Crohn’s is an autoimmune disease that begins in the ileum, or small intestine. If you were able to see the inside of the small intestine during a Crohn’s flare up it would look like a mass of ulcers throughout the ileum. Imagine the pain of a canker sore in your mouth, multiply it times a hundred or more. Now, imagine that feeling in your intestines as solids, liquids, and gastrointestinal fluids pass through. Crohn’s is quite painful and can lead to other health problems.
Sometimes, when a Crohn’s patient has a flare up, it requires hospitalization. The usual course of treatment involves prednisone, total liquid diet or TPN (total parenteral nutrition – intravenous feeding), pain and nausea medications, and usually an antibiotic. There is no known cure for Crohn’s. Current treatments include Remicade infusions every six to twelve weeks, Humira injections, or medications like Asacol that aim to keep the bodies white blood cells from attacking itself. Both Remicade and Humira are rheumatoid arthritis medications that have been found to relieve symptoms of moderate to severe Crohn’s.
Most Crohn’s patients live and eat in such a way as to avoid a flare up. This includes avoiding nuts, high fiber foods, and other food that are difficult to digest. Crohn’s maintenance also requires learning to deal with stress in positive ways, such as meditation, exercise, and developing a positive outlook. A flare up can keep a Crohn’s patient in the bed, or hospital for days or weeks at the time. Complete recovery time is even longer.
Some Crohn’s patients have learned some of the best ways to weather a flare up, without spending weeks in the hospital. With the help of family and friends, a Crohn’s patient can recover more quickly and in the privacy and comfort of their own home.
Tips to Surviving a Crohn’s Flare Up
The first and perhaps the most difficult thing to do outside the hospital is to stop what you are doing and get in the bed. In order to recover, you must allow your body to use the energy you have available to heal itself. Total bed rest means just that, stay in the bed. Don’t get up and cook. Don’t get up and do laundry. Stay in the bed. Rest. Allow yourself time to recover.
Another very important step is to put yourself on a clear liquid diet. No cheating. No toast and crackers. Your bowels must have rest in order to recover. A clear liquid diet includes non-carbonated beverages (carbon aggravates the intestines), Jell-O, popsicles, and soup broth. Stay away from pudding and ice cream. If you need a little flavor in your diet try an Italian Ice or sherbet.
Stay hydrated. Your cells need an adequate supply of water to work adequately and optimally. Ideally, keep a 32 ounce cup of ice water by your bed. Sip water all day long. This is difficult for some people, but the importance of hydrating your body cannot be overstated. If you cannot handle water, drink tea, or Kool-Aid. Once or twice a day add a drink of Gatorade or Propel; these help replenish electrolytes. Cranberry juice seems to be helpful, stay away from citrus juices which will aggravate your intestines.
If you are going to recover from a flare up at home, you will still need your doctor’s assistance. You should have established rapport with one gastroenterologist, as well as a general internist, or family doctor. A serious Crohn’s flare up usually requires pain and nausea medications. The doctor will also determine if you need to start a course of antibiotics and/or prednisone. If you are given antibiotics or prednisone it is absolutely essential that you take the medication as directed. Complete the full course of medicine. Don’t stop taking the meds when you start feeling better. It is dangerous to stop taking prednisone without tapering off, and your body can build up immunity to antibiotics if you don’t take them as prescribed.
Your doctor may want to admit you to the hospital right away. Talk openly with your doctor. Your doctor is the medical expert, and you are the expert when it comes to how you feel. If you think you can weather it at home, tell your doctor. Make the decision together. If your doctor acts like the Gestapo, I’d recommend searching the Crohn’s and Colitis Foundation website for another doctor in your area.
If you have not dealt with a severe Crohn’s flare up before, or do not have the support of friends or family, it is probably in your best interest to stay in the hospital. However, if you have been down this road more than you care to recall, you probably have a good idea of how this flare up compares to others. You also know what it takes for you to recover.
Be prudent in your decision. If there is any risk of a fistula, internal bleeding, or an obstructed colon get to the hospital. Sometimes your digestion becomes sluggish due to inflammation, but if you feel that horrid sensation of food backing up, be careful. If a few days in bed doesn’t help you begin to feel better, you need to have your colon x-rayed. Flare ups leave behind scar tissue. If you have had a number of flare ups you may have developed a blockage from scar tissue and/or severe inflammation.
With rest, liquids, antibiotics, and meds, you may be able to recover without an extended stay at the hospital. Advance your diet slowly, a good rule of thumb is that when you feel ready to advance your diet, wait one more day. As you advance your diet move from clear liquids to full liquids, full liquids to soft food and from there back to your regular diet. Once you begin your regular routine, stop and rest as needed. If your intestines start acting up again, back your diet up.
These tips for surviving a Crohn’s flare up are meant to help if you recognize and treat a flare up toward the onset. If you have a high fever, cannot have a bowel movement, or your abdomen becomes more distended than usual due to Crohn’s, go to the hospital.
Crohn’s is a difficult disease to live with and manage. Unfortunately, when you have an autoimmune disease, your life does sometimes have to revolve around the disease. However, you can help maintain healthy intestines by caring for yourself, and keeping a positive mental attitude.
Here’s to you for hanging in there on the days you don’t feel well. Here’s to you keeping a positive outlook on life. Now, go get some rest when you need it.
