If you have Crohn’s disease or ulcerative colitis, you might be symptom-free for weeks or even months. Then without warning, you can experience stomach pains or a fever, which are two possible symptoms of a flare.
Other symptoms that can gradually or suddenly appear may include diarrhea, the urgent need to use the bathroom, a loss of appetite and fatigue. Bloating, vomiting, rectal bleeding, or incontinence, are possible, but less common.
You can have one or more of these symptoms early on or as your flare progresses.
What Causes Flares?
“Most of the time the cause of a Crohn’s flare is unknown; however, possible causes of flares include:
- Nonadherence: Not taking your medications as instructed.
- Medications: Taking a non-steroidal anti-inflammatory medicines (NSAIDs) such as aspirin, naproxen, and ibuprofen.
- Diet: Eating too much of a food that the bowel can’t process or handle.
- Smoking, alcohol, and stress: Other possible causes of flares.
- Antibiotics, which can alter the amount and type of bacteria that normally live in your gut, can trigger diarrhea or inflammation.
Flares can last several days and then disappear on their own or they can worsen and potentially require surgery. This is why it is very important to try to prevent flares before they occur by sticking with the medical regimen that works for you or by intervening before the flare worsens enough to require surgery.
Other complications: disease complications like fissures, fistulas, strictures, or abscesses. Frequent bowel movements can cause fissures to develop. Call your doctor if you notice drainage of mucus or stool from your anus or from an area near the anus (possible sign of a fistula); nausea, vomiting, or constipation (possible signs of a stricture, or narrowing of a section of the intestine); or severe abdominal pain, painful bowel movements, discharge of pus, fever, or a lump at the edge of your rectum that’s swollen, red, and tender (signs of an abscess). All may require immediate attention.
What to do when you are experiencing a flare
As soon as you suspect a flare is occurring, it is important that you take steps to control it before a flare can injure your bowels and trigger additional medical problems like anemia (loss of blood resulting in low iron levels), intestinal obstructions, or even potentially cancer.
- No diet can prevent or reduce discomfort from flares, but there are a few general principles that may help. If your Crohn’s symptoms are mild, a bland diet — bananas, white bread, white rice, applesauce, smooth peanut butter, potatoes without skin, and steamed fish — will be easier on your digestive tract. Avoiding caffeine, fresh fruits, and uncooked vegetables also may help; greasy and fried foods can also trigger a flare in some people.
- Reducing stress is another way to address a flare-up. Stress reducers include getting enough sleep, meditation, deep breathing and yoga. Mindfulness-based therapy can help patients with Inflammatory Bowel Diseases better manage some of their bowel symptoms, according to a September 2014 study published in the Journal of Crohn’s and Colitis.
Over-the-counter medications may also help relieve some symptoms of flares. For example, anti-diarrheal medications can reduce the frequency of diarrhea episodes, while acetaminophen is generally a safe medication that can ease the pain. Just be sure to ask your doctor before taking these or other medications to ensure that they are safe for you. Keep in mind that your doctor may find it beneficial to adjust your medications occasionally to match your disease state.