Crohn's Relapse: 11 Tips for Dealing with the Return of Crohn's Symptoms

Only one thing is certain about relapses of Crohn's disease: They usually occur without much warning.

According to the Crohn's Colitis Foundation of America (CCFA), the cause of the disease remains unknown, and there is no medical cure. Patients suffer a relapse rate around 75 to 80 percent. No drug has proven effective in preventing relapses, and most patients I've met consider it futile to try to control them.

The only folks who can predict a relapse with any degree of certainty are the Crohn's patients who flare each year when autumn temperatures fade into the cold of winter. I'm one of them.

The signs of a relapse often are unmistakable. That familiar cramping as you run, not walk, to the bathroom is a giveaway. So are those aching joints, the rumbling gut, the fever and the overall malaise that makes you want to crawl back under the covers for a few weeks.

When it feels as though you're heading into a relapse, there are some definite steps you can take to make yourself as comfortable as possible.

Use a few days to assess the situation. Don't panic. If the symptoms pass after three or four days, either you were fortunate to have had a very short but real relapse or your gut simply got a bit angry. The latter happens frequently to those of us with shortened small intestines after repeated surgical resections to remove diseased tissue.

Adjust your food intake. You want to make it as easy as possible for your gut to digest the food you swallow. This is not the time for Oriental salads or popcorn. Go for bland and low-residue foods. It's easy to locate both types of diets on the Internet if your doctor hasn't given you the information. Eat small portions every few hours instead of full meals three times a day. Since the body is less able to digest food late in the day, I avoid eating after 8 p.m.

Call in the troops. Have your diary or calendar in hand when you call your physician to report symptoms of Crohn's activity. If you reach voicemail, which seems to be the norm in most medical practices these days, allow the staff 48 hours to get back to you unless you've left a message that you're experiencing an emergency. If that's the case, get some family members or friends to help you scurry off to the emergency room. Make sure to bring your diary and a list of all current medications you take for inflammatory bowel disease (IBD), plus a change of clothing in case you have to stay overnight.

Practice deliberate relaxation. Whether it's deep breathing or visualization, techniques to reduce stress will calm your sore gut and allow it to function better. Pick the method that works best for you, and use it every few hours. Some patients report it can actually lower the level of pain.

Get extra rest. You are suffering from a relapse of a major illness. Try going to bed at least one hour earlier each night. If you have time before dinner, take a short nap.

Bring down the fever. Once you've taken your temperature for a few days, you obviously know if you have a fever. Use over-the-counter medication to reduce it and make yourself more comfortable.

Drink lots of fluids. If you're experiencing diarrhea during the relapse (who doesn't?), to avoid becoming dehydrated, you need to replenish the extra fluids you've lost. Drink at least eight glasses of water or decaffeinated liquids a day. This is the time to banish to the back of the pantry cola drinks and those with artificial sweeteners, because they increase diarrhea. The greatest offenders for causing hurried trips to the restroom include caffeine, alcohol, tobacco and sugar.

Carry some extra underwear. When ya gotta go, ya gotta go. Accidents happen. Keep a spare set of underwear in a large zippered plastic bag in your car or tote bag. Gals might want to add an extra pair of pantyhose. Use the plastic bag for storing soiled clothing. Now is a great time to haul out your oldest underwear.

Seek comfort in numbers. Whether you tell others you're experiencing a Crohn's relapse or keep it a secret (if symptoms will allow this), take comfort in the fact that most patients periodically flare. You aren't the only one.

Be open to new ideas. If your physician suggests a different medication, at least research it before protesting. Has the dosage of a current medication changed? Try it for a week or so before deciding it was a bad idea.

Participate in a support group. If you haven't already joined one, now's the time. Make sure you don't just take from the group. Find somebody else even sicker than you are, and be willing to give by just listening. If there's no formal group in your area, use the Internet to find a Crohn's site with lots of willing buddies, or locate blogs of patients who suffer from IBD.