Crohn disease - discharge

  • Alternative Names
    • Inflammatory bowel disease - Crohn's disease - discharge; Regional enteritis - discharge; Ileitis - discharge; Granulomatous ileocolitis - discharge; Colitis - discharge

  • When You Were in the Hospital
    • You were in the hospital because you have Crohn disease. This is an inflammation of the surface and deep layers of the small intestine, large intestine, or both.

      You may have had exams, lab test, and x-rays. The inside of your rectum and colon may have been examined using a flexible tube (colonoscopy). A sample of your tissue (biopsy) may have been taken.

      You may have been asked not to eat or drink anything and have been fed only through an intravenous line. You may have received special nutrients through a feeding tube.

      You may have also started taking new medicines to treat your Crohn disease.

      Surgeries you may have had include repair of a fistula, small bowel resection, or ileostomy.

  • What to Expect at Home
    • After a flare-up of your Crohn disease, you may be more tired and have less energy than before. This should get better. Ask your health care provider about any side effects from your new medicines. You should see your provider regularly. You may also need frequent blood tests, especially if you are on new medicines.

      If you went home with a feeding tube, you will need to learn how to use and clean the tube and your skin where the tube enters your body.

  • Diet
    • When you first go home, you may be asked to drink only liquids or eat different foods from what you normally eat. Ask your provider when you can start your regular diet.

      You should eat a well-balanced, healthy diet. It is important that you get enough calories, protein, and important nutrients from a variety of food groups.

      Certain foods and drinks can make your symptoms worse. These foods may cause problems for you all the time or only during a flare-up. Try to avoid foods that make your symptoms worse.

      • If your body does not digest dairy foods well, limit dairy products. Try low-lactose cheeses, such as Swiss and cheddar, or an enzyme product, such as Lactaid, to help break down lactose. If you must stop eating dairy products, talk with a dietitian about getting enough calcium.
      • Too much fiber may make your symptoms worse. Try baking or stewing fruits and vegetables if eating them raw bothers you. Eat low-fiber foods if that does not help enough.
      • Avoid foods that are known to cause gas, such as beans, spicy food, cabbage, broccoli, cauliflower, raw fruit juices, and fruits, especially citrus fruits.
      • Avoid or limit alcohol and caffeine. They may make your diarrhea worse.

      Eat smaller meals, and eat more often. Drink plenty of liquids.

      Ask your provider about extra vitamins and minerals you may need:

      • Iron supplements (if you are anemic)
      • Nutrition supplements
      • Calcium and vitamin D supplements to help keep your bones strong
      • Vitamin B-12 shots, to prevent anemia.

      Talk with a dietitian, especially if you lose weight or your diet becomes very limited.

  • Stress
    • You may feel worried about having a bowel accident, embarrassed, or even feel sad or depressed. Other stressful events in your life, such as moving, job loss, or the loss of a loved one, can cause problems with your digestion.

      These tips to help you manage your Crohn disease:

      • Join a support group. Ask your provider about groups in your area.
      • Exercise. Talk with your provider about an exercise plan that is right for you.
      • Try biofeedback to reduce muscle tension and slow your heart rate, deep breathing exercises, hypnosis, or other ways to relax. Examples include doing yoga, listening to music, reading, or soaking in a warm bath.
      • See a mental health professional for help.
  • Drug Treatment
    • Your provider may give you some drugs to help relieve your symptoms. Based on how bad your Crohn disease is and how you respond to treatment, your provider may recommend one or more of these drugs:

      • Anti-diarrhea drugs can help when you have very bad diarrhea. Loperamide (Imodium) can be bought without a prescription. Always talk to your provider before using these drugs.
      • Fiber supplements may help your symptoms. You can buy psyllium powder (Metamucil) or methylcellulose (Citrucel) without a prescription. Ask your provider about these.
      • Always talk to your provider before using any laxative medicines.
      • You may use acetaminophen (Tylenol) for mild pain. Drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn) may make your symptoms worse. Talk to your provider about medicines you can use. You may need a prescription for stronger pain medicines.

      There are many types of drugs that can help prevent or treat attacks of your Crohn disease.

  • When to Call the Doctor
    • Call your health care provider if you have:

      • Cramps or pain in your lower stomach area
      • Bloody diarrhea, often with mucus or pus
      • Diarrhea that cannot be controlled with diet changes and drugs
      • Weight loss (in everyone) and failure to gain weight (in children)
      • Rectal bleeding, drainage, or sores
      • Fever that lasts more than 2 or 3 days, or a fever higher than 100.4°F (38°C) without an explanation
      • Nausea and vomiting that lasts more than a day
      • Skin sores or lesions that do not heal
      • Joint pain that keeps you from doing your everyday activities
      • Side effects from any drugs prescribed for your condition
  • References
    • Dassopoulos T, Sultan S, Falck-Ytter YT, Inadomi JM, Hanauser SB. American Gastroenterological Association Institute technical review on the use of thiopurines, methotrexate, and anti-tnf-a biologic drugs for the induction and maintenance of remission in inflammatory crohn's disease. Gastroenterology. 2013 Dec;145(6):1464-78. PMID: 24267475

      Sandborn WJ. Crohn's disease evaluation and treatment: clinical decision tool. Gastroenterology. 2014 Sep;147(3):702-5. PMID: 25046160

      Sands BE, Siegal CA. Crohn's disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 111.