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Symptoms & Management

Ranging from mild to severe, symptoms of both Crohn’s disease and ulcerative colitis can include:

  • Diarrhea
  • Abdominal cramping and pain
  • Rectal bleeding
  • Urgent bowel movements
  • Small sores (ulcers) in the colon and rectum
  • Constipation

Symptoms vary from person to person, and may change over time. Complications may also develop for people with IBD — both within and outside the GI tract.

People with IBD often go through periods when few or no symptoms are present. A flare is the reappearance of the characteristic symptoms of Crohn’s disease or ulcerative colitis, such as those listed above. Medical treatment for IBD is aimed at establishing and maintaining a state of remission (no active disease or symptoms).

Potential triggers

IBD symptoms may flare up for no apparent reason, but some possible triggers have been identified:

  • Stress
  • Lapses in taking medications/incorrect dosing of medications
  • Recent use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or antibiotics
  • Eating certain foods
  • Smoking

Experiencing flare-ups of your disease can be upsetting and confusing. However, remember that the management of your disease is a partnership between yourself, your doctor, your loved ones, perhaps a dietitian, and other health care providers. Your health care provider is monitoring your condition. Therefore, it is important to stay in close communication with them. Keep a journal to write down questions to ask your doctor during your visits or call immediately if your question or concern is of an urgent nature. You should also contact your doctor if you think a change in medication may be needed. Do not attempt to alter medication doses or frequency of dosing on your own, as this may lead to a worsening of symptoms.

Tips for symptom management

  • To reduce anal irritation, use a moist towelette or wipe instead of bathroom tissue.
  • Practice good anal hygiene by showering with a hand shower or using a perianal cleansing product.
  • Apply an all-purpose skin protectorant (e.g., zinc oxide cream) at night to relieve irritation of the skin around the anus.
  • For anal soreness or painful bowel movements due to an anal fissure or fistula, bathe your buttocks in warm salt water.
  • To help manage diarrhea, anti-diarrheal medications (e.g., loperamide, bismuth subsalicylate) may be effective. Never take any of these drugs without consulting your health care provider.
  • For joint-related discomfort, doctors may recommend resting the affected joint as well as the occasional use of moist heat. Range-of-motion exercises, as demonstrated by a physical therapist, may also be helpful.
  • To reduce the irritation of small mouth ulcers (also known as canker sores), medicinal mouthwashes may be helpful, along with a balanced diet and a multi-vitamin/mineral supplement.
  • To help manage the symptoms of pain, experts say that acetaminophen may be the safest option for IBD patients. Acetaminophen should be used in moderation. Consult with your health care provider about the appropriate pain management options.
  • Remember to take care of yourself. Get plenty of sleep, eat well, and take time to recharge, and reduce stress when you need it.

Learn more about managing flares in the CCFA brochure Managing Flares and Other IBD Symptoms.