Flare-ups are a sudden reactivation of symptoms for people living with Crohn’s disease.

Taking the medications recommended by your doctor, regularly and as directed, will help prevent flare-ups. You should also work with your doctor to create a treatment plan for when they happen.

Research suggests that treatment is most effective when focused on the specific symptoms and severity of the flare-up.

What to do if you’re having a Crohn’s flare

  • Follow any existing plans set up by your healthcare team, including any approved pain or symptom relief treatments.
  • Contact your doctor if you need help with your symptoms or have questions.
  • Talk with your doctor about your current treatment plan and any changes that should be made to your medications or lifestyle based on your current symptoms.

Crohn’s can affect any part of the gastrointestinal system, from the mouth to the anus. Symptoms of a flare may occur gradually or suddenly and can vary in severity. They may also change over time.

Here are some potential signs of a Crohn’s flare-up:

  • abdominal pain
  • blood in the stool
  • diarrhea
  • fatigue
  • fever
  • frequent or urgent bowel movements
  • joint pain
  • lack of appetite
  • unexpected weight loss
  • mouth sores
  • pain near or around the anus
  • sores in the mouth or throat

How long does a Crohn’s flare-up last?

A period of Crohn’s flare-ups can last a few days or even a few months, depending on the severity.

It’s important to keep your doctor informed of changes in your symptoms, especially if they get worse.

There’s no specific test for diagnosing Crohn’s disease. Your doctor will likely use tests to eliminate other potential causes of your symptoms before making a diagnosis of Crohn’s.

These tests could include:

  • blood tests
  • stool sample tests
  • endoscopy
  • colonoscopy
  • imaging tests like CT scans and MRI scans
  • a biopsy of the intestinal tract tissue

You may go through multiple rounds of tests to rule out other conditions, especially similar conditions like other types of inflammatory bowel disease.

Some possible causes of flares include:

  • smoking tobacco
  • environmental pollution
  • disruptions or changes in medication
  • chronic stress
  • infections
  • nonsteroidal anti-inflammatory drugs (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 yet fully understand it. Research is ongoing on how to predict flares. Multiple factors have been shown to play a role in the disease, including:

  • genetics
  • intestinal bacteria (the gut microbiome)
  • immune system health

People living with Crohn’s should work with their doctors to develop a comprehensive treatment plan. This may include some at-home treatments.

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
  • over-the-counter medications advised by your doctor
  • disposable wipes

Pain relief

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 relieve pain. Ask your doctor about other alternative pain management recommendations, too.
  • Antidiarrheal 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.
  • 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.
  • Medicated mouthwash. Rinse and gargle with it to dilute the pain caused by mouth ulcers.
  • Moist heat. Use moist heat to help joint discomfort, and then set aside time for rest.
  • Physical therapy. Therapists can show you range-of-motion exercises to help relieve painful joints.

You can take a variety of preventive measures to make sure you stay healthy and strong. Try to stay physically active based on your doctor’s recommendations and, if you can, get a good night’s sleep.

Try to eat a nutrient-dense diet that doesn’t contribute to flares, and ask your doctor about vitamin and mineral supplements. A food diary can help you determine which foods cause you the most issues so you can aim to avoid them.

Aim to be as consistent as possible with your prescribed medications. 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. Smoking 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 were effective. Give a copy of your log 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.

Read this article in Spanish.