After a flare-up of your Crohn disease, you may be more tired and have less energy than before. This should get better. Ask your health care provider about any side effects from your new medicines. You should see your provider regularly. You may also need frequent blood tests, especially if you are on new medicines.
If you went home with a feeding tube, you will need to learn how to use and clean the tube and your skin where the tube enters your body.
When you first go home, you may be asked to drink only liquids or eat different foods from what you normally eat. Ask your provider when you can start your regular diet.
You should eat a well-balanced, healthy diet. It is important that you get enough calories, protein, and important nutrients from a variety of food groups.
Certain foods and drinks can make your symptoms worse. These foods may cause problems for you all the time or only during a flare-up. Try to avoid foods that make your symptoms worse.
If your body does not digest dairy foods well, limit dairy products. Try low-lactose cheeses, such as Swiss and cheddar, or an enzyme product, such as Lactaid, to help break down lactose. If you must stop eating dairy products, talk with a dietitian about getting enough calcium.
Too much fiber may make your symptoms worse. Try baking or stewing fruits and vegetables if eating them raw bothers you. Eat low-fiber foods if that does not help enough.
Avoid foods that are known to cause gas, such as beans, spicy food, cabbage, broccoli, cauliflower, raw fruit juices, and fruits, especially citrus fruits.
Avoid or limit alcohol and caffeine. They may make your diarrhea worse.
Eat smaller meals, and eat more often. Drink plenty of liquids.
Ask your provider about extra vitamins and minerals you may need:
Iron supplements (if you are anemic)
Calcium and vitamin D supplements to help keep your bones strong
Vitamin B-12 shots, to prevent anemia.
Talk with a dietitian, especially if you lose weight or your diet becomes very limited.
You may feel worried about having a bowel accident, embarrassed, or even feel sad or depressed. Other stressful events in your life, such as moving, job loss, or the loss of a loved one, can cause problems with your digestion.
These tips to help you manage your Crohn disease:
Join a support group. Ask your provider about groups in your area.
Exercise. Talk with your provider about an exercise plan that is right for you.
Try biofeedback to reduce muscle tension and slow your heart rate, deep breathing exercises, hypnosis, or other ways to relax. Examples include doing yoga, listening to music, reading, or soaking in a warm bath.
See a mental health professional for help.
Your provider may give you some drugs to help relieve your symptoms. Based on how bad your Crohn disease is and how you respond to treatment, your provider may recommend one or more of these drugs:
Anti-diarrhea drugs can help when you have very bad diarrhea. Loperamide (Imodium) can be bought without a prescription. Always talk to your provider before using these drugs.
Fiber supplements may help your symptoms. You can buy psyllium powder (Metamucil) or methylcellulose (Citrucel) without a prescription. Ask your provider about these.
Always talk to your provider before using any laxative medicines.
You may use acetaminophen (Tylenol) for mild pain. Drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn) may make your symptoms worse. Talk to your provider about medicines you can use. You may need a prescription for stronger pain medicines.
There are many types of drugs that can help prevent or treat attacks of your Crohn disease.
When to Call the Doctor
Call your health care provider if you have:
Cramps or pain in your lower stomach area
Bloody diarrhea, often with mucus or pus
Diarrhea that cannot be controlled with diet changes and drugs
Weight loss (in everyone) and failure to gain weight (in children)
Rectal bleeding, drainage, or sores
Fever that lasts more than 2 or 3 days, or a fever higher than 100.4°F (38°C) without an explanation
Nausea and vomiting that lasts more than a day
Skin sores or lesions that do not heal
Joint pain that keeps you from doing your everyday activities
Side effects from any drugs prescribed for your condition
Dassopoulos T, Sultan S, Falck-Ytter YT, Inadomi JM, Hanauser SB. American Gastroenterological Association Institute technical review on the use of thiopurines, methotrexate, and anti-tnf-a biologic drugs for the induction and maintenance of remission in inflammatory crohn's disease. Gastroenterology. 2013 Dec;145(6):1464-78. PMID: 24267475 www.ncbi.nlm.nih.gov/pubmed/24267475.
Sands BE, Siegal CA. Crohn's disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 111.
Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.