Reducing Flares in Crohn's Disease: The Role of Biologics

Explanation: Medical treatment can help you have fewer Crohn's flares. But even with good control, Crohn's disease is unpredictable. Symptoms may range from mild to severe and may develop slowly or come on suddenly, without warning. You can go through years of remission -- when symptoms disappear or decrease -- and then have a flare. However, with treatment and good communication with a doctor, most people with Crohn's can have a full and active life.

Explanation: There is not one type of food that aggravates Crohn's symptoms in everyone. In fact, Crohn's disease can flare up for no apparent reason. But many people find that certain foods aggravate their symptoms and lead to flares. Other triggers include stress, certain medications, smoking, and skipping Crohn's medications or taking the wrong dose.

Explanation: Some studies have shown that probiotics -- available in supplements and some foods -- may help some people stay in remission. But most studies have not shown a benefit. And side effects of probiotics can include mild bloating or gas. Studies of fish oil, which is rich in anti-inflammatory omega-3 fatty acids, have also shown mixed results. Tell your doctor if you use any complementary or alternative therapies, because they may interact with your medication.

Explanation: Crohn's disease can develop anywhere in the digestive tract, including the esophagus, stomach, and even mouth. But it usually affects the lower end of small intestine, called the ileum, and the beginning of the large intestine, or colon. This makes it different from ulcerative colitis, which only affects the colon. Your symptoms depend on which part of your digestive tract is affected. Crohn's can also affect other parts of your body such as skin, eyes, joints, and liver.

Explanation: Whether you are short on nutrients and vitamins -- and which ones -- depends largely on where your Crohn's is and how widespread. Vitamin B-12 is absorbed in the ileum, so if the disease affects that area, you may not absorb enough B-12 from your diet. If you have a low-fiber diet, you may not absorb enough vitamin C from fruits. People with Crohn's are often short on Vitamin D, especially those who have had surgery. People with extensive Crohn's can also become anemic because of an iron deficiency. Your doctor can determine if you need vitamin or other supplements.

Explanation: When you're having a flare, it's a good idea to steer clear of all carbonated drinks, which often cause gas. Beans, cabbage, broccoli, and caffeine are other gas-producers to avoid when flaring. Greasy and fried foods can cause gas or diarrhea. Milk isn't usually a problem unless you're lactose intolerant. Eating high-fiber foods such as raw vegetables or fruits may be a problem during a flare -- but it is still important to try to eat healthfully. Instead, try cooking them well. Eating smaller meals can also help ease symptoms.

Explanation: The exact cause of Crohn's is unknown, but researchers believe that a combination of a person's genes, immune system, and factors in the environment play a role. People with Crohn's may inherit certain genes that cause their immune system to overreact, leading to the chronic inflammation found in Crohn's. About one in five people with Crohn's has a parent, sibling, or child who also has it.

Explanation: There is no cure for Crohn's disease, so the goal of medical treatment is to reduce the inflammation that triggers your symptoms. This allows tissue in your intestine to heal and relieves symptoms like fever, diarrhea, and abdominal pain. Once you are feeling back to normal (in remission), medical therapy can keep you feeling that way by reducing flares. Your treatment may include medications, surgery, and nutritional supplements.

Explanation: Stress doesn't cause Crohn's. But like people with other chronic conditions, you may find that stressful events or situations make your symptoms worse. Just living with Crohn's can also be stressful. Relaxation and deep breathing, yoga and tai chi, and meditation techniques can help you lower stress before it gets to your gut. Having strong social support from family, friends, a support group, or a counselor can help you cope better with day-to-day life with Crohn's.

Explanation: The prospect of taking medication for a long time to control Crohn's inflammation may not be appealing. But uncontrolled inflammation increases the risk of scarring in your intestine and other complications. Aggressively treating Crohn's with medications may reduce complications as well as the need for future surgery or hospitalizations.

Explanation: The most common complication of Crohn's disease is intestine obstruction -- the intestine becomes blocked. This is caused when swelling and scar tissue thicken the intestine wall. Arthritis, eye or mouth inflammation, and kidney stones or gallstones are less common complications.

Explanation: Although people can get Crohn's at any age -- children as well as senior citizens can get Crohn's -- it usually starts in the teen and early adult years (between age 13 and 30). About one in four people with Crohn's get it before the age of 20. In children who develop Crohn's, there is usually a genetic connection. Crohn's can stunt growth or delay puberty in children and teens, but medical treatment can also be more effective in young people.

Explanation: About two-thirds of people with Crohn's disease need surgery to remove part of their intestine at some point. Surgery can help if medications are no longer controlling your symptoms or if you have complications such as intestinal blockage. Crohn's can return after surgery, and sometimes more than one operation is needed. But this may not happen for many years, and during that time, you may be symptom free.

Explanation: Smoking cigarettes may not only make your Crohn's symptoms worse -- it also makes surgery more likely. People who smoke tend to have more flares, more complications, and need higher doses of steroids and other medications. Quitting can reduce your risk of flares and complications. Your doctor can help you find a specialist to help you quit smoking.

Explanation: If you are like most people with Crohn's, you can have a healthy, active lifestyle. In addition to sticking with your medication, regular exercise and a good diet help make that possible. Talk to your doctor or a dietitian about foods to avoid and how to have a nutritious diet without them. Regular exercise helps keep you healthy and can reduce stress and Crohn's complications such as bone thinning.