What is a flare?
When disease symptoms have a sudden reappearance, this is what we call a flare. Patients with IBD can be symptom free for up to months at a time and then experience a flare without warning. Flares can come in many forms, which is why it is important for you to be able to recognize how they arise in your body and know what to do to help. According to the Crohn's & Colitis Foundation, the most common flares of IBD are:
- Frequent and/or urgent bowel movements
- Bloody stool
- Abdominal pain
- Nausea and vomiting
- Weight loss
Flares can also appear in less obvious forms such as fatigue, lack of appetite, joint pain, or rashes.
What is causing my flares?
Most of the time the exact cause of a flare is unknown. Although, there are several factors that are known to make symptoms worse. These are things all IBD patients should be aware of and take the steps to help reduce the possibility of a flare. Preventing flares before they occur with an effective medical maintenance regimen can change the path of your IBD. Intervention can prevent a severe flare and avoid having to admit you to the hospital or perform surgery.
Flares can be triggered by factors such as diet, medications, infections, antibiotics, stress, or underlying changes in the disease itself.
How can I manage my flares?
Food does not cause or cure IBD, but paying attention to your diet can help replace lost nutrients, promote healing, and reduce symptoms. Similarly, there is not one universal food that all IBD patients should stay away from. A helpful tip is to keep a food journal to track how your diet relates to your symptoms. This way you can easily see what foods bother you and what you should stay away from to prevent a flare.
As a general guide, it is best to avoid foods high in fiber such as fruits, raw vegetables, and whole grains, avoid greasy and fried foods, and foods that are likely to cause gas such as beans, cabbage, broccoli, caffeine, and carbonated drinks. Moderation of alcohol intake is also advised.
Missing intake your prescribed medications or taking an incorrect dosage is never a good idea. If you are taking your medications as prescribed and still experiencing flares, speak up and talk to your doctor about changing your dosage or the type of medication.
Non-steroidal anti-inflammatory drugs (NSAIDs) are also known to cause inflammation of the bowel. NSAIDs include aspirin, naproxen (Aleve®), and ibuprofen (Motrin®, Advil®, Nuprin®). It is recommended to take acetaminophen (Tylenol®) instead.
We know that reducing your stress is easier said than done, however there are a few simple things you can do to lead to less stress. The easiest is to make sure you are getting enough sleep. Additionally, taking just 30 minutes a day to practice yoga, meditation, or deep breathing can significantly improve your state of mind and reduce your stress levels.
The Crohn's & Colitis Foundation has also developed a symptom tracker that is easy to use. Incorporating a symptom tracker into your lifestyle can help you learn about your IBD and how manage it, and it can also help you doctor understand your symptoms better.
Symptom Tracker: https://www.crohnscolitisfoundation.org/sites/default/files/legacy/assets/pdfs/ibd-symptom-tracker.pdf
Crohn's & Colitis Foundation. Managing Flares and IBD Symptoms. (2020). https://www.crohnscolitisfoundation.org/sites/default/files/2019-07/managing-flares-brochure-final-online.pdf
Harvard Health Publishing, Harvard Medical School. Living with Crohn's disease: Recognizing and managing flares. (2019). https://www.health.harvard.edu/blog/living-with-crohns-disease-recognizing-and-managing-flares-2019112618410
Everyday Health. Is It a Crohn's Flare? How to Spot the Signs. (2019).