If you have Crohn’s disease, you know that many foods can trigger a flare-up and leave you suffering with abdominal pain, diarrhea and fatigue. But there’s more to managing your condition than making smart food choices.
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Understanding what other behaviors can make your condition worse can empower you to adjust your lifestyle to keep symptoms at bay, says gastroenterologist Benjamin Click, MD.
“An informed patient is the best patient,” he says. “They stand the best chance of better overall outcomes with the disease.”
Dr. Click advises avoiding these six mistakes to best position yourself for less severe symptoms and fewer flare-ups.
Taking herbs and supplements
Vitamin deficiencies that come with Crohn’s may make some supplements (like Vitamin D, B12 and folic acid, for instance) helpful.
But, other supplements can actually make your condition worse. St. John’s wort, for example, can increase upset stomach, nausea and vomiting, and black cohosh can cause liver problems.
Dr. Click recommends talking to your doctor before you start using any herbs or supplements. Only your provider can tell you how these products will interact with the prescription medications you’re taking.
You know smoking is bad for your health in general, but it can really wreak havoc on your system when you have Crohn’s disease, he says.
It doesn’t matter what you smoke – cigarettes, cigars and even vaping can promote inflammation and put you at greater risk for a relapse.
Lighting up could also mean you’ll need to take more medications or need more surgeries to control your condition.
Of course it’s your choice if you want to have an occasional cocktail or glass of wine when you’re out to lunch or in the evenings. But keep in mind that alcohol can interact negatively with certain medications you take.
Crohn’s disease irritates your intestinal lining, and excess alcohol can also aggravate it further. If your intestines are inflamed, you increase the likelihood of bleeding, malnutrition and worsening symptoms overall, Dr. Click says.
Drinking alcohol in moderation is likely not harmful, but each person’s threshold for irritations is different.
Maintaining your health by preventing infections is a critical part of living with Crohn’s, so don’t pass up the vaccinations your doctor recommends. They pose very little risk.
“The data have been very strongly in favor of vaccinating,” Dr. Click explains. “Generally, the recommendation is to avoid live vaccines when you’re immunosuppressed, but the number of live vaccines has declined over the years. We essentially have a ‘dead’ vaccine for most of the major illnesses for which we vaccinate in irritable bowel syndrome.”
Crohn’s leaves you more vulnerable to flu and pneumonia, so it’s especially important to get the influenza and pneumococcal vaccines.
And, if your doctor recommends that you take tofacitinib, discuss getting the zoster vaccine (Shingrix) as well, Dr. Click advises.
Discuss all vaccines and their possible side effects with your physician.
Letting stress get the best of you
When you’re anxious or stressed out, it directly impacts the severity of your symptoms, Dr. Click says.
You can minimize the effects of stress with good sleep hygiene. And get as much exercise as your body allows. It’s a good idea to discuss appropriate physical activity with your doctor.
Not talking about family planning
If you’re thinking about starting a family, it’s important to discuss it with your gastroenterologist. He or she can identify the best strategy for treating your Crohn’s disease during pregnancy.
“Data suggest that active Crohn’s disease is the most dangerous thing for a baby — not the medications we use to treat it,” Dr. Click says. “So always include your doctor in the conversation and make sure everyone is on the same page.”
Most importantly, work closely with your doctor to make sure you fully understand your treatment options, as well as which behaviors are most likely to make your Crohn’s worse.