What to do when you’re flaring
Contact your care team
It is important to fill us in so we can be proactive and intervene when necessary.
Start recording your symptoms
Keeping a record of your symptoms will help you and your care team determine the severity of your flare. Determining the severity will help us work with you about deciding what should be done next.
Get your lab values
Lab values can be indicators of anemia, infection, and electrolyte imbalances. They also include markers of inflammation that are indicators of the severity of a flare.
Consult with your care team about a dose adjustment
Sometimes mild flares can be taken care of by increasing the dose of a maintenance medication, particularly if you are being treated with a 5-ASA medication. Always contact your care team before changing the dose of your medication.
Avoid foods that worsen your symptoms
Some people with IBD know which foods can make them feel worse. Even if you don’t know for sure, you may have a hunch. If you feel a flare coming on, you may be able to prevent it from getting worse by avoiding problem foods.
Avoid foods that increase stool output
Foods that increase stool output include fresh fruits and vegetables, prunes, and caffeinated beverages.
Avoid concentrated sweets
Juices, candy, and soda pull water into your intestines, so they may contribute to watery stools.
Consider a low-residue diet
The idea behind a low-residue diet is to reduce the number and size of bowel movements you have so IBD symptoms such as cramping, diarrhea, bloating, and gas decrease; a low-residue diet does not affect inflammation or the IBD itself.
Essentially a low-reside diet is a diet low in fiber. Some of the important high-fiber foods to avoid if you are on a low-residue diet include whole-grain breads and cereals, nuts, seeds, and many fruits.
The skins and seeds of many fruits and vegetables are rich in fiber, so peeling the skin and avoiding seeds is consistent with a low-residue eating plan. Well-cooked vegetables or canned vegetables are relatively low in fiber, so you can eat asparagus tips, beets, carrots, spinach, and potatoes without the skin. Acceptable fruits include ripe bananas, soft cantaloupe, and honeydew melon.
Other foods to avoid if you are following a low-residue diet include strong cheeses, juices with pulp, popcorn, high-cocoa chocolate, and food containing whole coconut.
Drink plenty of water
Dehydration is a problem that many people having during a flare because your body loses lots of water if you’re having frequent bouts of diarrhea.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause a flare and,once it is occuring, make it worse. The NSAIDs include aspirin, celecoxib (Celebrex), ibuprofen (Motrin, Advil), and naproxen (Aleve). Acetaminophen (Tylenol) is not an NSAID.
Try stress management techniques
Stress can aggravate symptoms in some people, so it’s important to avoid and limit the stress in your life. Yoga and meditation are classic stress reducers, but there are multiple ways of reducing stress: exercise, sleep, playing with your children. It’s a question of finding something that works for you and your particular circumstance.
Consider a nutritional supplement
If your appetite is poor and you are not tolerating solid foods, you may benefit from a nutritional supplement like Ensure.