Managing the Acute Abdominal Pain That Comes with Crohn’s

The acute abdominal pain patients with Crohn’s disease suffer has to be one of the most severe forms of discomfort in the world. The only thing that comes close to it would be labor pains.

Sometimes acute abdominal pain starts slowly and rolls over the body in predictable waves, as the natural movement of peristalsis tries to push food through the digestive tract. When there’s an intestinal obstruction, either partial or complete, the pain is excruciatingly sharp with each wave.

At other times, the patient feels acute abdominal pain as a continual burning. This is caused by the inflammation of intestinal tissue that leads to ulceration. According to the National Digestive Diseases Information Clearinghouse (NDDIC), the most common symptoms of Crohn’s disease include abdominal pain and diarrhea.

In the nearly 30 years since I was diagnosed with Crohn’s disease, also known as ileitis, I have hit the doors of various hospitals more than 100 times. Although I’ve undergone five Crohn’s-related surgeries, the majority of my visits landed me smack in the middle of emergency rooms for pain. I agreed to have the first of several surgeries to remove sections of my small bowel when I felt such intense pain while driving that I had to get off the road.

Some patients are more prone to intestinal obstructions than others. My first gastroenterologist explained that the small bowel typically swells due to active Crohn’s disease or narrows as the result of scarring from burned-out disease. Regardless of which cause is operative, the result is narrowing, making it difficult for food to pass during a partial obstruction or impossible when there’s a total blockage in progress.

With either, the result is acute abdominal pain. It’s the kind of pain that causes you to collapse because it just hurts too much to try to be upright. Lying down brings almost no relief.

Over the years, I’ve found these remedies effective for the managing acute abdominal pain.

Deep breathing: Bring out the deep breathing and panting you used during labor and delivery. If you’ve never given birth, ask someone who has. She’ll be all too willing to show what to do.

Guided imagery and meditation: Food is not a good thing to picture when experiencing acute abdominal pain. I generally choose a favorite beach scene or flowers. Lots of people picture a waterfall. Others have a particular mantra or repetitive prayer that helps. You need to experiment a bit to find out what works for you.

Fasting: Withholding food and liquids is a must if you even remotely suspect your discomfort is due to an obstruction, partial or complete. Hold off for four or five hours and see what happens to the pain level. At that point, you’ll need to make a decision about whether to stay home or get treatment in the emergency room.

Pain pills: Sometimes a gastroenterologist or other medical provider will prescribe painkillers like Tylenol #3 or #4 for the patient to keep at home in small quantities. However, this almost never occurs unless the practitioner knows the patient’s medical condition and habits extremely well. Most of the time, over-the-counter medications won’t even begin to touch acute pain. It’s important to realize that narcotics for pain considerably slow down movement in the digestive tract. While this is a blessing if you’re making multiple trips to the bathroom every hour, the rest of the time, it can eventually make you constipated.

A blessed hypodermic: Crohn’s patients know when things have progressed so far that they need help for acute abdominal pain. The first stop should be contacting your physician to let him or her know what’s going on. If you have health insurance, your next step might be dictated by your policy. Should you go to the emergency room, expect to undergo still X-rays and most likely a CT scan to check for obstructions and the necessity of surgery. You should not hesitate to ask for the friendly syringe with a narcotic injected directly into your IV while waiting for the results.

Perspective: What has helped me the by far the most with acute abdominal pain has been the realization that other people have undergone exactly the same thing, maybe even worse, and lived through it. You might have a rare disease, but you’re not alone in your suffering.

Reference:

• National Digestive Diseases Information Clearinghouse web site