Understanding Crohn's: The Remission and Relapse Cycle

Overview

Crohn’s disease is a disorder that causes irritation and swelling in the lining of the digestive tract. It’s a chronic illness, so most people will experience symptoms on and off throughout their life.

Keep reading to learn more about the disease, including the remission and relapse cycle.

Remission and relapse

Inflammation from Crohn’s disease can happen anywhere along the digestive tract. It most commonly affects the end of the small intestine (the ileum) and the beginning of the large intestine or colon.

Even with treatment, people with Crohn’s disease will likely experience flare-ups, or periods of time when disease symptoms are very active.

Symptom flare-ups can last weeks to months. During that period, symptoms can vary from mild cramping and diarrhea to more serious symptoms such as severe abdominal pain or bowel blockages.

During periods of remission, no symptoms of the disease are noticeable. The lining of the digestive tract heals and may show no signs of inflammation.

Periods of remission can last anywhere from a few days to years. The main goal of Crohn’s disease treatment is to achieve and maintain remission.

Crohn’s disease treatment

There are two main types of treatment for Crohn’s disease: medications and surgery. 

Most Crohn’s disease medications are meant to help reduce inflammation in the gastrointestinal tract. Some medicines are used to treat flares, while others help keep Crohn’s in remission once symptoms have gone away.

Surgery is an option, but it’s usually saved for hard-to-treat disease. Surgery can be used to open a part of the intestine that has become blocked. It can also be used to remove a damaged portion of the intestine.

Surgery doesn’t cure Crohn’s, but it can help to achieve remission.

Flare triggers

It’s not always possible to know what causes a flare. Flares happen even while you’re taking your medications as prescribed.

You may experience the same types of digestive problems you had when you were first diagnosed with the disease or you may experience new symptoms.

There are a few known triggers for flare-ups. They include:

• Stress: Stressful situations or strong emotions can lead to flare-ups. It’s impossible to eliminate all stressful-producing events in life, but you can change the way your body reacts to stressful situations.
• Missed medications: Many people with Crohn’s disease take medications on a daily basis, even during periods of remission. It’s not uncommon to miss some medication doses, but long periods of not taking prescribed medications can lead to flare-ups.
• Use of nonsteroidal anti-inflammatory drugs (NSAIDs): Some commonly used medications, including aspirin, naproxen (Aleve), and ibuprofen (Motrin, Advil), are possible triggers for flares.
• Use of antibiotics: Using antibiotics can lead to changes in the bacteria that normally live in the intestine. This can lead to inflammation and symptom flares in some people with Crohn’s.
• Smoking: People who smoke tend to have more flares than nonsmokers.
• Certain foods: Some people have diet-related flare triggers. No one type of food aggravates symptoms in all people with Crohn’s. Keeping a food diary to identify any potential triggers can help you to better understand how your diet relates to your symptoms.

Crohn’s is an unpredictable disease and is not the same for everyone. Your relapse and remission cycle will vary depending on your symptoms and environmental triggers.