Remission and Relapse Cycle in Crohn’s

Overview of Crohn’s Disease

Crohn’s disease is a type of chronic inflammatory bowel disease (IBD) that is marked by inflammation of the gastrointestinal tract. Crohn’s can affect any part of the digestive tract, starting from the mouth all the way down to the anus. However, it is most commonly known to affect the end of the small intestine.(1)
Crohn’s can also affect your eyes, skin, and joints.

Some of the common symptoms of Crohn’s disease include:(2)

  • Frequent and recurring diarrhea
  • Rectal bleeding
  • Bloody stools
  • Abdominal cramping and pain
  • Fever
  • Unexplained weight loss
  • Loss of appetite
  • Fatigue and an overall feeling of low energy

There is no cure for Crohn’s disease and being a chronic and progressive disease, most patient will keep experiencing symptoms on and off throughout their life.

In order to manage the symptoms of the disease, it is essential to understand the remission and relapse cycle of Crohn’s. Read on to learn more about this.

Remission and Relapse Cycle in Crohn’s

Crohn’s disease causes inflammation, and it can happen anywhere throughout the digestive tract. Most commonly, though, the inflammation affects the end of the small intestine, known as the ileum, and the beginning of the colon or the large intestine.

Even while undergoing treatment, people who have Crohn’s disease will keep suffering from flare-ups, which are periods during which the disease symptoms become intense or very active.

These flare-ups of symptoms can last for several weeks to even a couple of months. During this period, you can experience mild symptoms such as mild cramping and diarrhea, or you can also experience severe symptoms such as bowel blockages and severe abdominal pain and cramping.

A period of Crohn’s flare-up is usually followed by a period of remission, during which no symptoms of the disease are noticeable. This does not mean, though, that the disease has been cured. It only means that during remission, the lining of the gastrointestinal tract is healing, and due to this, there are no signs of inflammation, which cause the symptoms.

Remission can last for a period of a few days to even a couple of years. The ultimate goal of Crohn’s treatment that your doctor will be focusing on is to achieve and maintain remission for as long as possible.

It is essential to keep in mind that even while you are in remission, you will still need to continue taking your medication.

Treating Crohn’s Disease

The ultimate goal of treatment for Crohn’s is to achieve and prolong the period of remission. Treatment revolves around two phases. The first phase is induction, during which your doctor tries to get your symptoms under control and the disease into remission.

The second phase is known as maintenance therapy, during which the focus is to keep a person in remission for as long as possible,

There are many medications, such as corticosteroids, that are used in the first phase for induction. There are other drugs that are prescribed for maintenance therapy. Some medicines, including biologics, are used during both the stages of treatment.(3)

It is essential that you continue taking whatever therapy and medications your doctor has prescribed, regardless of the fact that you stop experiencing your symptoms. Missing your drugs can cause the symptoms to return more aggressively.

Once your doctor has established that there is no digestive inflammation remaining and the gastrointestinal tract has healed, only then will you be able to cut down on your medications, or stop taking some of the drugs. However, this should only be done under the guidance and supervision of your medical team, never by yourself.

Identifying the Flare Triggers of Crohn’s

In many cases, it is not easy to understand what caused the Crohn’s to flare-up. Flare ups can still happen even when you are taking your medications and following all your doctor’s advice.

You might experience the same type of digestive issues you experienced before when you were first diagnosed with Crohn’s disease, or you may even experience new symptoms.

There are a couple of known triggers for a flare-up of Crohn’s that you should be aware of and watch out for. These include:

  • Missed Medications: The most common trigger for a flare-up is missing your medication. Most patients of Crohn’s disease have to take medications on a daily basis, even during the periods of remission. These medications are for keeping the symptoms at bay and for maintenance of the disease during the remission phase. It is quite common for any person to miss a dose or two of their medications; however, going for an extended period of time without taking your prescribed drugs can cause a flare-up of your Crohn’s symptoms. This is why it is so important to follow what your doctor says and to keep taking your medications, even if you are feeling fine.
  • Use of NSAIDs (non-steroidal anti-inflammatory drugs): Some of the commonly available pain killers belong to the class of drugs known as NSAIDs. These include naproxen (brand name: Aleve), aspirin, and ibuprofen (brand name: Advil and Motrin). Taking NSAIDs in any type of inflammatory bowel condition can prove to be a cause of flare-up of your Crohn’s symptoms. It is believed that NSAIDs further aid in the inflammation, aggravating your symptoms.
  • Stress: Stressful situations or any type of strong emotions you are bottling up inside can also lead to a Crohn’s flare-up. While it is impossible to eliminate all stressful conditions in our life, but it is possible to change the manner in which you react to these situations. Also practicing stress-relieving activities such as yoga and meditation can help lower your stress levels.
  • Antibiotic Usage: Using antibiotics that too without your doctor’s approval, can lead to a change in the bacteria that is present in your intestine. Regular use of antibiotics, over a period of time, also kills off the friendly gut bacteria. This can cause inflammation along with symptom flares in many people who have Crohn’s disease.
  • Smoking: It is known that people who are regular smokers tend to experience more Crohn’s flare-ups than non-smokers.
  • Alcohol: People who are heavy drinkers have been found to experience more Crohn’s disease flares than those who do not drink.
  • Certain Foods: Many people with Crohn’s go on to experience diet-related flare triggers. While there is no one type of food that aggravates Crohn’s symptoms but maintaining a food diary will help identify any potential triggers and will also help you better understand which foods aggravate your condition and which calm your symptoms.

Conclusion

Crohn’s is an unpredictable disease, and every person experiences the condition differently. Your remission and relapse cycle will be different from others and will depend to a great extent on your symptoms and triggers, especially any environmental triggers you might be exposed to.

References:  

  1. Crohn’s and Colitis. (2019). Learn the Facts About Crohn’s Disease. [online] Available at: https://www.crohnsandcolitis.com/crohns [Accessed 2 Sep. 2019].
  2. Crohn’s and Colitis. (2019). Learn About the Common Symptoms of Crohn’s Disease. [online] Available at: https://www.crohnsandcolitis.com/crohns/disease-symptoms [Accessed 2 Sep. 2019].
  3. Crohn’s and Colitis. (2019). Learn About Treatment Options for Crohn’s Disease. [online] Available at: https://www.crohnsandcolitis.com/crohns/disease-treatment [Accessed 2 Sep. 2019].

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