What to know about Crohn’s disease relapse

Relapse is a recurrence of symptoms in Crohn’s disease after a period of remission. Relapses may occur at any time, even if a person is currently receiving treatment for Crohn’s disease.

Symptoms of Crohn’s disease vary but commonly include:

• stomach pain and cramps
• diarrhea
• weight loss
• tiredness
• fever
• anemia
• eye pain and redness
• joint pain
• nausea
• loss of appetite
• skin changes, such as red, bumpy patches

Other factors may affect the likelihood that someone with Crohn’s disease will experience relapse. According to a 2016 study, factors that influence the risk of Crohn’s disease relapse include:

• genetics, such as the age of onset of the disease
• disease location and severity
• environmental factors, such as:
  • smoking
  • having had surgery of the appendix
  • taking certain drugs, such as:
    • hormone replacement therapy drugs
    • nonsteroidal anti-inflammatory drugs (NSAIDs)
    • antibiotics
    • steroid involvement from the outset
  • experiencing stress
• short previous remission period
• history of surgery

Certain foods may not worsen inflammation or cause the disease, but they may influence symptoms. For example, greasy or fried foods can cause gas and diarrhea, worsening relapse symptoms.

General causes

It is unclear what causes Crohn’s disease. It is the result of inflammation in the intestines. Research suggests that the disease could have various causes, including:

• problems with the immune system where it mistakenly attacks healthy tissues to cause inflammation in the bowels
• genetic changes that run in families
• smoking
• certain medications, such as aspirin
• certain diets, such as those that are high in fat

To suitably treat and manage a flare, people should consult a doctor to check whether the symptoms are due to a Crohn’s disease relapse or something else. A doctor may recommend blood or stool tests.

If the symptoms are due to a relapse, treatments could involve:

• taking corticosteroids to reduce inflammation and symptoms or other medications, such as aminosalicylates and immunomodulators
• checking drug levels, including whether the person has become resistant to their antibiotic medications
• changing medication dosage or type
• resting the bowels by only drinking certain liquids or avoiding eating and drinking in general

These treatments might help with relapse symptoms, but doctors may suggest more intensive treatments to address the condition in severe cases.

Around 60% of people have surgery within 20 years of receiving a diagnosis of Crohn’s disease. Surgery type will vary depending on the condition but could include removing part of the small or large intestine.

Crohn’s disease is a chronic condition that may require regular contact with a doctor. People who experience a relapse of symptoms or find their symptoms worsening should speak with their gastroenterologist immediately.

Doctors can help adjust treatments to deal with relapses. They can also manage the risk of complications, such as:

• ulcers
• malnutrition
• abscesses

There is no guaranteed way of preventing relapse in people with Crohn’s disease. However, the Crohn’s & Colitis Foundation suggests tips for maintaining remission, which include:

• seeing a doctor regularly
• following recommended guidelines for testing and procedures for Crohn’s disease
• monitoring and tracking the disease and its symptoms
• exercising regularly
• taking multivitamins or supplements to reduce the risk of malnutrition
• quitting smoking
• reducing stress
• keeping a well-balanced diet

Below are some frequently asked questions.

What causes relapse in Crohn’s disease?

Relapse in Crohn’s could result from several factors, including smoking, stress, or certain medications, such as hormone replacement therapy drugs.

How long does Crohn’s relapse last?

Crohn’s disease relapses cause symptoms that may last days or weeks, depending on the individual.

How often do Crohn’s flare-ups happen?

The frequency of Crohn’s disease flare-ups varies. Without treatment, people may experience symptoms that come every few weeks or months. The gaps may be longer with treatment.

Is Crohn’s remission the same as a cure?

There is currently no cure for Crohn’s disease. Remission is when symptoms go away for a period but may still return.

Crohn’s disease causes symptoms that include diarrhea, stomach pain, and weight loss.

People with Crohn’s disease may go through periods of remission without symptoms. However, symptoms can reoccur, referred to as a relapse. Getting treatment for the disease — which could include taking medications, resting the bowels, or undergoing surgery, in some cases — will reduce the risk of relapse.