With Your Doctor
Taking medications as prescribed is the number one way you can manage your Crohn’s disease. Recurrence can be a sign that your medications need an adjustment, so make an appointment with your primary care doctor or gastroenterologist as soon as possible. Some people need to take more or different medications (for example, corticosteroids) during flare-ups to heal the body and relieve symptoms.
2. Find Relief
Unfortunately, many Crohn’s disease medications take time to work, so you may still experience diarrhea, cramping, nausea and fever for a while. For relief of mild to moderate symptoms, ask your doctor about:
Acetaminophen (Tylenol ) for pain and fever
Balneol, Desitin, and vitamin A & D ointment for anal soreness and rawness
Loperamide (Imodium) for diarrhea
Always double-check with your doctor before buying anything from the pharmacy aisle. Some over-the-counter medications—notably anti-inflammatory drugs such as ibuprofen (Advil), naproxen (Aleve), and aspirin—can aggravate your symptoms. Others can interact with your prescriptions.
3. Nourish Yourself
Having a chronic illness like Crohn’s disease means your body may actually need more calories to function. At the same time, symptoms such as decreased appetite and abdominal pain can make eating uncomfortable. Some types of Crohn’s disease also interfere with the absorption of protein, fat, carbs, vitamins and minerals from food.
For these reasons, good nutrition is important during a flare. Eating well helps you feel better and may prevent future complications such as osteoporosis. Also, many medications work best when you’re well nourished.
There’s no magic diet that works for everyone with Crohn’s disease, and your needs may change with time. Unless your doctor or dietitian recommends a specialized diet, try to keep things balanced and varied. Include foods from each food group, and aim for a mix of carbohydrates, protein and fats.
4. Tame Food Triggers
While there’s no evidence that food causes or worsens inflammation in your digestive tract, some foods can aggravate symptoms such as cramping and diarrhea. Food intolerances in Crohn’s disease are highly individual: What upsets one person’s system may be fine for another.
Common food triggers include:
Dairy (if you’re lactose intolerant)
Fried or greasy foods
Nuts and seeds
Bear in mind that eating too restrictively during a flare can lead to poor nutrition. It’s important to eliminate only foods that consistently cause discomfort. Keeping a food diary can help you make connections between your food intake and your symptoms.
Eating large meals can also trigger Crohn’s disease symptoms. If this is a problem for you, try eating fist-sized portions every three to four hours for a total of five meals per day.
5. Supplement Yourself
People with Crohn’s disease have an increased risk for vitamin and mineral deficiencies, so consider taking a daily multivitamin. Your doctor or dietitian may also recommend supplements for:
People with Crohn’s disease are more likely to have low bone density, so do your best to include some calcium in your diet. If dairy is a trigger for you, try yogurt, which contains less lactose than other milk products.
6. Drink Up
Diarrhea and rectal bleeding during a flare can speed up water loss from your body. The resulting dehydration may cause feelings of weakness and increases your risk for kidney stones.
To ensure you’re getting enough fluids, aim to drink one-half ounce of clear liquid per pound of body weight each day. Add a little extra after sweating due to exercise or hot weather.
7. Adapt and Adjust
Having a chronic illness like Crohn’s disease means making adjustments now and then. However, getting out, seeing friends, and keeping life as normal as possible can be a great psychological boost.
Before heading out, pack extra underwear and clothing and your favorite moist towelettes. When possible, call ahead or use a mobile app to locate toilet options at your destination.
A flare-up can mean that your medications need adjustment, so see your doctor as soon as possible.
For relief of mild to moderate symptoms, ask your doctor about using acetaminophen for pain, ointment for anal soreness, or loperamide for diarrhea.
Eating too restrictively during a flare can lead to poor nutrition. Eliminate only foods that consistently cause discomfort.
- Diarrhea and rectal bleeding during a flare can speed up water loss from your body. Aim to drink one-half ounce of clear liquid per pound of body weight each day.
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- Bone Loss in IBD, Crohn's & Colitis Foundation of America, 2012 (http://www.ccfa.org/assets/pdfs/boneloss.pdf);
- Diet, Nutrition and IBD, Crohn's & Colitis Foundation of America, 2013 (http://www.ccfa.org/assets/pdfs/diet-nutrition-2013.pdf);
- Managing Flares, Crohn's & Colitis Foundation of America, 2009 (http://www.ccfa.org/assets/pdfs/flares_brochure_final.pdf);
- Living with Crohn's Disease, Crohn's & Colitis Foundation of America, 2010 (http://www.ccfa.org/assets/pdfs/living_w-crohns_final.pdf);
- An Update of the Role of Nutritional Therapy in the Management of Crohn's Disease. M. Alhagamhmad et al. Journal of Gastroenterology. 2012, no. 47, pp. 872-82.;
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