Table of ContentsView AllTable of ContentsCommon TriggersManaging FlaresPrevention TipsWhen to Contact a Provider
Table of ContentsView All
View All
Table of Contents
Common Triggers
Managing Flares
Prevention Tips
When to Contact a Provider
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1. Stress
The vagus nerve connects the brain and gut. This connection allows signals to travel between your brain and nervous system and gut (the gastrointestinal, or GI, tract) in both directions. When psychological factors like stress affect your brain, they can also impact your digestive health. This can create a cycle in which stress worsens your symptoms of Crohn’s disease, which causes more stress. This chronic cycle of stress can make you more sensitive to pain signals from your gut and trigger symptoms.
2. Medications
Certain over-the-counter and prescription medications are linked with the onset of Crohn’s disease flares. The following medications can contribute to flares in the following ways:
3. Diet
Research indicates that eating certain foods can trigger symptoms in people with Crohn’s disease. However, the impact of certain foods differs from person to person. If you have Crohn’s disease, you must identify which foods trigger symptoms in order to avoid them. Some common trigger foods and beverages include:
4. Smoking
While the exact connection between smoking and Crohn’s disease isn’t fully understood, research indicates that you are likely to have more flare-ups if you smoke. Smoking with Crohn’s disease is also linked with having more severe disease and complications, includingstrictures(a narrowing in the bowel that can cause a blockage) andperianal disease(conditions in the area around your anus).
Smoking may be a factor in flare-ups because it affects your body in the following ways:
5. Infections
Bacterial and viral infections can act as triggers for a flare-up of Crohn’s disease.Clostridioides difficile(commonly referred to as C. diff) infection is a common bacterial gut disease that produces infectious colitis. As a result, C. diff is linked with worse clinical outcomes in people with inflammatory bowel disease (IBD) like Crohn’s and ulcerative colitis. If you have C diff, you need antibiotic therapy to eradicate the bacteria.
Norovirusis another common infection thought to trigger flare-ups in Crohn’s disease. Research suggests that most people with Crohn’s disease have a genetic mutation (a permanent change in DNA sequence of a gene) that makes their gut lining cells more vulnerable to damage from a viral norovirus infection, which triggers symptoms.
6. Environmental Irritants
There is evidence that a wide range of external environmental factors play a key role in the onset of symptoms of IBDs, like Crohn’s. These environmental irritants include:
7. Vitamin D Deficiency
Growing evidence indicates that vitamin D may play a key role in regulating flare-ups of IBD like Crohn’s disease. Studies show an association between vitamin D deficiency and greater disease activity. It is also linked with a higher risk of relapse.
8. Incorrect Medication Use
Missing a prescribed medication dose or taking a prescription medication incorrectly can also trigger Crohn’s flare-ups. Skipping a dose, doubling a dose, or weaning off a medication can increase your risk of symptoms recurring. It’s important to continue taking prescribed drugs for Crohn’s disease even during times of remission (when there is little to no disease activity) to avoid a flare-up.
9. Food Additives
10. International Air Travel
There is evidence that people with IBD often experience disease flare-ups during international air travel. Research shows that people most likely to have flare-ups during international air travel were those who had anelevation in levels of fecal calprotectin(a measurement of inflammation in the intestines) before air travel, a history of emergency room visits, and the presence of a comorbid (co-occurring) disease.
Crohn’s Disease And Flare Symptoms
How to Manage a Flare-Up
Depending on the severity of your Crohn’s disease, a flare-up can last from a few days to as long as a few months. Your healthcare provider can help you determine the best ways tomanage a Crohn’s disease flare-upand return to remission based on your condition.
You may be able to improve symptoms with the following treatment options.
Self-Care
Self-care treatments are conservative therapies that you can perform at home to relieve discomfort and promote healing. Some common self-care strategies to use for managing a flare-up include:
Medications
Prescription medications can help improve symptoms of a Crohn’s disease flare-up. The most common medications for flare-ups include:
Corticosteroids: Also known as steroids, corticosteroids slow the activity of your immune system and decrease inflammation. They include:
Aminosalicylates: These drugs contain 5-aminosalicylic acid (5-ASA), which helps control inflammation. They include:
Immunomodulators: These drugs reduce the activity of your immune system to reduce inflammation in your digestive tract. They include:
Other medications:
Bowel Rest
Bowel rest may be advised to treat severe flare-ups. This treatment involves restricting your diet for a few days to several weeks. During this time, you may be asked to limit your diet to aliquid dietthat contains nutrients. Or, you may receive nutrition through a feeding tube inserted into your stomach or an intravenous (IV) tube into your vein.
Vitamin Supplementation
People with Crohn’s disease often develop vitamin or mineral deficiencies due to gastrointestinal bleeding ormalabsorption. Common vitamin supplements that may be used to treat deficiencies ofvitamin D,calcium, andvitamin B12, all of which are absorbed in yoursmall intestine.
Surgery
Surgery may be necessary to treat complications and restore normal bowel function when other treatments are inadequate for flare-ups. Common surgeries used to treat Crohn’s disease flare-ups include:
Crohn’s Disease Facts and Statistics: What You Need to Know
Tips for Preventing Flare-Ups
Try the following tips for preventing flare-ups and reducing your risk of dealing with symptoms:
When to Contact a Healthcare Provider
Generally, you should contact a healthcare provider if you have any of the followingsymptoms during a Crohn’s flare-up:
Crohn’s Flare: Symptoms, Causes, When to Go to the Hospital
Summary
While several known triggers exist, they can vary from person to person and change over time. Knowing your triggers can help you work to reduce or avoid them.
Contact your healthcare provider when a flare occurs. While some flares can be managed with self-care, having bloody stools and other severe symptoms may require medical treatment. Your healthcare provider can help you determine the best way to manage symptoms for your condition.
15 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Peppas S, Pansieri C, Piovani D, et al.The brain-gut axis: psychological functioning and inflammatory bowel diseases.J Clin Med. 2021;10(3):377. doi:10.3390/jcm10030377Crohn’s & Colitis Foundation.Managing flares and other IBD symptoms.Crohn’s & Colitis Foundation.What should I eat?Crohn’s & Colitis UK.Smoking.Binion D.Clostridium difficileInfection and Inflammatory bowel disease.Gastroenterol Hepatol (NY). 2016;12(5):334-337.NYU Langone Health.Norovirus link to Crohn’s disease may point to new therapies.Abegunde AT, Muhammad BH, Bhatti O, Ali T. Environmental risk factors for inflammatory bowel diseases: Evidence based literature review.World J Gastroenterol. 2016;22(27):6296-6317. doi:10.3748/wjg.v22.i27.6296Park J, Yoon H, Shin CM, Park YS, Kim N, Lee DH.Clinical factors to predict flare-up in patients with inflammatory bowel disease during international air travel: A prospective study.PLoS ONE.2022;17(1):e0262571. doi:10.1371/journal.pone.0262571National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for Crohn’s disease.Owczarek, D.; Rodacki, T.; Domagala-Rodacka, R. et al.Diet and nutritional factors in inflammatory bowel disease.World J Gastroenterol.2015; 22(3):895-905. doi:10.3748/wjg.v22.i3.895NYU Lagone Health.Surgery for inflammatory bowel disease.Harvard Health Publishing Harvard Medical School.Living with Crohn’s disease: recognizing and managing flares.Hackensack Meridian Health.Managing Crohn’s disease: flare-ups and treatment options.Saint Luke’s.Discharge instructions for Crohn’s disease.Mount Sinai.Crohn disease — discharge.
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Peppas S, Pansieri C, Piovani D, et al.The brain-gut axis: psychological functioning and inflammatory bowel diseases.J Clin Med. 2021;10(3):377. doi:10.3390/jcm10030377Crohn’s & Colitis Foundation.Managing flares and other IBD symptoms.Crohn’s & Colitis Foundation.What should I eat?Crohn’s & Colitis UK.Smoking.Binion D.Clostridium difficileInfection and Inflammatory bowel disease.Gastroenterol Hepatol (NY). 2016;12(5):334-337.NYU Langone Health.Norovirus link to Crohn’s disease may point to new therapies.Abegunde AT, Muhammad BH, Bhatti O, Ali T. Environmental risk factors for inflammatory bowel diseases: Evidence based literature review.World J Gastroenterol. 2016;22(27):6296-6317. doi:10.3748/wjg.v22.i27.6296Park J, Yoon H, Shin CM, Park YS, Kim N, Lee DH.Clinical factors to predict flare-up in patients with inflammatory bowel disease during international air travel: A prospective study.PLoS ONE.2022;17(1):e0262571. doi:10.1371/journal.pone.0262571National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for Crohn’s disease.Owczarek, D.; Rodacki, T.; Domagala-Rodacka, R. et al.Diet and nutritional factors in inflammatory bowel disease.World J Gastroenterol.2015; 22(3):895-905. doi:10.3748/wjg.v22.i3.895NYU Lagone Health.Surgery for inflammatory bowel disease.Harvard Health Publishing Harvard Medical School.Living with Crohn’s disease: recognizing and managing flares.Hackensack Meridian Health.Managing Crohn’s disease: flare-ups and treatment options.Saint Luke’s.Discharge instructions for Crohn’s disease.Mount Sinai.Crohn disease — discharge.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Peppas S, Pansieri C, Piovani D, et al.The brain-gut axis: psychological functioning and inflammatory bowel diseases.J Clin Med. 2021;10(3):377. doi:10.3390/jcm10030377Crohn’s & Colitis Foundation.Managing flares and other IBD symptoms.Crohn’s & Colitis Foundation.What should I eat?Crohn’s & Colitis UK.Smoking.Binion D.Clostridium difficileInfection and Inflammatory bowel disease.Gastroenterol Hepatol (NY). 2016;12(5):334-337.NYU Langone Health.Norovirus link to Crohn’s disease may point to new therapies.Abegunde AT, Muhammad BH, Bhatti O, Ali T. Environmental risk factors for inflammatory bowel diseases: Evidence based literature review.World J Gastroenterol. 2016;22(27):6296-6317. doi:10.3748/wjg.v22.i27.6296Park J, Yoon H, Shin CM, Park YS, Kim N, Lee DH.Clinical factors to predict flare-up in patients with inflammatory bowel disease during international air travel: A prospective study.PLoS ONE.2022;17(1):e0262571. doi:10.1371/journal.pone.0262571National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for Crohn’s disease.Owczarek, D.; Rodacki, T.; Domagala-Rodacka, R. et al.Diet and nutritional factors in inflammatory bowel disease.World J Gastroenterol.2015; 22(3):895-905. doi:10.3748/wjg.v22.i3.895NYU Lagone Health.Surgery for inflammatory bowel disease.Harvard Health Publishing Harvard Medical School.Living with Crohn’s disease: recognizing and managing flares.Hackensack Meridian Health.Managing Crohn’s disease: flare-ups and treatment options.Saint Luke’s.Discharge instructions for Crohn’s disease.Mount Sinai.Crohn disease — discharge.
Peppas S, Pansieri C, Piovani D, et al.The brain-gut axis: psychological functioning and inflammatory bowel diseases.J Clin Med. 2021;10(3):377. doi:10.3390/jcm10030377
Crohn’s & Colitis Foundation.Managing flares and other IBD symptoms.
Crohn’s & Colitis Foundation.What should I eat?
Crohn’s & Colitis UK.Smoking.
Binion D.Clostridium difficileInfection and Inflammatory bowel disease.Gastroenterol Hepatol (NY). 2016;12(5):334-337.
NYU Langone Health.Norovirus link to Crohn’s disease may point to new therapies.
Abegunde AT, Muhammad BH, Bhatti O, Ali T. Environmental risk factors for inflammatory bowel diseases: Evidence based literature review.World J Gastroenterol. 2016;22(27):6296-6317. doi:10.3748/wjg.v22.i27.6296
Park J, Yoon H, Shin CM, Park YS, Kim N, Lee DH.Clinical factors to predict flare-up in patients with inflammatory bowel disease during international air travel: A prospective study.PLoS ONE.2022;17(1):e0262571. doi:10.1371/journal.pone.0262571
National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for Crohn’s disease.
Owczarek, D.; Rodacki, T.; Domagala-Rodacka, R. et al.Diet and nutritional factors in inflammatory bowel disease.World J Gastroenterol.2015; 22(3):895-905. doi:10.3748/wjg.v22.i3.895
NYU Lagone Health.Surgery for inflammatory bowel disease.
Harvard Health Publishing Harvard Medical School.Living with Crohn’s disease: recognizing and managing flares.
Hackensack Meridian Health.Managing Crohn’s disease: flare-ups and treatment options.
Saint Luke’s.Discharge instructions for Crohn’s disease.
Mount Sinai.Crohn disease — discharge.
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