When you say “Crohn’s disease” to most people, the first symptom that comes to mind (if they know what the disease is) is diarrhea. It tops the list of symptoms in almost any information you find on-line or from your doctor. What that word doesn’t express is just how severe the diarrhea can be, and how very difficult it can be to live with.
The severe diarrhea of Crohn’s disease happens because the cells of the intestinal wall absorb lots of water and salt. Unfortunately, your colon can’t absorb that water into your body, so you end up with watery diarrhea, which is frequently “explosive.” If you have Crohn’s, you know what that means and how it feels; if you don’t, it’s pretty much what it sounds like. No matter how hard a person with Crohn’s tries to “hold it in” and get to the bathroom, that diarrhea is not controllable. It blows out. If you don’t like reading that, imagine how we feel living with it.
If you’re having a relapse or flare of Crohn’s disease, chances are that you are experiencing severe diarrhea. You are probably in the bathroom for anywhere from 5 to 20 minutes at a time (I’m basing this on my own experience; I couldn’t find any statistics, no matter how hard I searched), and when you leave the bathroom, you are probably back in it within 10 to 15 minutes. It is impossible to sleep very long when your diarrhea is severe. If you are trying to sleep, you should wear an “adult incontinence product” such as Depends TM because there’s a very good chance that at least once you won’t make it to the bathroom in time. I’m seriously considering getting an inflatable mattress to use in the bathroom when I’m having a flare; I wish that were a joke, but with the severe diarrhea of a Crohn’s flare, I don’t want to be in my own bed when I have to go, because when you have to go, you have to go NOW, not 15 or even 2 minutes from now.
There is little point in trying to travel or work with the severe diarrhea of Crohn’s. What you can do to make yourself feel a little better is to keep drinking water. This sounds like the exact opposite of good advice, but your gut needs the water to processes everything else that’s going on. You can also add fiber to your diet, or take a fiber supplement like Benefiber TM or MetamucilTM. If your severe diarrhea is resulting in literally dozens of bowel movements a day, it’s time to talk to your doctor. He or she may prescribe a medication like BentylTM which slows the muscle movement of the cramping. For severe diarrhea, he or she may prescribe loperamide (ImodiumTM) or even a deodorized opium tincture or codeine, which also help with the pain of the cramping that accompanies severe diarrhea. It is really important to discuss taking even over-the-counter diarrhea medications when you have Crohn’s disease, because there is a risk of something called “toxic megacolon,” which is an inflammation that can be life-threatening. Your use of anti-diarrhea medications should be monitored by your doctor to avoid that.
If you have Crohn’s, you know when your diarrhea has graduated from moderate, which may allow you to lead a fairly normal life, to severe. Don’t ignore it; it is better to stay home and avoid the stress of trying to hide it, which is impossible if it’s severe, or to get to a public bathroom, which may not be as clean or well-equipped as your bathroom at home. Diarrhea itself can be life-threatening if you go too long without treatment, causing you to become dehydrated and die. It isn’t something you can overlook.
Severe diarrhea is almost always going to be a part of a Crohn’s flare. But there are treatments from your doctor, and it will usually get better, although not as quickly as most of us would like.
