Managing Symptoms & Flares of Inflammatory Bowel Disease

April 16, 2024

For most people, stressful events, eating certain foods, or drinking too much alcohol during  a night out isn’t a big deal. Most of our bodies can handle these situations, but for someone with an inflammatory bowel disease, it may cause major health issues. 

Ulcerative colitis (UC) and Crohn's disease are the two main forms of inflammatory bowel disease (IBD), and they are both characterized by chronic inflammation of the digestive tract. 

Crohn’s disease can affect any part of the gastrointestinal tract, as well as areas from the mouth to the anus. It most commonly impacts the end of the small intestine (ileum) where it links to the beginning of the colon. Ulcerative colitis symptoms reside in the large intestine (colon) only. It affects everyone differently, and symptoms range in severity. 

Oftentimes, we are able to manage the conditions, allowing patients to go into remission. For various reasons, it’s common for flare-ups to occur. As patients cycle through these times of remission and flares, there are strategies that can help manage symptoms when they arise.

Why Do Inflammatory Bowel Disease Flares Occur?

According to the Crohn’s and Colitis Foundation, a flare is the reappearance of disease symptoms. The most common symptoms of Crohn’s disease and ulcerative colitis include:

• Frequent and/or urgent bowel movements

• Diarrhea
• Bloody stool
• Abdominal pain
• Nausea and vomiting
• Weight loss

People also report symptoms such as fatigue, lack of appetite, joint aches, body aches,

rashes, and eye problems. The symptoms of IBD vary from person to person, and may change over time. Medical treatment is aimed at bringing the conditions into a state of remission and keeping it that way for as long as possible.  

However, flares do happen. There are several factors that may impact a flare and/or make symptoms worse, such as:

Missed Medications or Incorrect Dosing

Many people with IBD take medications on a regular basis, even when the disease is in remission. Flares can occur when medications are not taken as prescribed. If you are taking your medications as prescribed and still experiencing flares, it’s probably time for a visit with your doctor. It may be time to change dosage, frequency, or type of medication. 

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs, which include aspirin, naproxen, and ibuprofen, may lead to inflammation of the bowel and can make symptoms worse. For mild pain or to reduce a fever, we typically recommend that people with IBD take acetaminophen (Tylenol) rather than an NSAID.

Antibiotics

Antibiotics are good for treating bacterial infections, but they can alter the bacteria that normally live in the intestines. Changes in the balance of intestinal bacteria may cause diarrhea (such as antibiotic-associated diarrhea) or may lead to excessive growth of specific bacteria that can cause inflammation. 

Smoking

Smoking cigarettes raises the risk for developing Crohn’s disease and can also trigger flares. People with Crohn’s disease who smoke tend to have more disease activity and more surgery, and they often have a greater need for medications to control their disease. Crohn’s disease patients who have quit smoking report fewer flare-ups and a reduced need for medications to control their disease. 

Stress

Physical and emotional stress do not cause IBD. However, stressful situations or strong emotions may impact IBD symptoms. For those with IBD who know that stress can be a trigger, it may be helpful to be prepared for this reaction and to learn stress-management techniques.

Diet

While what you eat does not cause or cure IBD, paying attention to your diet may help you reduce symptoms, replace lost nutrients, and promote healing. But no one type of food or beverage aggravates symptoms for all people with Crohn’s disease or UC. Each person with IBD should determine which foods impact symptoms and which do not. Keeping a food journal may help you track how your diet relates to your symptoms. 

Tips for Managing Flares

You cannot completely prevent flare-ups of Crohn’s disease or ulcerative colitis. However,

in addition to taking your medications regularly and eating a well balanced diet, the following

tips may help you manage your disease during flares and remission:

• See your doctor regularly. Remember that the management of your disease is a partnership between yourself and your healthcare team. During times of remission, you will probably visit your doctor every six months. During times of flares, you may visit more often. 
• Monitor and track your disease. It is important to track your disease between medical appointments so that you and your doctor can see how IBD is impacting your life and determine if any changes need to be made.
• Be careful with what you eat. In general, when experiencing a flare, it’s best to avoid greasy and fried foods, which can cause gas and diarrhea. Some people find that foods high in fiber, such as fruits, vegetables, and whole grains, can be problematic.You may also want to avoid foods that are likely to cause gas, such as beans, cabbage, broccoli, caffeine, and carbonated drinks. Eating smaller, more frequent meals may be helpful. Alcohol intake, whether moderate or in excess, may also make symptoms worse. 
• Consider taking vitamins or supplements. Because Crohn’s disease and UC can impair the body’s ability to absorb vitamins, minerals, and other nutrients, it is important to get tested for vitamin and mineral deficiencies. As always, be sure to consult your doctor about which supplements are recommended and safe for you to take.
• Exercise. Regular exercise can improve overall health, and may be particularly beneficial for people with IBD. It can reduce stress and maintain and/or improve bone strength. Some research has also shown that exercise relieves depression and boosts the body’s immune system.. 
• Quit smoking. Smoking can make the symptoms of IBD worse and can make it more difficult to treat.
• Reduce stress. Managing stress can help you to stay calm and maintain

perspective. There are numerous stress-management techniques, and no one method has proven more effective than another. Find the one that works best for your lifestyle.

Let Alabama Colon & Rectal Institute Help Manage Inflammatory Bowel Disease

The key to managing Crohn’s disease or ulcerative colitis during remission or flares is to get a confirmed diagnosis and begin treatment as soon as possible. Our board-certified colon and rectal surgeons are highly-experienced and trained in a variety of colon and rectal conditions and diseases. 

Alabama Colon & Rectal Institute specializes in treating diseases of the colon, rectum, and anus. We are  experts in performing colonoscopies, anorectal surgery, and minimally invasive colon surgery. Our three doctors are known regionally for their expertise in these areas. Visit our website for more information, give us a call to make an appointment at 205-458-5000, or email us at [email protected].