This week we have a great guest post from Harley Petrina and Max Gottlieb of https://www.seniorplanning.org/ discussing some background information and important knowledge about Crohn’s Disease and potential disease management tips in order to ensure that individuals newer to dealing with Crohn’s or friends/family/employers of individuals with Crohn’s disease have a better overall understanding of the condition and how they can be most supportive. I hope you enjoy and learn something from the article below and would love to hear your thoughts or feedback.
Contrary to popular belief, Crohn’s disease doesn’t just negatively affect the bowels. Crohn’s disease impacts the entire gastrointestinal tract. This means it can involve everything from the colon to the mouth (canker sores/heartburn) and even the eyes. It is a chronic autoimmune disorder, meaning the body mistakenly attacks healthy cells, which inflames and hinders the body’s digestion ability. As it is chronic, the disease involves significant lifestyle changes.
Prior to diagnosis, symptoms vary, but a person may notice things like abdominal cramps, frequent diarrhea, stunted or delayed growth in children, fatigue, weight loss incongruent with diet, fever, and anemia. Also, it generally appears early in life, usually around 15 years old according to Johns Hopkins School of Medicine. Doctors think it may be genetic since oftentimes members of the same family are affected and it disproportionately affects Jewish people.
To make matters more complicated, there is not simply one type of Crohn’s disease, which is why it can take anywhere from nine months to two years to diagnose. There are five types, including Ileocolitis (the most common form), Ileitis, Crohn’s colitis, Gastroduodenal Crohn’s, and Jejunoileitis. Each type causes inflammation to a different part of the intestines and some can even lead to the formation of fistulas. To diagnose, a doctor will perform a physical exam as well as laboratory tests. Once diagnosed, treatment can begin. While there is currently no cure, treatment is necessary to control symptoms and complications associated with Crohn’s.
Flare-ups are triggered by a variety of factors, including medication changes, dietary variations, infections, illnesses, stress, and even changes in the type of Crohn’s disease itself. For some people, they can identify and avoid their trigger, but for others, the triggers remain unknown.
The main thing is to have an idea of what the standard symptoms are when the body is in remission, or in-between flare ups. Remission can last anywhere from days to years so it helps to take note and track things like bowel movements, symptoms, food choices, and medications during remission and during a flare up. The Crohn’s & Colitis Foundation has even created a handy symptom tracker.
If your disease is becoming more active or you are experiencing a flare up, you should contact your doctor at the first sign. The sooner the better so they can test to see if the flare up is being caused by an infection, or by any new medications or antibiotics. If the flare up cannot be reversed, the doctor may prescribe a course of corticosteroids. Likewise, a flare up may also be signaling that your current form of treatment is no longer working against the disease. For example, if you are taking immunomodulator or biologic medications like Remicade or Humira, your body may stop responding, which would be signaled by a major flare. A doctor would perform tests to verify if this is the case and if so, prescribe different medication.
Beyond Crohn’s specific pharmaceutical medications, dietary and lifestyle changes can also help improve remission times and reduce the severity of flare ups.
- Avoid Nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen or naproxen, commonly branded as Aleve. These medications reduce the ability of the GI tract to protect and heal itself, and can trigger a flare. Likewise, when taken in high doses, these medications can cause ulcers as well as cause liver damage. If you are trying to reduce pain, take acetaminophen instead of NSAIDs.
- Quit Smoking. Full stop. Smoking is terrible for a variety of reasons, but it has been shown to be a strong risk factor for developing Crohn’s and is connected to flare ups. For people with Crohn’s, quitting smoking is sharply linked with fewer flare ups and decreased medication requirements.
- Implementing stress reduction strategies in your daily routine can help fend off frequent flare ups. Although stress does not cause Crohn’s, stress is thought to be precipitate a flare up. Reducing stress can take the form of breathwork, yoga, meditation, and even behavioral therapy.
- Although diet also does not cause Crohn’s disease, some people report that certain foods worsen their Crohn’s symptoms. Many people eliminate things like dairy or greasy foods. Elimination diets can help increase remission times or reduce the symptoms associated with a flare up. Caffeine, alcohol, foods that cause gas, and foods that are too high in fiber should also be eliminated or eaten in moderation, especially during a flare.
The unpredictable nature of Crohn’s disease makes it an incredibly hard disease to cope with, both emotionally and physically. Although it can be extremely difficult, it is helpful to let family and friends know what you are going through with Crohn’s disease. Many people are unfamiliar, so educating them will allow them to be supportive when there is a flare up. Since the disease is chronic, employers should also be aware that you may have to take time off due to flare up symptoms. Although it seems embarrassing, being open up-front will let others know what to expect and can make your life drastically easier during a time when your body is feeling terrible.
(Max Gottlieb is the content manager of Senior Planning. Senior Planning is a free Arizona service designed to help seniors make the transition into new living arrangements or find the benefits they need.)
If you are struggling with the food management portion of your Crohn’s Disease please feel free to reach out to myself at https://denversdancingdietitian.com or any other Registered Dietitian with experience and knowledge of Crohn’s Disease.
Wishing you a healthy rest of your week,
–Ricci-Lee Hotz, MS, RDN
Denver’s Dancing Dietitian
A Taste of Health, LLC
“Improving Quality of life one bite at a time”