Crohn’s disease - discharge

Alternate Names

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

When You Were in the Hospital

You were in the hospital because you have Crohn?s disease, 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. A doctor may have taken a sample of your tissue (biopsy) or looked inside your rectum and colon using a flexible tube (colonoscopy).

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's disease.

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

See also:

• Ileostomy - discharge
• Small bowel resection repair - discharge

What to Expect at Home

After a flare-up of your Crohn?s disease, you may be more tired and have less energy than before. This should get better. Ask your doctor about any side effects from your new medicines. You should see your doctor on a regular basis.

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.

See also:

• Gastrostomy feeding tube
• Nasogastric feeding tube care

Diet

When you first go home, your doctor may ask you to drink only liquids or eat different foods from what you normally eat. Ask your doctor 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 essential 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 doctor 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 every month, 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.

Ask your doctor or nurse about these tips to help you manage your Crohn’s disease:

• Join a support group. Ask your doctor, nurse, or dietitian about groups in your area.
• Exercise -- talk with your doctor about an exercise plan that’s right for you.
• Try biofeedback to reduce muscle tension and slow your heart rate, deep breathing exercises, hypnosis, or other ways to relax -- such as yoga, listening to music, reading or soaking in a warm bath.
• See a mental health professional for help.

Drug Treatment

Your doctor may give you some drugs to help relieve your symptoms. Based on how bad your Crohn’s disease is and how you respond to treatment, your doctor 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 doctor or nurse before using these drugs.
• Fiber supplements may help your symptoms. You can buy psyllium powder (Metamucil) or methylcellulose (Citrucel) without a prescription. Ask your doctor about these.
• Always talk to your doctor 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 doctor first. Your doctor may also give you a prescription for stronger pain medicines.

There are many types of drugs your doctor may use to prevent or treat attacks of your Crohn’s disease.

When to Call the Doctor

Call your doctor or nurse 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 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

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References

Clark M, Colombel JF, Feagan BC, Fedorak RN, Hanauer SB, Kamm MA, et al. American gastroenterological association consensus development conference on the use of biologics in the treatment of inflammatory bowel disease, June 21-23,2006. Gastroenterology. 2007 Jul;133(1):312-39.

Cummings JR, Keshav S and Travis SP. Medical management of Crohn's disease. BMJ. 2008;336(7652):1062-6.

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: Saunders Elsevier; 2010:chap 111.