1. Call your doctor.
If you’re in the middle of a Crohn’s disease flare, you need to reach out to your doctor right away. And be open about the symptoms you’re experiencing, whether that’s fever, chills, abdominal pain, bleeding, or frequent diarrhea, all of which can indicate that your condition is worsening, says Ramanujan Samavedy, MD, a gastroenterologist and clinical assistant professor at The University of Tennessee Graduate School of Medicine. “The relationship you have with your doctor is one of the most important parts of managing Crohn’s disease,” says Kathy Walker-Oaks, RN, a nurse at University Gastroenterology at The University of Tennessee Medical Center in Knoxville. If you and your doctor don’t already have a plan for how to handle a flare, be sure to develop one soon.
2. Don’t take just any medication.
Some pain medications — even over-the-counter ones — can make your symptoms worse, so talk to your doctor about which drugs you can safely take. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can cause inflammation, says Carlos Rollhauser, MD, a gastroenterology specialist at The University of Tennessee Medical Center, so he recommends acetaminophen to his patients. In the meantime, try easing joint pain with heat therapy, gentle massage, and rest. Staying hydrated can also help relieve stiffness, adds Walker-Oaks. “Bland foods and clear liquids are best during a flare,” Walker-Oaks says. Keep a supply of cooked or canned vegetables, broth-based soups, bread or crackers, and lean meats on hand. You might want to talk to your doctor about taking a nutritional supplement during flares as well. “Drinking plenty of water can also help prevent dehydration,” Walker-Oaks says. Aim for at least 64 ounces of fluids a day; if you’re experiencing diarrhea, you should drink even more and include sports drinks with electrolytes, Dr. Samavedy says. He also recommends avoiding sodas and other sugary drinks, which can worsen the symptoms of Crohn’s disease. If your diarrhea is severe, tell your doctor right away. Dehydration is a leading cause of hospitalization for patients with Crohn’s, says Rollhauser. You may need to have fluids and other nutrients administered intravenously to give your intestines time to rest and heal. Called bowel rest, this is typically needed only during severe flares, when hospitalization is necessary.
4. Give your skin some TLC.
During periods of frequent diarrhea, the skin around the anus may become raw and irritated. Walker-Oaks advises keeping the area as clean and dry as possible. If the skin isn’t broken, you can apply a zinc oxide–based topical ointment for relief. If the skin is broken, call your doctor before using anything; you should also call if the skin doesn’t heal. Painful mouth ulcers, similar to canker sores, are also common in people with Crohn’s disease. “Good oral hygiene is key,” Walker-Oaks says. “Flossing, brushing, and follow-up dental care for mouth health are important.” These ulcers usually go away without treatment in 10 to 14 days. If they linger or are bothersome, your doctor may prescribe a medication that can help.
5. Go easy on yourself.
“Stress and lack of rest can affect any disease in a negative manner,” Walker-Oaks says. She recommends getting adequate rest and practicing techniques to help manage your Crohn’s disease. “Mental health is extremely important,” says Rollhauser. “We know that stress, depression, and anxiety can be driving factors in a flare-up.” He recommends seeing a healthcare professional to take care of your mental and emotional well-being. In addition, he says, studies have shown the importance of exercise for relieving stress and reducing anxiety. It’s also important to protect your overall health as much as possible. If you’re taking medications that suppress your immune system, be sure to avoid contact with people who have colds or other common infections, Samavedy says, because you can be at risk for serious infection. Given your risk for communicable airborne disease, you should also talk to your doctors about getting vaccinated for the flu, pneumonia, and COVID-19. Crohn’s disease can be unpredictable, but take comfort in knowing there are steps you can take to minimize flares when they occur. Stay in touch with your doctor, and follow your treatment plan as directed. Be mindful of your nutrition, make sure you get enough rest, minimize your stress, and be diligent when it comes to hygiene. Crohn’s disease symptoms can worsen if you neglect any of these areas of general health.
