Crohn’s disease is a chronic condition that affects the gastrointestinal (GI) tract. People with Crohn’s experience flares, which cause more pronounced symptoms. Symptoms include diarrhea, abdominal cramps, bloating, constipation, and rectal bleeding.
Crohn’s disease is a type of inflammatory bowel disease (IBD). Around 3 million people in the United States have IBD, affecting males and females equally. Most people with Crohn’s disease receive their diagnosis between the ages of 20 and 30.
Typically, people with Crohn’s disease alternate between flares, which are periods where they have noticeable symptoms, and remission, where they might not notice their symptoms at all.
This article looks at which symptoms a person might experience during a Crohn’s flare and when to contact their doctor or seek help. It also lists medical treatment options that could help ease symptoms and at-home methods to help prevent flares.
During a Crohn’s flare, symptoms can vary depending on which part of the GI tract the condition affects.
The most common symptoms of a Crohn’s flare are:
- frequent or urgent bowel movements
- blood in the stool
- abdominal pain
- nausea and vomiting
- weight loss
However, a Crohn’s flare can also lead to:
- lack of appetite
- joint aches
- body aches
- eye problems, including pain, redness, or loss of vision
Many people with Crohn’s disease have developed methods to manage mild flares, including restricting their diet for a short time. Those with a newer diagnosis can work with their doctor or other experts to find the correct management methods for them.
However, some symptoms may require immediate medical attention. A person should seek emergency medical care if they:
- cannot keep down liquids due to nausea
- vomiting, or pain
- notice rectal bleeding with or without clots of blood in the stool
- are in constant pain
- have a fever above 100.3°F (38°C)
Various tests can help a doctor diagnose Crohn’s disease or help doctors understand what happens inside a person’s GI tract when someone experiences flares.
These tests can include:
- Blood test: One of the first tests for Crohn’s may involve a blood test.
- Stool test: Lab technicians examine a sample of stool.
- Imaging tests: A doctor may order an X-ray, MRI, or CT scan of the upper or lower GI tract. A person may need to take a contrast fluid to make images as clear as possible.
- Endoscopy: An upper endoscopy is also known as an esophagogastroduodenoscopy (EGD). It involves threading a thin tube through the mouth and into the small intestine to evaluate the oral cavity, esophagus, stomach, and the first part of the small bowel. A colonoscopy is a type of endoscopy where doctors insert a thin tube through the anus to examine the colon, rectum, and anus.
- Chromoendoscopy: Doctors use this technique during a colonoscopy exam. It involves spraying blue dye to highlight the mucosal pattern of the colon, which allows doctors to see any abnormal patterns. This technique can be helpful for colon cancer screening, specifically in people with IBD.
- Biopsy: A doctor may use biopsy forceps to sample parts of the digestive tract for diagnostic purposes.
Medication for Crohn’s aims to bring symptoms into remission. Over time, a person receiving the correct medication plan may find that the periods in which they experience flares get shorter, and the remission periods get longer.
A person who experiences Crohn’s flares and is already receiving treatment for the condition may require the following steps:
- Adding medication: A person who already takes medication for Crohn’s disease may need to add another medication to make treatment more effective. This is called combination therapy. It might mean, for example, that a person takes a biologic and an immunomodulator at the same time. A person may experience more side effects with combination therapy.
- Changing medication: Another treatment option is to increase a person’s medication dosage, add another drug to their regimen, or try a new medicine. A doctor might check for levels of medicine in a person’s blood to find out whether they have developed any resistance to the medication they are taking.
Surgery may be an option for people experiencing regular, severe flares that medication is no longer helping. As many as three-quarters of people with Crohn’s disease may need surgery to improve their quality of life. Surgical procedures might include the following steps:
- Resection: A surgeon takes out the damaged part of the bowel.
- Anastomosis: A surgeon attaches two healthy ends of the bowel.
As every person with Crohn’s disease experiences it differently, finding the best ways to manage and treat the disease can take trial and error. It can be helpful to keep a record of flare-ups and diet and behavioral factors that could affect the disease.
Regular communication with a doctor may also improve a person’s chances of finding a treatment regimen that is right for them.
The majority of people with Crohn’s disease experience periods of flare, and avoiding them altogether is unlikely. However, several diet and lifestyle factors seem to have a positive effect in reducing Crohn’s flares.
Findings from a
- processed foods
- animal protein
- refined carbohydrates
- total fat
- dairy fat
However, diets do not provoke Crohn’s flares nor improve symptoms. Evidence to suggest that certain foods can help a person treat their Crohn’s flares is anecdotal. Some people try to treat their Crohn’s disease by diet alone, but this can worsen their symptoms and lead to hospitalization.
A person should speak to their doctor to find the treatment that will work for them.
Although there is anecdotal evidence of the benefits of exercise in Crohn’s disease, future studies could find a more significant link.
Research has found that smoking may also lead to poorer outcomes in people with Crohn’s disease than ex-smokers and those who have never smoked.
Living with Crohn’s disease can be extremely uncomfortable, and some people may find it distressing. The following techniques can help a person manage their stress and stay positive:
- mindfulness and meditation
- exercises such as yoga, tai-chi, walking, running, and boxing
- playing music that helps release stress
- talking to friends or other people with Crohn’s
- spending time in nature
The Crohn’s and Colitis Foundation has also set up support groups around various states where people living with IBD can connect.
A person might also wish to access mental health resources.
Experiencing occasional flare-ups is an inevitable part of Crohn’s disease. It is not possible to prevent flares from occurring, but some treatments, such as medication and surgery, can help a person manage the symptoms and limit the effects.
Although some people make dietary changes to help treat their symptoms rather than take medication, there is no scientific evidence to back this up. It may also cause worsening of symptoms and lead to hospitalization.
Anyone with Crohn’s disease who experiences new symptoms or does not know the cause of the flare should consider contacting a doctor or specialist who can investigate and give advice.