Remission is the goal of Crohn’s disease treatment. There are different types of remission depending on clinical findings. Knowing the possible ways to keep your Crohn’s in remission can help you avoid flare ups.
The main goal of Crohn’s disease treatment is to achieve and maintain remission. This is when symptoms improve or disappear entirely. Periods of remission can last anywhere from a few months to several years. Symptoms usually come back at some point.
Doctors have different ways of describing particular types of remission depending on your symptoms and the clinical findings.
Types of remission include:
Clinical remission
This is the term your doctor will typically use to describe your remission. It means your symptoms have improved or gone away. Yet you may still have inflammation in your GI tract.
Endoscopic remission
This means there’s no evidence of inflammation on tests like a colonoscopy or sigmoidoscopy.
This type of remission is harder to achieve than clinical remission, but it’s the goal of treatment because it means the damage to your GI tract has stopped.
Radiographic remission
There’s no sign of inflammation on an MRI scan or other imaging scans of your GI tract.
Histological remission
Though there’s no agreed-upon definition for this type of remission, it generally refers to reduced inflammation and healing in the lining of the GI tract.
With histological remission, there’s no evidence of inflammation when tissue samples are studied under a microscope.
Many methods can help keep your Crohn’s symptoms in remission. No one way will work for every person, so it’s important to take note of your personal response to any methods to find the best option for you.
Diet
A few diets may help some people in maintaining remission:
- Gluten-free diet. Gluten is a protein found in grains like wheat, barley, and rye. Some people with Crohn’s disease find that not eating gluten helps with symptoms.
- Low fiber diet. Limiting high fiber foods like whole grains, nuts, and popcorn may relieve symptoms like belly pain and loose bowel movements.
- Low FODMAP diet. FODMAP is shorthand for five sugars that your intestines may not absorb well. You’ll find them in foods that contain natural sugars like sorbitol and xylitol, as well as in chickpeas, lentils, garlic, and wheat.
- Low red processed meats diet. Some people find that when they reduce the amount of beef and other red meat that they eat, as well as lunch meat, hot dogs, and bacon, they don’t get as many flare-ups.
- Mediterranean diet. This diet is high in fruits, vegetables, fish, olive oil, and low fat dairy. It’s low in red meat.
- Specific carbohydrate diet. This diet removes certain sugars as well as fiber and some grains.
- A dairy-free or lactose-free diet. This
may help , although more research is needed.
So far, none of these diets have been proven to maintain remission, but they may work for certain people. Talk with your doctor or a dietitian before changing the way you eat.
Treatment
When your Crohn’s is in remission, it’s still important to continue treatment. Continuing to take your medication as prescribed by your doctor can help prevent a new flare of symptoms as well as complications.
Drugs used to maintain remission include:
- Aminosalicylates (5-ASAs) like sulfasalazine (Azulfidine). These drugs block certain pathways to bring down inflammation in the lining of the intestine.
- Immunomodulators such as azathioprine (Azasan). These drugs reduce the immune system response to stop inflammation. You may be prescribed one of these medications if the aminosalicylates don’t work for you.
- Biologic drugs. This newer group of drugs targets certain proteins in your body that cause inflammation. Biologics are administered as an injection or infusion you get under the skin.
Other tips for maintaining remission
Certain factors tend to trigger flare-ups. Here are a few things you can do to avoid a return of your symptoms:
- Manage stress. Stressful situations or strong emotions can lead to flare-ups. It’s likely not possible to prevent or remove all stress-producing events in your life, but you can use relaxation techniques like deep breathing and meditation to help change the way your body reacts to stressful situations.
- Avoid nonsteroidal anti-inflammatory drugs (NSAIDs). Some commonly used medications, including aspirin, naproxen (Aleve), and ibuprofen (Motrin, Advil), are possible triggers for flares. If possible, it can help to use alternatives.
- Limit antibiotics. Taking antibiotics can cause changes in the bacteria that typically live in the intestine. This can lead to inflammation and symptom flares in some people with Crohn’s. Limiting unnecessary antibiotic treatment may help maintain remission.
- If you smoke, consider quitting. People who smoke tend to have more flares than nonsmokers. If you smoke and are having trouble quitting, consider talking with your doctor about supportive resources to help you.
- Be mindful of triggers in your diet. Some people have diet-related triggers. No one type of food worsens symptoms in every person with Crohn’s. Keeping a food diary to identify any potential triggers can help you better understand how your diet relates to your symptoms.
Even with treatment, people with Crohn’s disease will likely experience flare-ups or periods of time when their disease symptoms are active.
It’s not always possible to know what causes a flare. Flares can happen even while you’re taking your medications as prescribed and following self-care practices.
Symptoms
Symptoms of a relapse can vary from mild cramping and diarrhea to severe abdominal pain or bowel blockages. You may experience the same types of digestive problems you had when you were first diagnosed, or you may have new symptoms.
Typical symptoms during a flare include:
- diarrhea
- frequent bowel movements
- blood in the stool
- belly pain
- nausea and vomiting
- weight loss
Duration
Symptom flare-ups can last from weeks to months. Flare-ups can happen naturally when Crohn’s is untreated. They can also happen when Crohn’s doesn’t respond to treatments.
How long can a Crohn’s remission last?
The length of remission can vary. If disease activity is below a certain threshold and you have no symptoms, a doctor will say you are in remission.
In a
What induces remission in Crohn’s?
Using immunosuppressants and biologic medications can help induce and maintain remission once disease activity is below a certain level. Other factors that may help include avoiding smoking and managing stress.
How long does it take for Crohn’s to go into remission?
This will depend on how Crohn’s affects you and if you’re able to take measures to manage it. Factors that worsen symptoms include not having treatment, smoking, stress, and taking certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs).
Can you be healed from Crohn’s?
Crohn’s is a long term condition. Currently, there is no cure, but advances in medicine are making it easier to manage and increasing the chances of prolonged remission. With treatment and self-care practices, many people with Crohn’s are able to enjoy a full life.
Crohn’s disease can be unpredictable, and it’s not the same for everyone.
Your relapse and remission cycle will vary depending on your symptoms and triggers. It will also depend on how well your Crohn’s responds to particular treatments.
Working with your doctor to prevent relapses and managing them when they do happen can help you stay on top of your condition.