“People who’ve lived with Crohn’s all their lives get to know their symptoms and flares very well, but even the most experienced can get confused," says Cyrus Tamboli, MD, a gastroenterologist and director of the inflammatory bowel diseases service at the University of Arkansas for Medical Sciences in Little Rock. A Crohn’s disease flare implies a worsening of the inflammation, but symptoms can occur for other reasons, namely complications of the disease. “This can include an infection, an abscess, or rarely, a tumor in the colon,” Dr. Tamboli says. If inflammation is causing your symptoms, your doctor might need to adjust the dosage of your medications. A short-term adjustment, or dose tailoring, may be enough to get symptoms back under control, according to a study published in February 2015 in the Internal Medicine Journal. However, Tamboli says your doctor might also order tests to find out whether you’re experiencing complications that would benefit from other treatment. Dehydration Start by making sure you’re getting enough fluids. “The best thing people with Crohn’s disease can do is to be able to make lots of clear urine by drinking plenty of fluids,” says Peter Higgins, MD, PhD, director of the inflammatory bowel disease research program at the University of Michigan Medical School in Ann Arbor. The Crohn’s and Colitis Foundation (CCF) suggests drinking at least 8 ounces of water a day, or enough so that your urine is clear. Ask your doctor if you can stay hydrated well enough on your own or if you need to be rehydrated intravenously at your local clinic. Discomfort from diarrhea Frequent bowel movements can create irritation. For relief, the CCF suggests to:
Soak in a warm bath and gently pat peri-anal skin dry.Apply an emollient to protect delicate peri-anal skin.Avoid foods or beverages that might worsen diarrhea.
Abdominal pain Cramping, bloating, and gas can be painful. Try these steps to reduce discomfort:
Eat smaller meals, but eat them more often to get enough calories.Avoid foods that might worsen cramping, such as dairy products and fatty foods.Limit high-fiber foods.
Nausea Talk with your doctor if nausea is keeping you from eating, drinking, or taking medications. Dr. Higgins says that some people might need anti-nausea medications that either dissolve slowly in the mouth or are available as suppositories. You can also try to relieve nausea naturally with options such as ginger or aromatherapy. Weight loss If a Crohn’s disease flare keeps you from eating, drinking, or absorbing nutrients, weight loss can be a serious concern. The CCF recommends these steps to maintain a healthy weight:
Work with a dietitian to create a plan for eating well despite your symptoms.Look for high-calorie, nutrient-dense foods you can tolerate. Consider peanut butter, bananas, cooked white rice, canned fruits, and cooked fish.Keep a food diary to keep track of the calories you take in.Rapid weight loss may require medical attention, so keep your doctor informed.
Fever Fever is triggered by inflammation and will likely decrease as your treatment starts to work. Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs) without your doctor’s approval because they can aggravate the digestive system, Tamboli says. Acetaminophen is usually safe as long as you don’t exceed the recommended dosage. Fatigue Higgins says fatigue should improve if you stay hydrated, manage your diet, and stick to your treatment plan. To avoid worsening fatigue, get enough sleep and pace yourself throughout the day. Mouth sores If mouth sores are part of a Crohn’s disease flare, ask your doctor about using lidocaine jelly to manage discomfort, Higgins says. The CCF recommends using medicinal mouthwashes as an option for some mouth sores. Vision trouble About 10 percent of people with Crohn’s disease experience symptoms such as blurring vision, eye pain, dry eye, and sensitivity to light, according to the CCF. Make sure your eye doctor knows you have Crohn’s, and ask whether there are any eye drops that can help you manage your symptoms and protect your eyes from inflammation. Skin problems Symptoms of a Crohn’s disease flare can include tender red bumps, skin tags, and mouth sores, as well as damage to the sensitive skin around the anus. Try these skin care tips:
Keep peri-anal skin clean and dry.Use moisturizers.Avoid tight clothing that might irritate peri-anal skin.
Taking these self-care steps should help you to feel more comfortable during a flare of Crohn’s disease symptoms.
