How to Keep Crohn's Disease in Remission
Staying on track with medications and healthy lifestyle choices can help keep the symptoms of Crohn's disease at bay for months or even years.
Crohn’s disease is an autoimmune condition that primarily attacks the gastrointestinal tract but can also involve other parts of your body. Symptoms can include abdominal pain, diarrhea, fatigue and weight loss. Crohn’s symptoms can worsen for periods of time called flares. However, with the right treatment, Crohn’s symptoms can also disappear for months or even years; this period of calm is called remission. Although everyone’s Crohn’s is different, following your treatment plan diligently can help you keep symptoms at bay.
It’s helpful to recognize the symptoms of a flare early to start treatment as soon as possible. Because Crohn’s disease can affect other parts of your body, like your mouth, skin and joints, it is important to have a close relationship with your gastroenterologist and primary care doctor. They can help identify what’s a flare and what is not.
During a flare, your doctor may prescribe antibiotics, steroids and other anti-inflammatory medications to combat the active inflammation. This medication regimen may last days to months. Most treatments can be taken at home; if severe symptoms are present, it is recommended to be monitored in the hospital.
After a flare, some type of medication is usually continued to prevent new or worsening symptoms and maintain remission. These medications may include:
- Anti-IL12/23 like ustekinumab (Stelara) and risankizumab (Skyrizi)
- Immunomodulators like mercaptopurine (6-MP) and azathioprine (Imuran)
- Biologic therapies like infliximab (Remicade) and adalimumab (Humira)
- Small molecule drugs like upadacitinib (Rinvoq)
All three classes of medication have a unique way to prevent inflammation. Taking these medications as prescribed by your gastroenterologist is important to prevent another flare-up. The medicines may require frequent monitoring of infections, side effects and lab studies. Patients with severe Crohn’s may be evaluated for surgery to help control the disease better.
Changing your habits will benefit your overall health and help keep your Crohn’s in remission.
- Stop smoking. Smoking worsens Crohn’s disease (and a lot of other medical conditions).
- Exercise regularly. Try walking 30 minutes 4-5 times per week.
- Avoid NSAIDs, like ibuprofen and naproxen. These are known to worsen Crohn’s disease.
- Consider a food diary. Some people may notice that certain foods increase their symptoms during flares. Avoiding “trigger” foods may help manage symptoms.
Crohn’s disease impacts more than just your gastrointestinal system. Side effects of Crohn’s can cause problems that affect your whole body, including:
- Malnutrition. People with Crohn’s have a hard time absorbing key nutrients from food, which can lead to malnutrition. Seek help from a nutritionist or dietitian to ensure that you’re eating a well-balanced diet.
- A weak immune system. Crohn’s disease and medications can weaken your immune system so it’s not as capable of fighting infections. Make sure to stay current on vaccinations, especially flu and pneumonia vaccines.
- Osteoporosis. When medications like steroids are used to treat flares on a regular basis, there is a concern about bone loss, also known as osteoporosis. Testing for osteoporosis is important to discuss with your gastroenterologist and primary care doctor.
- Cancer. Crohn’s disease is known to increase the risk of certain cancers. People with Crohn’s should be screened for colon cancer more often than the general population. Women with Crohn’s should be tested for cervical cancer on a regular basis. Certain medications may increase the risk of different cancers as well; talk with your gastroenterologist or primary care doctor to learn more about your treatment options. Also, it's important to schedule a yearly check up for skin cancer. Immunomodulators and biologics are associated with an increased risk of skin cancer.
Crohn’s affects everyone differently, so it’s important to understand your individual condition. What works for some Crohn’s patients may not be as effective for others. However, by working closely with your gastroenterologist, you can find the right treatment plan to keep your Crohn’s symptoms in remission.