Chron's Pre-Flare Signs: Cold Weather, Throbbing Muscles, Intestinal Gurgling & More

When I flip the calendar page to November every year, I assume a visitor is headed my way. My body confirms this fairly quickly.

For years, I insisted when cold weather arrived, so did a flare of my Crohn's disease. My doctors just shook their heads and shooed me out of emergency rooms. Today, medical professionals readily agree that Crohn's typically flares as winter seeps into autumn throughout most of the United States. Some patients report getting sick just as spring sends winter packing.

My brain causes a drum roll by sending a message to all my joints to torment me. Within a few hours, my muscles throb and my temperature starts climbing past 100 degrees F. My head tells what's left of my small intestine after three surgical resections to start gurgling and it begins acting definitely angry. Within 24 hours, my trips to the restroom soar from a few a day to multiples per hour. I might also experience night sweats and a few...well, accidents, while asleep. There's no mistaking what's happening.

I should note that I experience periodic flares of Crohn's disease despite years of the standard, indefatigable medications such as Asacol and daily doses of the immunosuppressive drug Imuran. While there appears to be nothing I can do to absolutely prevent the Crohn's flares, most of which are seasonal, there's a lot I can take to reduce their impact.

One practical step is to take an antihistamine such as Allegra. For many Crohn's patients, this has reduced the fire power of the flare. Some who take antihistamines are actually able to ward off seasonal Crohn's flares, but they appear to just soften the blow where I'm concerned.

When the unmistakable signs of a Crohn's flare appear, I shift into a different gear to protect my overworked remnant of a small bowel. For a period of three to five days, I cut back to a liquid diet to make digestion easier. Since, like many Crohn's patients, I'm lactose intolerant, I avoid products with cow's milk all the time. One delicious alternative is bottles of butter pecan-flavored Ensure. I also watch and wait to see if the Crohn's flare continues. On occasion, I have to add a course of a steroid such as Budesonide, typically a week or two.

If Crohn's spirals out of control, I experience heavy-duty abdominal cramping. By then, I am headed for a longer course of steroids, potentially Prednisone and all its nasty side effects in addition to my standard Crohn's prescriptions. Also in the picture: a likely hospital stay. However, if Crohn's calms down, I am able to progress to a low-residue diet with baked chicken and hard-boiled eggs as primary sources of protein. Diet or regular soda goes to the back of the pantry for the duration. Raw fruits and vegetables become the stuff of fantasies.

While married to my former husband, I saw firsthand the early warning signs of ulcerative colitis. He had suffered from the second imflammatory bowel disease (IBD), a cousin to Crohn's, since early childhood. As a result, he always knew when it was about to cause a commotion. Foods he could normally tolerate suddenly caused a tremendous amount of flatulence. He experienced bleeding and horrendous headaches. His temperature quickly rose a few degrees.

Between bouts of cramps, he spent 30 to 45 minutes in the bathroom at a time. Although this made it difficult to make it to the graduate classes he took as well as those he taught, he always toughed it out and relied solely on a conventional drug without turning to steroids. Both of us also learned to be vigilant in avoiding sugar during flares. The substances most patients recognize as causing diarrhea include caffeine, alcohol, tobacco, and sugar.

Each of us also made it a point to get extra sleep once we were convinced we were heading into a flare and made sure we alerted each of our doctors as to potential disease activity. While this sometimes resulted in quick trips to the office for a face-to-face appointment, more often than not, our information went on our respective charts for discussion at our regular three- to six-month appointments.

Although removal of the colon will cure ulcerative colitis, there is no cure for Crohn's disease. Between 75 to 80 percent of Crohn's patients will experience a relapse, according to the Crohn's Colitis Foundation of America (CCFA). Incidence of Crohn's patients who experience just one episode in their lifetimes are extremely rare. Therefore, it's unrealistic to think you'll never experience another flare of Crohn's or ulcerative colitis after being diagnosed.

It's very important to realize that being emotionally unstable doesn't cause either Crohn's or ulcerative colitis to flare, and neither does eating a particular food or food group. According to the CCFA, the estimated cost of IBD for the 1.4 million Americans who suffer from it is between $1.8 and $2.6 billion a year.

Understanding that you are likely to experience a surge in activity in either Crohn's or ulcerative colitis from time to time is crucial to avoid emotional and physical exhaustion. Taking simple steps such as tailoring your diet to the flare, getting extra rest, and keeping in close contact with your gastroenterologist can make them more bearable.