For people with Crohn’s disease, a flare is when symptoms — diarrhea, abdominal cramps, bloating, constipation, and rectal bleeding — become more pronounced. Medication and other strategies can help prevent and manage flares.

Crohn’s disease is a type of inflammatory bowel disease (IBD). Around 3.1 million people in the United States have IBD, which affects males and females equally.

While Crohn’s disease is more common in adulthood, about 25% of people receive their diagnosis as children or adolescents.

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 a doctor or seek help. It also lists medical treatment options that could help ease symptoms and at-home methods to help prevent flares.

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During a Crohn’s flare, symptoms can vary depending on which part of the gastrointestinal (GI) tract the condition affects.

The most common symptoms of a Crohn’s flare are:

However, a Crohn’s flare can also lead to:

Learn about and see the visual signs of Crohn’s disease.

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 experience any of the following:

  • inability to keep down liquids due to nausea and vomiting
  • severe abdominal pain
  • blood in the stool
  • constant pain
  • a fever above 100.3°F (38°C)

Learn more about the stages of Crohn’s disease.

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 abdomen or 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.

Learn more about tests for Crohn’s disease.

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 or try a new medication. A doctor might check for levels of medication in a person’s blood to find out whether they have developed any resistance to the drug they are taking.

Learn treatment options for a person with Crohn’s disease.

Surgery

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 usually 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.

Learn more about surgical options for Crohn’s disease.

The majority of people with Crohn’s disease experience periods of flares, and avoiding them altogether is unlikely. However, several diet and lifestyle factors seem to have a positive effect in reducing Crohn’s flares.

Diet

Findings from a 2019 case report showed that certain diets affected the severity of Crohn’s flares in one group of people. According to this individual study, it might be possible for a person to reduce flares by modifying their diet, such as by reducing:

  • processed foods
  • animal protein
  • refined carbohydrates
  • total fat
  • dairy fat

However, diets, in general, do not trigger 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 with their doctor to find the treatment that will work for them.

Learn more about whether there is a cure for Crohn’s disease.

Exercise

Researchers have suggested that regular exercise can benefit people with Crohn’s disease. As well as improving overall physical fitness and mental health, exercise might decrease fatigue, bone mineral loss, and inflammation.

Although there is anecdotal evidence of the benefits of exercise in Crohn’s disease, future studies could find a more significant link.

Learn about the benefits of exercise here and how to start.

Quitting smoking

Research shows that smoking is associated with a higher chance of developing Crohn’s disease.

In addition, smoking may also lead to poorer outcomes in people with Crohn’s disease than ex-smokers and those who have never smoked.

Learn 11 tips on how to quit smoking.

Stress management

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:

  • practicing mindfulness and meditation
  • performing exercises such as yoga, tai-chi, walking, running, and boxing
  • playing music that helps release stress
  • talking with 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.

Learn about which mental health resources are available.

Below are answers to some commonly asked questions about Crohn’s flares.

How do I know if my Crohn’s is flaring?

Signs of a Crohn’s flare include generally feeling unwell, going to the bathroom more than five times per day or waking up at night, diarrhea with blood for longer than 3 days, stomach pain, and fever. You may also experience symptoms affecting the skin, the eyes, the joints, or your mood.

How do Crohn’s flares start?

Many things can trigger Crohn’s flares, including stress, medications, illness, or the progression of the disease itself.

Where do you feel pain during Crohn’s flare-up?

A person can feel pain in the abdomen, the joints, or the mouth.

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.