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Crohn disease - discharge

Definition

Crohn disease is a disease where parts of the digestive tract become inflamed. It is a form of inflammatory bowel disease.

Alternative Names

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

When You're 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. Some experts believe that you should avoid dairy products altogether until you are tolerating your regular diet.
  • 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 have iron deficiency anemia)
  • Nutritional 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 help you to 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 if necessary.

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 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, Hanauer 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;145(6):1464-1478. PMID: 24267475 www.ncbi.nlm.nih.gov/pubmed/24267475.

Sandborn WJ. Crohn's disease evaluation and treatment: clinical decision tool. Gastroenterology. 2014;147(3):702-705. PMID: 25046160 www.ncbi.nlm.nih.gov/pubmed/25046160.

Sands BE, Siegel CA. Crohn's disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 115.

Review Date:12/2/2016
Reviewed By:Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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