In the Event of a Flare-Up
Crohn’s disease follows a relapsing-remitting pattern, flaring up for periods of time and sometimes quietly disappearing for weeks or even years. At the height of an exacerbation, you may experience intense abdominal cramps, chronic diarrhea, rectal bleeding, and weight loss.
If you are experiencing symptoms you think could be related to Crohn’s disease, consider keeping a log of the foods you’re eating and when you’re having flare-ups. Dr. Chad Charapata, gastroenterologist on staff at CHI Memorial, says, “Symptoms of Crohn’s disease have significant overlap with other intestinal disorders such as ulcerative colitis, celiac disease, and irritable bowel syndrome. Consult your gastroenterologist for a history and physical exam so appropriate testing can be initiated.”
Tests range from blood tests that look at inflammatory and genetic markers associated with Crohn’s disease to CT scans that capture images of your entire bowel. “Initial testing usually includes a colonoscopy, which examines the terminal ileum (end of the small intestine) and colon,” explains Dr. Charapata. “If this exam is negative and symptoms continue, then small bowel imaging with MRI would be the next step.” Depending on the results, further testing may be required to confirm a diagnosis.
Dr. Camille Sommer
Gastroenterologist, Gastroenterology Associates of Chattanooga
If your gastroenterologist determines that you do have Crohn’s disease, he or she may try a spectrum of options to counter the symptoms. One or a combination of treatments may help calm a flare-up and also prevent more from occurring in the future. “Because Crohn’s is chronic or ongoing, treatment is also considered chronic, and there are a variety of medications available,” explains Dr. Kessler. “Medications are chosen based on disease severity and the patient’s risk profile with a goal of controlling inflammation, controlling symptoms, and healing the intestinal lining.”
Anti-inflammatory drugs such as corticosteroid therapy can be effective as a first line of defense. You may respond quickly to this type of medication, but it is not a long-term solution and should only be used to calm inflammation that occurs during a flare-up of Crohn’s.
Immunosuppressant therapies may also ease inflammation. They may be taken by themselves or in combination with each other to provide the best results. This is a long-term treatment method.
Antibiotics can be helpful when you have developed abscesses or fistulas (abnormal connections between organs and other structures) that need to heal. They may also reduce the development of dangerous bacteria in the intestines. Simple over-the-counter fiber supplements can counteract diarrhea by thickening your stool, while acetaminophen can relieve mild pain.
If you are experiencing poor quality of life in spite of these treatments for Crohn’s disease, talk to your doctor about how surgery may help. By removing the diseased portion of your gastrointestinal tract, colon, and/or rectum, a surgeon can take steps to preserve your bowel and overall comfort level.