Crohn’s: Emergency Flare-Up Guide

Flare-ups are a sudden reactivation of symptoms for people living with Crohn’s. A flare-up can cause active inflammation anywhere along the gastrointestinal tract with:

• mouth sores
• abdominal cramps
• nausea
• diarrhea
• rectal pain
• joint pain
• rashes

Some possible causes of flares may include:

• smoking tobacco
• pollution
• disruptions or changes in medication
• chronic stress
• NSAIDs
• antibiotics

However, it’s important to note that research is often inconsistent on the precise cause of Crohn’s disease flares. Crohn’s is a complex condition and scientists don’t fully understand the disease. Research is ongoing on how to predict flares in patients with Crohn’s. Multiple factors have been shown to play a role in the disease, including:

• genetics
• healthy intestinal bacteria
• immune system

To help prevent flare-ups, you should take the medications recommended by your doctor regularly and as directed. You should also work with your doctor to create a treatment plan for flare-ups. Research suggests that treatment is most effective when therapy is directly focused on the specific symptoms and severity of the flare-up.

Calming a flare-up

Nonprescription remedies for Crohn’s flare-ups range from topical solutions to oral medicines.

Because flare-up attacks can be unpredictable, it’s a good idea to pack a portable supply kit. This can include items such as:

• medicated mouthwash
• protective barrier ointment
• antidiarrheal medications like loperamide
• disposable wipes

Here are some other things to use in the event of a Crohn’s flare-up in addition to your prescribed medications:

• Acetaminophen(Tylenol): If your doctor approves, use this medication to relive pain. Ask your doctor about other alternative pain management recommendations too.
• Anti-diarrheal medications: Under the guidance of your doctor, control bouts of diarrhea with medications such as loperamide (Imodium) or bismuth (Pepto-Bismol).
• Soothing moist towelette: Soothe anal irritation with a moist towelette rather than toilet paper, which can feel abrasive to tender skin.
• Vitamin-enriched ointments: Use these for relief from anal itching.
• Sitz baths: Soak in warm salt water to relieve anal fissure or fistula soreness.
• Hand-held showerhead with a mild, fragrance free soap: Use these to wash your anal area.
• Medicinal mouthwash: Rinse and gargle with it to dilute the pain caused by mouth ulcers.
• Moist heat: Use moist heat to alleviate joint discomfort and then set aside time for rest.
• Physical therapy: Therapists can show you range-of-motion exercises to help relieve painful joints.

Preventative safety measures

You can take a variety of preventative safety measures to ensure you stay healthy and strong. Every day, remember to exercise with a goal of 30 minutes and get a good night’s sleep. Be sure to eat a nutritious balanced diet and consider taking a multivitamin. Also, make sure to listen to your doctor and take your prescribed medications regularly. Even if you have no symptoms, missing a dose can lead to a flare-up.

If you smoke cigarettes, take steps to quit. Smoking has been shown to decrease healthy bacteria in the gut, which may affect the course of Crohn’s disease. It also damages intestinal tract tissue and is a risk factor for cancer of the mouth, throat, esophagus, stomach, intestines, liver, and pancreas.

Start a log to track your flare-ups by date and rate their level of intensity. You should also log your symptoms as well as what relief actions you took and what treatments have been effective. Give a copy to your doctor to add to your file of medical records and reserve another copy for emergency room visits.

While going through a flare-up can be troubling, your efforts will go a long way toward helping you manage this condition and improving your quality of life.