1. Don’t smoke. “Smoking makes Crohn’s disease much worse,” says Miguel Regueiro, MD, chair of the Digestive Disease & Surgery Institute at Cleveland Clinic in Ohio. “If you have Crohn’s disease and are a smoker, you must quit.” People who smoke have more Crohn’s disease flares and emergency surgeries — and are more likely to be diagnosed with Crohn’s in the first place.
  2. Drink in moderation. Alcohol can irritate the lining of your intestinal tract and make symptoms worse. It may also interfere with medications you’re taking. Even if you find that you can tolerate alcohol, it’s important to limit how much you drink.
  3. Exercise regularly. Both aerobic activity and resistance training can help manage Crohn’s disease. Exercise not only helps your digestive tract work more efficiently, Dr. Regueiro says, but can also help reduce stress due to the release of endorphins, or feel-good hormones, that come with getting your blood pumping. Weight-bearing exercise can also help prevent osteoporosis (a disease that weakens and thins the bones), a common complication of Crohn’s disease. To stay motivated, choose an exercise you enjoy. “I always feel better after I work out at the gym,” says John Nesco, 48, who was diagnosed at age 15 and was a volunteer group facilitator and member of the Connecticut board of the Crohn’s & Colitis Foundation.
  4. Get enough sleep. When you’re tired, you’re more likely to feel stressed, which can worsen your symptoms. You’ll sleep better at night if you stick to a routine, with a set time for getting up and going to bed on weekdays and also on weekends. Be sure to give yourself enough time to wind down before bed so you can focus on sleep and not other distractions. A study published in August 2020 in the journal Inflammatory Bowel Diseases showed that poor sleep is associated with higher disease activity and even hospitalization.
  5. Seek support. Find Crohn’s support groups that meet online or face-to-face near where you live or work. “People who join support groups tend to have the same reaction,” Nesco says. “They hadn’t met anyone else with the same disease and can’t believe how similar their experiences are. Having supportive friends and family is great, but their level of understanding only goes so far. … People who face the same challenges can share stories of best practices as well as triumphs. This can go a long way in terms of motivation and outlook.” Nesco had surgery for his Crohn’s disease at age 35. Facing surgery was scary, and he knew it would require a lot of recovery time. “Talking to someone who went through it gave me the confidence and security I needed to move forward,” he says. After being helped by others, Nesco vowed to give back. “After surgery, I wanted to do something positive to offset the negatives associated with this disease. So I contacted the Crohn’s & Colitis Foundation and told them I wanted to make a difference,” he says. Volunteering his time to help others also helped him.
  6. Communicate what you feel is appropriate. Are you stressed out from hiding your condition from coworkers or because you don’t know what to tell friends and family? Everyone handles Crohn’s disease differently, and you should decide for yourself whom to tell and when, Nesco says. Keep it simple with something like, “I just want you to know I have a digestive disorder that affects what I can eat.” If you get too technical, he says, you’ll lose people in the details.
  7. Start with the basics. Most people with Crohn’s disease find that they feel better if they:

Eat small amounts more frequently throughout the day, rather than two or three large meals.Avoid greasy or fatty foods, especially fried dishes.Cut down on milk and other dairy products, which can be hard on your stomach.Limit high-fiber foods, especially those that are more difficult to digest, such as popcorn, seeds, and nuts.

  1. Work with a dietitian or nutritionist. You may want to avoid certain foods or food groups if you know they exacerbate your symptoms during flares, but when you eliminate entire food groups, you run the risk of malnutrition. A nutritionist or dietitian can help you create a meal plan that avoids the foods that bother you but is still nutritious.
  2. Limit caffeine. Like alcohol, caffeine can aggravate some Crohn’s disease symptoms, including diarrhea. Caffeine is in coffee, tea, chocolate, and some sodas. Carefully read the labels on foods and beverages to check if caffeine is listed. Caffeine can also interfere with sleep, so be sure to stop drinking it early in the day.
  3. Stick to your treatment plan. You may think you can skip your medications when you’re feeling better, but you risk a flare if you do. It’s important to take your medications according to your doctor’s directions. If you feel a change is needed, talk to your doctor first, Regueiro says.
  4. Avoid over-the-counter anti-inflammatory drugs. Many people with Crohn’s disease also have arthritis and may want to take a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen or naproxen, for the pain. “But over-the-counter medications, aside from acetaminophen, are generally bad for Crohn’s disease,” Regueiro says. Another reason to avoid these pain relievers: They can cause ulcers in the lining of your intestines. Talk to your doctor about your options.
  5. Be careful about antibiotics. Antibiotics can sometimes cause Crohn’s symptoms to flare. Don’t take antibiotics unless your doctor prescribes them to you. (They may be needed, however, for a specific reason, such as an infection that isn’t healing on its own.)
  6. Protect against bone loss. Crohn’s disease and some of its treatments can increase your risk of developing osteoporosis, which makes bones weak and fragile, increasing the risk of fractures. Talk to your doctor or a nutritionist about how to get enough calcium, vitamin D, and other nutrients in your diet to help keep your bones strong, as well as whether you should get a bone density test.
  7. Get screened for colon cancer. Having Crohn’s disease increases your risk of developing colon cancer, so it’s important to have regular colonoscopies to check for any signs of the disease. Talk to your doctor about how frequently you should be screened.
  8. Stay up to date with your immunizations. To stay healthy, consider being vaccinated against the flu, COVID-19, pneumonia, and human papillomavirus, as well as hepatitis A and B.
  9. Check in with your doctor regularly. If you’re feeling well, you might only need to see your doctor twice a year. But if you’re experiencing frequent flares , you may need to schedule appointments more often, possibly to adjust your treatment. (One note of caution: Never change your medication dosage, scheduling, or any other aspect of your health plan on your own. This could have dangerous results.)
  10. Have new symptoms evaluated quickly. Other complications of Crohn’s disease — abscesses, ulcers, anal fistulas, fissures — are rare, but you should know the signs and symptoms so you can contact your doctor right away if you experience them. You may need prescription medications to help heal. Over-the-counter and at-home remedies, such as topical creams and sitz baths, may also help in some instances, such as for relieving the pain of fissures.
  11. Start a journal. “One way that helps many people with Crohn’s disease manage their lives better is by keeping a journal,” Nesco says. Include what you eat, when you eat, when you exercise, when you experience stress, and anything else that affects you and your Crohn’s disease symptoms. He suggests looking back at your entries regularly to see what makes you feel good and what may have a negative effect on your health. Then share the information with your doctor so the two of you can use it to tweak your Crohn’s disease treatment plan as needed.