Crohn’s disease: What happens during a relapse?

Crohn's disease occurs in relapses. This means that the disease does not cause permanent complaints. Rather, the course of Crohn's disease is subdivided into phases: Phases with complaints (relapse) and phases without complaints (remission) alternate.

How do you know the next relapse is coming? And can you do anything yourself to prevent the next relapse?

An acute relapse in Crohn's disease

The symptoms of Crohn's disease are triggered by an increase in inflammatory activity in the body. The immune system reacts particularly strongly to harmful bacteria that penetrate the intestinal mucosa, sometimes triggering reactions throughout the body. In contrast to ulcerative colitis, another chronic inflammatory bowel disease, inflammation in Crohn's disease is not limited to the bowel but can affect the entire digestive tract.
As soon as the typical symptoms of Crohn's disease appear, it is usually clear that a new relapse begins. Slight abdominal pain or soft stools can also occur occasionally during remission. However, a relapse is accompanied by acute symptoms that can last for several days, weeks or even months.

Frequency of relapses of Crohn's disease

The intervals at which a relapse occurs vary from person to person. The therapy of Crohn's disease aims at prolonging the remission phases and preventing relapses. However, medication cannot always prevent the next acute phase.

Anyone who repeatedly suffered from relapses in the early stages of Crohn's disease is likely to experience relapses in the later course of the disease. However, a reliable prediction cannot be made.

What to do during an acute relapse?

During a relapse, Crohn's disease patients can alleviate their symptoms mainly with special medication. These help against the pain and should reduce the inflammation as quickly as possible. For a fast improvement of the complaints the patients should consult with their doctor and follow the agreed treatment plan.

Consequences of a relapse for pregnant women and children

Apart from the acute symptoms, a relapse of Crohn's disease can have further consequences. In children repeated relapses can slow down body growth and generally delay development.

Dramatic consequences can also have a relapse for pregnant: The risk of miscarriage is increased during a Crohn's disease relapse. Long-lasting symptoms can also interfere with the development of the unborn child. Most drugs can be taken by pregnant women without hesitation - they should also be taken to prevent a relapse.

If a woman suffering from Crohn's disease wants to become pregnant, she should know that during a relapse fertility appears to be compromised.

Can a relapse be prevented?

For the so called remission-maintaining therapy, there are various tried and tested drugs that are designed to delay the next relapse for as long as possible. Doctors also recommend:

  • not to smoke
  • to pay attention to a balanced diet in order to prevent any symptoms of deficiency
  • to receive psychotherapy, if necessary

A strong intestinal mucosa as protection against a relapse of Crohn's disease

Studies suggest that a strong and intact intestinal mucosa can prevent the outbreak of acute inflammation and thus a relapse of Crohn's disease. Scientists are investigating to what extent this finding can be used in the future for the treatment of Crohn's disease.1.

If you know your bowel better and understand the processes in it better, it can help you protect this important organ. A step towards a better understanding of your own body can be an intestinal flora test like a stool test like with from BIOMES. The detailed analysis will tell you a lot about your intestinal bacteria and what effects an unbalanced intestinal flora can have on the whole body. And you get practical tips on how you can do good to your intestines.

1. Aden K, Tran F, Ito G, et al. ATG16L1 orchestrates interleukin-22 signaling in the intestinal epithelium via cGAS–STING. Journal of Experimental Medicine 2018:215(11), 2868-2886.