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How to Handle a Crohn's Flare

Flares and Crohn's Disease

When your Crohn's disease is flaring, you'll want to take quick action. Finding the right treatment can give you relief and help prevent damage to your colon. Medication, diet, and lifestyle changes can help stop inflammation, pain, diarrhea, and other common symptoms.

Medicines to Stop a Flare

Your doctor may prescribe:

  • Corticosteroids to curb inflammation. Because they can have serious side effects, doctors prescribe them for only as short a time as needed.
  • Other anti-inflammation drugs called 5-ASAs
  • Antibiotics to prevent or treat infections or fistulas, which are breaks in the intestinal wall. Two of the most commonly used antibiotics for Crohn's disease are metronidazole (Flagyl) and ciprofloxacin (Cipro).

Tame Your Stress

Stress doesn't cause Crohn's disease, but it may make symptoms worse and even trigger a flare. To help manage your stress, use relaxation techniques, such as deep breathing or meditation. Make sure you get enough exercise and sleep. Set limits, so that when you don't feel well because of a flare, you aren't doing too much.

Drugs for Crohn's-Related Diarrhea

Over-the-counter medications such as loperamide (Imodium A-D) and bismuth subsalicylate (Kaopectate) may help ease diarrhea. Because they can cause dry mouth, it helps to suck on ice or hard candies. Check with your doctor before taking any medication for diarrhea.

Check Your Diet

Foods don't cause Crohn's, but some can worsen your Crohn's symptoms, particularly during flares. Common triggers include high-fiber foods, fried items, and spicy dishes. Keep a food diary to see what foods bother you, and then avoid them. For comfort when your disease is active, try soft, bland foods, such as toast, and eat smaller meals throughout the day. Work with a registered dietitian to make sure you get enough nutrients.

Pain Relief for Crohn's Flares

Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, for pain and discomfort. These can irritate the stomach and small intestine and make your Crohn's symptoms worse. Talk to your doctor about using acetaminophen (Tylenol) instead.

Drugs for Tough Cases

Doctors may use medications called immunomodulators to treat severe Crohn's disease when steroids don't work. These include azathioprine (Imuran), 6-MP, and methotrexate (Rheumatrex). Other medicines called biologics also target your immune system to help control inflammation. Some used for Crohn's include certolizumab (Cimzia), adalimumab (Humira), infliximab (Remicade), ustekinumab (Stelara), and natalizumab (Tysabri).

Drink Enough Water

When you're having a flare and you have diarrhea, that can leave you dehydrated. Drink several glasses of water a day. Depending on the severity of diarrhea, you may need even more. Your doctor can tell you how much fluid is right for you.

Surgery for Severe Crohn's

If medications don't help your Crohn's, or if you have other complications, you may need surgery. Fistulas, abscesses, or bowel obstructions may require an operation. During surgery, doctors work to remove damaged parts of your intestines and preserve as much as possible to try to keep digestion normal.

Reviewed by Melinda Ratini, DO, MS on October 31, 2014

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