A Crohn’s disease flare-up is when a range of Crohn’s symptoms, such as abdominal pain and diarrhea, appear or worsen between times of remission. Stress management and medications may help manage or prevent a flare.
Crohn’s disease is a type of inflammatory bowel disease (IBD). The symptoms of this condition will depend on how severe it is and which part of the intestinal tract it affects.
This article explores the causes, symptoms, treatment, duration, and prevention of a Crohn’s flare-up.
- Autoimmune reaction: In this response, a person’s immune system attacks healthy cells. The damage causes inflammation, which leads to symptoms of the disease.
- Genes: Studies show that having an immediate family member with Crohn’s disease increases an individual’s risk of developing it.
- Smoking: Smoking may double the likelihood of developing Crohn’s disease.
- High-fat diet: This may slightly raise the risk.
- Certain drugs: Some medications — including antibiotics, birth control pills, and nonsteroidal anti-inflammatory drugs (NSAIDs) — may slightly increase the risk.
It is not clear why flares happen, but
- weight loss
- pain and cramping in the abdomen
Other symptoms may include:
Crohn’s disease is chronic, which means that it is a long-term condition.
People with Crohn’s disease experience flare-ups, during which the symptoms of the condition are active. In these periods, a person will likely have various symptoms from the list above.
Between flare-ups, people with Crohn’s have periods of remission, during which their symptoms improve or disappear.
The duration of a flare-up may vary from a few days to weeks or months.
It is helpful for a person to keep a record of the duration of their flare-ups and the symptoms they experience. The Crohn’s & Colitis Foundation (CCF) provides this symptom tracker that someone can fill out and share with their doctor.
Various treatment options are available, including medications, bowel rest, and surgery.
Although medications do not cure Crohn’s, they can provide symptom relief. Medical treatment options for people with Crohn’s include:
- Corticosteroids: Doctors may prescribe corticosteroids for people with moderate-to-severe symptoms. They reduce inflammation and decrease the activity of the immune system, but possible side effects include weight gain, high blood pressure, and high blood sugar. Examples of corticosteroids include hydrocortisone and prednisone.
- Immunomodulators: Doctors may prescribe immunomodulators to individuals who do not respond to other treatments. These drugs lower immune system activity, which decreases inflammation in the intestinal tract. Possible side effects include inflammation of the pancreas and a low white blood cell count, which increases the risk of infections. Examples of these medications include 6-mercaptopurine and cyclosporine.
- Biologic therapies: Biologic therapies neutralize certain proteins, which results in decreased inflammation in the intestinal tract. Examples include antitumor necrosis factors, such as certolizumab, and anti-interleukin-12 drugs, such as ustekinumab.
- Aminosalicylates: Balsalazide, mesalamine, and other aminosalicylates can help manage inflammation. They only have approval for use in ulcerative colitis, but a doctor may prescribe them off-label for Crohn’s disease.
- Other medications: Doctors may sometimes prescribe drugs to treat specific symptoms or reduce complications. For example, they may recommend antibiotics for infections, acetaminophen for mild pain, and loperamide to slow severe diarrhea.
If a person has severe symptoms, a doctor may advise them to rest their bowels for at least a few days and possibly up to several weeks.
Bowel rest involves consuming certain liquids that contain nutrients while refraining from eating anything. Doctors may recommend that some people take the liquids through a feeding tube or intravenous tube rather than drinking them.
In addition to medications and bowel rest, many individuals need surgery to reduce the symptoms of the disease and treat complications. The
- Intestinal obstruction: This term describes a blockage in the small or large intestine.
- Fistula: A fistula is an ulcer that develops on the inner intestinal wall and grows to form a tunnel.
- Life-threatening bleeding: A person with continuous bleeding that nonsurgical treatment cannot stop will need surgery.
Types of surgery may include:
- Small bowel resection: This is the removal of part of the small intestine.
- Subtotal colectomy: This procedure involves the removal of part of the large intestine.
- Proctocolectomy and ileostomy: A surgeon will remove the entire colon and rectum.
Individuals who experience symptoms of Crohn’s disease or lingering bowel changes should speak with their doctor. They should do so at the first sign of a flare-up because a doctor:
- can try to identify the trigger
- can prescribe medication to relieve the symptoms
- needs to know if a current treatment is not working
In addition, people with Crohn’s disease should see their doctor every 6 months during periods of remission.
The CCF states that although a person cannot completely prevent flare-ups, these measures may help:
- following the doctor’s instructions for procedures and tests
- asking a doctor about taking a vitamin and mineral supplement
- keeping a record of any symptoms between doctor appointments
- getting regular exercise
- practicing stress management techniques
- quitting smoking, if a smoker
- drinking alcohol only in moderation
In addition to adopting the above measures, eating a varied, nutritious, and balanced diet can help prevent the nutritional deficiencies that Crohn’s disease can cause.
Most people will benefit from avoiding fried or greasy foods during flare-ups. However, a person should try to determine all of the foods that make their symptoms worse so that they can avoid them.
People can work with a registered dietitian to develop a personalized eating plan.
Here are some questions people often ask about Crohn’s flare-ups.
What does a Crohn’s flare-up feel like?
Common symptoms include abdominal pain and cramping, diarrhea, loss of appetite and weight loss, fatigue, fever, joint pain and other symptoms.
How long do Crohn’s flare-ups usually last?
A flare-up can last from a few days to weeks or months.
What happens during a Crohn’s flare-up?
During a Crohn’s flare, a person’s symptoms either reappear or worsen. This can affect their mental and physical wellbeing as well as their quality of life for between a few days to several months.
How do you calm a Crohn’s flare-up?
Medication is the main option for managing a flare.
A Crohn’s flare-up may last just a few days, or it may persist for several months. People should contact their doctor when they notice the first signs of a flare-up. Medications and bowel rest may help, and if severe symptoms or complications develop, surgery is an option.
Although there is no guaranteed way to prevent flare-ups, certain lifestyle practices, such as exercising regularly, may help.