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Is It a Crohn’s Flare? How to Spot the Signs

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If you have Crohn’s disease, you might be symptom-free for weeks or even months. Then, without warning, you can experience stomach pains or a fever. Those are two possible symptoms of a flare — and it’s important that you take the right steps to manage them.

Other symptoms may include diarrhea, the urgent need to use the bathroom, a loss of appetite, and fatigue, according to the Crohn’s &ColitisFoundationofAmerica(CCFA).Thesesymptomsmaycomeonsuddenlyorslowly,theCCFAsays.Youcanhaveoneormoreofthesesymptomsearlyonorasyourflareprogresses.

Otherwarningsignsofaflare,likebloating,vomiting,rectalbleeding,orincontinence,arepossiblebutlesscommon, saysJamesF.Marion,MD,directorofeducationandoutreachattheSusanandLeonardFeinsteinInflammatoryBowelDiseaseClinicalCenteratMountSinaiHospitalinNewYork.

WhatCausesFlares?

“MostofthetimethecauseofaCrohn’sflareisunknown,”Dr.Marionsays.But,hesays,themostcommoncausesofflaresinclude:

  • Nonadherence:Nottakingyourmedicationsasinstructed
  • Medications:Takinganon-steroidalanti-inflammatorymedicines(NSAIDs)suchasaspirin,naproxen,andibuprofen
  • Diet:Eatingtoomuchofafoodthatthebowelcan’tprocessorhandle

Otherpossiblecausesofflaresinclude:

  • Smoking
  • Alcohol
  • Stress
  • Antibiotics,whichcanaltertheamountandtypeofbacteriathatnormallyliveinyourgut,triggeringdiarrheaorinflammation,theCCFAsays.

Thereareothercausesofflares:diseasecomplicationslikefissure,fistula,stricture,orabscess.Fissuresareoftentheresultoffrequentbowelmovements,theCCFAsays.Callyourdoctorifyounoticedrainageofmucusorstoolfromyouranusorfromanareaneartheanus(signofafistula);nausea,vomiting,orconstipation(possiblesignsofastricture,ornarrowingofasectionoftheintestine);orsevereabdominalpain,painfulbowelmovements,dischargeofpus,fever,oralumpattheedgeofyourrectumthat’sswollen,red,andtender(signsofabscess).Allmayrequireimmediateattention.

Aflarecanlastseveraldaysandgoawayonitsown.Oryoucanhaveaflarethatgetsprogressivelyworseandrequiressurgery,saysAshkanFarhadi,MD,agastroenterologistatOrangeCoastMemorialMedicalCenterinFountainValley,California.

PreventingflaresbeforetheyoccurwithaneffectivemedicalmaintenanceregimencanchangethepathofyourCrohn’sdisease,Marionsays.

“Withintervention,wecanpreventasevereflareandavoidhavingtoadmityoutothehospitalorperformsurgery,”Dr.Farhadiadds.

WhattoDoWhenYou’reExperiencingaFlare

Assoonasyoususpectaflareisoccurring,it’simportantthatyoutakestepstocontrolit.

That’sbecauseeachflarecanproduceaninjurytothebowel,Marionsays.FrequentCrohn’sflarescantriggercomplicationslikeintestinalobstruction,systemicproblems(anemia,boneloss,orclottingissues),orevencancer,hesays.

AlanSegal,69,wholivesnearAtlanta,hashadCrohn’sdiseaseformorethan40years.“I’vehaditlongenoughthatIcanrecognizewhenI’mhavingaroutineflare-uporit’ssomethingdifferent,”hesays.Ifit’saflare,Segalexplains,heiscarefultoavoidfoodsthatheknowscausehimtroubleandtostaynearbathrooms.Hemighttakeacetaminophen,ifnecessary,forthepain.

Nodietcanpreventorreducediscomfortfromflares,butthereareafewgeneralprinciplesthatmayhelp.IfyourCrohn’ssymptomsaremild,ablanddiet—bananas,whitebread,whiterice,applesauce,smoothpeanutbutter,potatoeswithoutskin,andsteamedfish—willbeeasieronyourdigestivetract,accordingtotheCCFA.Avoidingcaffeine,freshfruits,anduncookedvegetablesalsomayhelp; greasy and fried foods can also trigger a flare in some people.

Reducing stress is another smart strategy, Farhadi says. Make sure you’re getting adequate sleep and doing relaxing activities like yoga, meditation, and mindfulness, he says. Mindfulness-based therapy can help patients with inflammatory bowel diseases such as Crohn’s better manage their some of their bowel symptoms, according to a September 2014 study published in theJournal of Crohn’s and Colitis.

Over-the-counter medications may also help relieve some symptoms of flares. For example, anti-diarrheal medications can reduce the frequency of diarrhea episodes, while acetaminophen is generally a safe medication that can ease the pain. Just be sure to ask your doctor before taking these or other medications to ensure that they are safe for you.

Finally, your doctor may need to adjust your medications during your flare, Farhadi says. That’s why when you have Crohn’s, it’s important to have good communication with your gastroenterologist. “Your doctor can help you navigate and recognize the relapsing and remitting symptoms of your disease,” Marion says. And always let your doctor know if you have a change in symptoms, he adds.






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Date: 15.12.2018, 11:44 / Views: 44494