As you can imagine, talking about Crohn’s disease becomes taxing, especially at parties. No one really wants to hear about bowel movements at the best of times. Right? Right! But I’ve decided to let you all in on a little secret. I’ve lived with Crohn’s disease for most of my adult life – and have had my fair share of flare-ups over the years.

Crohn’s disease is arguably one of the most puzzling conditions out there, which is why it’s so important to educate yourself about Crohn’s in order to best manage the symptoms and reclaim a sense of normalcy. Just when you think you know everything there is to know about Crohn’s it comes back to bite you in the butt (often with vengeance). Welcome to the world of Crohn’s Disease.

What is Crohn’s disease?

When it comes to understanding Crohn’s disease, it can be challenging navigating through the streams of information available online, most of which is written in medical jargon that’s difficult to make head or tail of. Simply put, Crohn’s disease is a condition that causes parts of your intestine to become inflamed and incredibly painful. It’s chronic, which means it lasts a very, very long time. The odd thing about Crohn’s is that the pain is not always consistent. You’ll have good days. You’ll have bad days. And, sometimes, you’ll have those in between days where the pain is there, but it’s manageable.

CROHN’S IS MORE COMMON THAN YOU MIGHT THINK

While Crohn’s is said to be a ‘rare’ disease, it actually affects numerous South Africans, with about seven in every 100 000 diagnosed with Crohn’s in SA each year. That’s roughly 3 500 new cases in 365 days. While the signs and symptoms of Crohn’s can differ, a few common signs many sufferers experience are blood in the toilet, on toilet paper, or in the stool, diarrhoea, nausea or vomiting, fever, low energy, skin tags, sores, joint pain ,mouth sores, weight loss, malnutrition and severe abdominal pain.

Despite tons of research, the exact cause of Crohn’s disease is still not clear. Experts say it is probably a combination of genetics (so blame your family tree), the immune system, and something in the environment that triggers inflammation in the gastrointestinal tract.

F is for F-Flare-ups!

If you have Crohn’s, you’ll know the term ‘flare-ups’ well. Almost everyone with Crohn’s disease will experience a flare-up at some point. It is important to recognize symptoms of a flare and to manage flares when they do happen. One of the best ways to do this is to have a good sense of your baseline symptoms at remission and how your Crohn’s disease manifests when it is more active.

How to recognise Crohn’s disease flare-ups

Flare-ups can hit out of the blue, or be triggered by various factors. These may (or may not) include changes in your diet, new medications, infections and antibiotics, stress, and even changes in the underlying disease itself. Sometimes you’ll know what your triggers are, but other times, you won’t. That’s the nature of the beast when it comes to Crohn’s – it’s often unpredictable. From personal experience, I’ve found that when I was struck with a flare-up, focussing on strength maintenance and low-impact activities such as walking did help with symptoms. I also found it was important to work on one muscle group at a time, rest when you I needed to, and stop when my body told me to.

WHEN TO CALL YOUR DOCTOR

The biggest lesson I learnt on my journey with Crohn’s is that if you are unsure of something, don’t be afraid to speak up. You should contact your doctor if you think you are experiencing a flare so he or she can test to see if the flare is due to an infection or determine if any new medications or exposures, such as recent antibiotics, might have triggered the flare. In the absence of illness (or another reversible cause of the flare), your gastroenterologist may recommend a treatment course.

HOW FOOD AND STRESS AFFECTS CROHN’S DISEASE FLARES

“Don’t eat pizza, don’t drink milk, stay away from curry, eat lots of kale even if you don’t like it”…okay, let’s stop right there. Yes, there are some additional measures you can take to help manage flares when they do occur but don’t believe everything you hear when it comes to Crohn’s disease. While it is true that the two most significant causes of flares are stress and diet, neither directly cause Crohn’s but they can impact IBD symptoms. Many people with Crohn’s disease find the regular use of stress management and stress reduction techniques to help. These can include meditation, deep breathing, biofeedback, yoga, and cognitive behavioural therapy. There is also no specific diet that prevents or cures Crohn’s disease, but you may identify particular foods that tend to worsen your symptoms. Keeping a food journal can help you make these connections.

Five foods that can bring on a flare – (although everyone is different)

Avoid greasy and fried food.
Limit foods that are high in fibre, such as raw vegetables and whole grains.
Avoid foods that tend to cause gas (beans, cruciferous vegetables).
Limit your diet to well-cooked vegetables.

Minimize caffeine and alcohol. They may make symptoms worse during a flare.

The bottom line

Even with the best lifestyle changes, if you have Crohn’s disease, odds are you will experience a flare at some point or another. Carefully monitoring and tracking symptoms every day will help you recognise a flare-up when it begins so you can nip it in the bud. Let your gastroenterologist know about a flare-up and to be sure to follow recommendations for medications and tests. Dietary and lifestyle modifications can also help manage flare-ups when they do occur.

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