You’re in a meeting with a client when it starts. The gurgling. The cramping. The pain. You know that if you don’t get to the bathroom now, you may have a problem.
With a hasty “excuse me,” you get up from the table and make a mad dash, leaving your client confused and your co-workers worried.
When you have a condition like Crohn’s disease or ulcerative colitis, it can flare at any time -- even in the middle of the meeting of your life.
Megan Starshak, a marketing coordinator in Milwaukee, WI, knows that’s possible. She’s been upfront about her ulcerative colitis with her bosses and co-workers throughout her career.
“In my first job out of college, I worked in an office with only six people. In an office that small, people notice when you’re in the bathroom for a while,” Starshak says.
Sometimes, her ulcerative colitis would flare in the morning. “I told my boss right away when it started, and that if I’m a few minutes late, it’s because of my colon, not because I’m lazy.”
Clear communication like Starshak’s is wise if you have inflammatory bowel disease (IBD), says Joshua R. Korzenik, MD, director of the Crohn's and Colitis Center at Brigham and Women’s Hospital.
“One of the difficulties with having an IBD is that most people who have it look healthy. You might be feeling miserable, but your boss or colleagues might say, ‘Well, you look fine.’ ”
Korzenik says it’s up to each person to decide how open to be about their condition, but at some point, you'll probably need to clue your employer in.
“You might not know when a flare will happen, but other things are predictable, like doctor’s appointments and IV treatments that require you to take time off, or operations that might limit your abilities while you recover.”
Starshak is in remission, which generally means you have few to no symptoms. But her current boss knows what’s possible.
“I explained that this is what I have and how it affects me, and I said I know all of this because I’ve had it for over 10 years. I let my boss know I’m willing to come in early or stay late to make up time [for appointments or being late because of a flare].”
It's important to know your rights, says Patricia Kozuch, MD, director of the Inflammatory Bowel Disease Program at Thomas Jefferson University Hospitals.
“Chronic conditions like IBD are covered under the Americans with Disabilities Act, and employers are required to provide reasonable accommodations so people can do their jobs,” she says. “For IBD patients, that could mean time for frequent bathroom breaks, a workstation that is closer to a bathroom, and time to accommodate appointments.”
Put Your Health First
Sometimes when people feel good, they think they don’t need their meds anymore.
“But you’re feeling good because you’re taking medication,” Kozuch says.
Flares can still happen, but if the drugs helped you get to remission, they’ll probably help you stay there, he says.
It's important to practice good habits, too.
“Get enough sleep, don’t smoke, make sure you eat right, and try to manage your disease long-term, every day, instead of waiting for the next flare,” Korzenik says.
Regular visits with your health care team can help you avoid complications that can drag you down. People with inflammatory bowel disease can get depression and anxiety. Both should be treated, even if they’re because of your digestive problems.
“The tendency is to say that someone wouldn’t be depressed if they didn’t have IBD, so let’s get the IBD taken care of,” Kozuch says. “But that doesn’t mean we shouldn’t treat depression or anxiety.”
Something else to keep an eye on is stress.
“Work is stressful, even in the healthiest person," says Dana J. Lukin, MD, PhD, director of the Einstein-Montefiore Program for Inflammatory Bowel Diseases.
Pile on IBD, and it’s easy to feel overwhelmed. But you've got ways to release some pressure.
Lukin says you could do things like:
- Listen to music.
- Talk with friends.
- Join a support group for people with inflammatory bowel disease.
Just find whatever works for you.
“Remember that stressful situations can make IBD symptoms worse, so finding an outlet for your stress can play a large role in maintaining balance,” Lukin says.
Starshak can vouch for that, and she says it’s a cycle for her.
“Exercising and staying active helps me stay in remission. And because I am in remission, I can exercise and stay active, like running, doing yoga, and riding my bike.”
She also says her outlook is crucial for her.
“Jobs are important, but if I’m getting overwhelmed and feeling stressed, I will step back, slow down, and take things one at a time. I’ll remind myself not to put myself in a flare.”
Put Your Health First, Continued ...
That may include a leave of absence.
“It’s a difficult decision, in terms of losing income and not feeling like you’re part of the company and involved at work,” Korzenik says. “But if you’ve been pushing yourself hard and things are becoming too difficult, it could be better to take some time off and focus on getting your health back.”
For Starshak, it all comes down to having a plan, whether it’s for dealing with a flare or keeping up with routine care.
“If you want to disclose your IBD, do it in ways that show you have a plan in place, to show that you’ll still be able to do your job and be an asset to the company,” she says. “If you’re proactive, people not only see that you have a handle on your disease, but that you can take on the responsibilities and challenges of your professional life.”