Crohn's Relapse: Coping when Your Crohn's Symptoms Return

Crohn's disease is a relapsing/remitting illness, as are many chronic illnesses. I can go for months with few or no Crohn's symptoms, then get hit with a relapse that knocks me off my feet. There is seldom much warning, and a relapse is always both frustrating and disappointing, along with the debilitating symptoms that come with Crohn's.

When my Crohn's symptoms return, the first thing I do is call or go in to see my doctor to find out what medications I may need. I'm always hoping there will be a new one or a cure, but no cure for Crohn's or any other inflammatory bowel disease (IBD) has yet been found. Most often, I am put on steroids if I haven't been taking them on a daily basis. Usually I take prednisone as an anti-inflammatory steroid for Crohn's, but there are others that can work. It often seems that different medications work better for different individuals, since no course of Crohn's disease seems to run the same. Depending on what my symptoms are, my doctor may also prescribe an anti-spasmodic such as Bentyl for the abdominal cramping that accompanies Crohn's, or prescribe an anti-diarrhea medication (or advise me to get an over-the-counter medication) to help with the diarrhea.

The next thing I do is reduce the stress that can come from obligations. I excuse myself from meetings, postpone dates with friends or family, and say, "no" when asked to do things such as usher at church (or at least say, "not this month"). Depending on the severity of the Crohn's symptoms, I may put my dogs in a kennel for a few days. My friends and family know that I have multiple chronic illnesses, so no one is particularly surprised when I do any of these things. Stress makes any illness worse, and it definitely makes my Crohn's disease worse.

An important coping method is to limit my diet to foods that I know are the least likely to irritate my intestinal system. (Unlike ulcerative colitis, which affects only the colon, Crohn's disease can affect the entire digestive tract.) Some of those foods are rice, apple juice, chicken and rice soup and toast. I try to avoid foods I know will make my Crohn's symptoms worse, which for me include raw vegetables and high fiber foods such as bran cereal, whole grain bread or too much sugar or fat. It isn't an exciting diet, but it helps me to feel more like myself.

Rest is an important factor for me in coping with Crohn's symptoms. If I am able to get uninterrupted sleep, which can be difficult given that one of the symptoms of Crohn's is diarrhea - and usually an explosive diarrhea that requires me to be in the bathroom - I will feel better. Even just lying down without sleeping can help.

One of the worst aspects of a Crohn's relapse for me is the feeling of frustration, or even failure, that the illness has come back again. There are very few people I can talk to about it, because really, unless they have the disease or live with someone who does, most people just don't understand Crohn's disease or what it's like to live with it. My counselor is a lifesaver for me; she doesn't have Crohn's, but she does understand what it's like for me, and she can help me to see that it isn't my fault. The support group that once met in my hometown was another great resource for talking to people who understand what I'm going through.

I try to remember when I'm mostly free of the symptoms of Crohn's disease that they can return without warning, and it doesn't always have anything to do with what I do or don't do. It's important to keep a positive attitude, whether I'm symptom-free or dealing with a relapse. State of mind plays an important role in any illness, at least for me. If I feel sorry for myself, and focus on the illness and the Crohn's symptoms or the fact that I'm having another relapse, it only seems to make the illness worse. The best coping mechanism is to focus on the fact that however trite it may sound, "this too shall pass," and focus on what I need to do to get better and stay that way.