Crohn's and Colitis For Dummies
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Taking your medications as prescribed is one way to keep your Crohn’s and colitis under control. However, the disease can become active despite taking medications. Certain things are known to trigger Crohn’s and colitis flares or increase your symptoms. But if you know about these triggers ahead of time — and avoid them — you can help yourself stay in remission and avoid flares. Here are the common triggers for Crohn’s and colitis:

  • Smoking: Smoking not only increases your risk of having Crohn’s disease, but also makes the disease worse, causing you to have more flares. Studies have also shown that smoking brings Crohn’s disease back after surgery.

  • Drugs: A variety of drugs can trigger Crohn’s and colitis symptoms, including frequent use of non-steroidal anti-inflammatory drugs (NSAIDs), such as Motrin, Advil, or Aleve. Certain antibiotics (such as ciprofloxacin and penicillin) increase your risk of having infection of your intestines, which can mimic acute flare.

    Talk with your doctor if you have any concerns about medications you’ve been prescribed. Don’t stop taking a prescribed antibiotic without consulting with your doctor first.

  • Diet: Certain foods may give you more problems than others, but everyone reacts differently to different foods — so what your sibling with Crohn’s or colitis can tolerate and what you can tolerate may be different. Pay attention to which foods are giving you trouble and avoid them in the future. Here are some common culprits:

    • Artificial sweeteners

    • Fatty foods

    • High-fiber food

    • Gas-producing food (lentils, beans, legumes, broccoli)

    • Caffeine

    • Spicy foods

    • Nuts and seeds

    • Dairy products (if you’re lactose intolerant)

    • Wheat and other products (if you’re sensitive to gluten)

  • Alcohol: Studies have not shown that drinking adversely affects the inflammation in Crohn’s and colitis patients. Alcohol does, however, irritate the intestines and can worsen symptoms of diarrhea in some patients. It can also interact with certain medications you may take for your disease, such as metronidazole and methotrexate.

  • Dehydration: Active disease makes you go to the restroom frequently, causing you to lose water and salt and putting you at risk for dehydration. Dehydration itself can cause stress to your body functions and cause more weakness and inability to cope with illness. And a vicious cycle starts. . . . Bottom line: Stay hydrated by drinking at least eight 8-ounce glasses of clean water a day.

    The amount of water you need may vary depending on your age, weight, activity level, and body fluid losses (such as water lost during diarrhea). Talk with your doctor and dietitian about your total daily water requirement.

  • Depression: Studies have shown that depression can cause disease flare. You can have more symptoms and an increase in inflammation of the intestines when you’re depressed. Your doctor may prescribe an antidepressant to treat depression and, thus, reduce the symptoms of your Crohn’s or colitis. Be sure to talk with your doctor if you’re feeling depressed.

  • Lack of sleep: Sleep can affect the immune system, and poor sleep or sleep deprivation can activate inflammation. Poor sleepers tend to have more inflammation of their intestines and are at risk for future flares. Getting an uninterrupted seven to eight hours of sleep can keep your symptoms at a bay.

  • Stress: Stress has a negative impact on the immune system. Physical and emotional stress has been shown to cause disease flare and an increase in symptoms. Nobody has a stress-free life, but do what you can to keep your stress at a minimum, even if that means taking a yoga class or dropping the kids off at your health club’s daycare center while you sit in the sauna for 30 minutes. (Just make sure to stay hydrated if you’re sweating out your stress.)

About This Article

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Tauseef Ali, MD, is an expert in the field of inflammatory bowel disease. Currently, he serves as a faculty member in the Section of Digestive Diseases and Nutrition at the University of Oklahoma College of Medicine. He is also the director of the OU Physicians Inflammatory Bowel Disease Center. Dr. Ali has served as an academic editor-in-chief of the World Journal of Gastroenterology.

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