Simple Steps to Get Pain Relief for Crohn’s Disease Flares

For people with Crohn’s disease, flares are something everyone hopes to avoid. According to the Crohn’s & Colitis Foundation of America (CCFA), symptoms of a Crohn’s flare often include abdominal pain, diarrhea, urgent bowel movements, loss of appetite, weight loss, and fever.

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Keeping your disease in remission for as long as possible — by taking the drugs prescribed by your doctor for this purpose — is an important part of treatment. But even when you take your medications diligently, there’s a possibility that a number of factors — including stress, certain foods and drugs, and smoking — may trigger a flare anyway.
As noted in an article published in January 2016 in the World Journal of Gastroenterology, many flares happen in a random, unpredictable way, with no known incident or behavior triggering them.
The good news is that there are steps you can take to minimize the pain associated with flares. Some of these are things you can safely do on your own, while others require the involvement of your doctor. Not every measure described here will work for everyone, but each offers a chance for relief from pain and discomfort.
How to Treat Inflammation From Crohn’s
The single most important thing you can do to relieve pain from a flare is to see your doctor for treatment, says Joel B. Levine, MD, a gastroenterologist and professor of medicine at the University of Connecticut. The best strategy, Dr. Levine says, “is really the opposite [of] the treatment of isolated pain,” but rather “to look at the nature of the pain.”
Due to where nerves are located, says Levine, inflammation in the intestinal wall “is very likely to produce pain” in Crohn’s disease. By reducing this inflammation, pain can be relieved.
To treat the inflammation causing your flare, your doctor may change the dose of a drug you already take or add a new drug. Drugs used to treat inflammation include aminosalicylates, corticosteroids, immunosuppressants, and biologics.
Drugs Can Provide Pain Relief for Crohn’s
Not all doctors agree that treating pain, specifically, from Crohn’s disease is the right course of action. Levine prefers to focus on the root causes of pain. “When those are treated effectively, the pain goes away,” he says.
But Robert Carroll, MD, a gastroenterologist and associate professor of medicine at the University of Illinois College of Medicine at Chicago, believes that targeted pain relief has a role to play in managing Crohn’s flares. He often sees patients who were recently discharged from the hospital and are already on pain medications.
“I think if you completely deny the use of narcotics,” says Carroll, “you end up undertreating pain.” But he tries to use the least strong narcotics when possible, often prescribing acetaminophen with codeine. Although, given the addiction risks of opiates, it’s important to have clear discussions with your doctor about the potential risks of using opiate medications to manage chronic pain
Some patients, says Carroll, benefit from using lidocaine patches on certain parts of their abdomen. He’s “surprised by how effective that can be,” he says.
Carroll also believes that medical marijuana can be effective in some patients, especially those with moderate disease. “There’s some evidence that the cannabinoid receptors are involved in the inflammatory process in IBD [inflammatory bowel disease],” he says, adding that large trials of cannabis are needed before it becomes a standard treatment.
Diet Is An Important Part of Treating Crohn’s
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As the CCFA notes, not everyone with Crohn’s experiences diet-related symptoms. But common dietary causes of discomfort include dairy foods, uncooked fruits and vegetables, greasy foods, caffeine, alcohol, and carbonated drinks.
You may benefit from avoiding these foods during a flare, or from keeping a food journal to see if anything in your diet is related to your symptoms.
As far as taking dietary supplements, Carroll finds that some patients benefit from probiotics. Taking supplements containing iron, in contrast, can aggravate symptoms and cause pain, he says. Carroll believes that IV iron replacement is a better solution to low iron levels in IBD patients that have iron deficiency and anemia.
Rest and Exercise Can Reduce Crohn’s Pain
Getting enough rest and exercising may seem like opposites, but both are key to keeping your body in good shape and can help minimize pain, Carroll says.
When it comes to specific exercises for pain relief, Carroll likes Pilates and yoga. “I think both of those are able to get people to focus on other things besides abdominal pain.”
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But remember that distracting from your pain — through exercise or other activities — can only go so far. “I try and emphasize with patients,” says Carroll, that ultimately, “getting the disease controlled should relieve their pain.”