Introduction

If you’re living with inflammatory bowel disease (IBD), you know that flare-ups can feel overwhelming and unpredictable. One day you’re managing well, and the next, you’re dealing with intense symptoms that disrupt your entire routine. The question “What should I do during an IBD flare?” is one of the most common concerns we hear from people in our community, and it’s absolutely valid.

Whether you’re newly diagnosed or have been managing IBD for years, knowing how to respond during a flare can make a significant difference in your recovery time and overall well-being. This guide will walk you through both immediate steps you can take at home and when it’s time to reach out for professional help. Remember, every person’s IBD journey is unique, so what works for one person may need adjustment for another.

The Short Answer

During an IBD flare, your first priority is to contact your healthcare provider to discuss your symptoms and potential treatment adjustments. While waiting for medical guidance, focus on staying hydrated, eating easily digestible foods, getting adequate rest, and monitoring your symptoms closely. Don’t try to “tough it out” – early intervention often leads to better outcomes and shorter flare duration.

The Complete Answer

Immediate Steps to Take

When you recognize the signs of a flare beginning, time is often of the essence. Here’s your step-by-step action plan:

1. Document Your Symptoms
Start keeping a detailed record of what you’re experiencing. Note the frequency of bowel movements, presence of blood or mucus, pain levels (on a scale of 1-10), and any other symptoms like fever, fatigue, or joint pain. This information will be invaluable when you speak with your healthcare team.

2. Assess the Severity
Not all flares are created equal. Mild flares might involve slightly increased bowel movements and mild cramping, while severe flares can include significant bleeding, high fever, dehydration, or severe pain. Understanding the severity helps determine how quickly you need medical intervention.

3. Review Your Current Medications
Take stock of your current IBD medications and make sure you’re taking them exactly as prescribed. This isn’t the time to skip doses or make changes on your own. If you’ve been tapering off steroids, you may need to discuss pausing that process with your doctor.

Managing Symptoms at Home

While you’re coordinating with your healthcare team, there are several supportive measures you can take:

Dietary Modifications
During a flare, your digestive system needs all the help it can get. Consider switching to a bland, low-residue diet temporarily. This might include white rice, bananas, toast, boiled chicken, and well-cooked vegetables without skins. Avoid high-fiber foods, spicy dishes, dairy (if you’re lactose intolerant), and alcohol.

Hydration is Critical
Increased bowel movements can lead to dehydration quickly. Sip water throughout the day, and consider electrolyte solutions if you’re having frequent diarrhea. Coconut water, diluted sports drinks, or oral rehydration solutions can help replace lost minerals.

Rest and Stress Management
Your body is fighting inflammation, which is exhausting work. Prioritize sleep and rest. Stress can worsen IBD symptoms, so practice relaxation techniques like deep breathing, meditation, or gentle stretching if you’re able.

When Medication Adjustments May Be Needed

Your healthcare provider might recommend several approaches depending on your current treatment plan:

• Steroid therapy: For moderate to severe flares, corticosteroids are often prescribed to quickly reduce inflammation
• Dose adjustments: Your current maintenance medications might need temporary increases
• Additional medications: Anti-diarrheal medications or pain relievers might be recommended for symptom management
• Topical treatments: For people with ulcerative colitis, rectal medications like suppositories or enemas might be added

Important note: Never start, stop, or change IBD medications without consulting your healthcare provider first.

What Patients Should Know

Questions to Ask Your Doctor

When you contact your healthcare team during a flare, come prepared with specific questions:

• Based on my symptoms, how severe is this flare?
• Should I make any immediate changes to my current medications?
• What dietary modifications do you recommend right now?
• How long should I expect this flare to last with treatment?
• What symptoms would indicate I need emergency care?
• Should I continue working/attending school, or do I need time off?

Red Flags: When to Seek Emergency Care

While most flares can be managed with adjustments to your treatment plan, certain symptoms require immediate medical attention:

• Severe dehydration (dizziness, dry mouth, little to no urination)
• High fever (over 101°F/38.3°C)
• Severe abdominal pain that’s getting worse
• Significant bleeding or passing large amounts of blood
• Signs of infection or sepsis
• Inability to keep fluids down due to vomiting
• Severe weakness or fainting

Trust your instincts. If something feels seriously wrong, don’t hesitate to go to the emergency room or call your doctor’s after-hours line.

Managing Work and School During a Flare

IBD flares can significantly impact your ability to maintain your normal schedule. Here’s how to navigate this challenge:

Communication is Key: If you’re comfortable doing so, have an honest conversation with your supervisor or teachers about your condition. Many people are more understanding than you might expect, especially when you provide clear information about your needs.

Know Your Rights: In many countries, IBD qualifies as a disability under employment protection laws. This might entitle you to reasonable accommodations like flexible work hours, the ability to work from home during flares, or additional sick leave.

Plan Ahead: During periods of remission, consider discussing contingency plans with your employer or school. Having arrangements in place before you need them reduces stress during flares.

Related Questions

How long do IBD flares typically last?

Flare duration varies significantly from person to person and depends on factors like flare severity, how quickly treatment begins, and individual response to therapy. With prompt treatment, mild flares might resolve in days to weeks, while more severe flares could take several months to fully settle. Early intervention often leads to shorter flare periods.

Can I prevent IBD flares from happening?

While you can’t prevent all flares, you can reduce their frequency and severity by staying consistent with medications, managing stress, maintaining a healthy diet, getting adequate sleep, and avoiding known triggers. Regular monitoring with your healthcare team also helps catch early warning signs.

Should I avoid all physical activity during a flare?

Light, gentle movement is often beneficial during flares, but high-intensity exercise should be avoided. Listen to your body – short walks, gentle stretching, or restorative yoga might help with stress and mood, while intense workouts could worsen symptoms. Always check with your healthcare provider about appropriate activity levels.

Is it normal to feel anxious or depressed during a flare?

Absolutely. Flares are physically and emotionally challenging, and it’s completely normal to experience anxiety, frustration, or sadness. The inflammatory process itself can also affect mood. Don’t hesitate to discuss these feelings with your healthcare team – mental health support is an important part of IBD care.

The Bottom Line

Managing an IBD flare effectively requires a combination of prompt medical attention, self-care strategies, and patience with the healing process. The most important step is reaching out to your healthcare team early – they’re your partners in managing this condition and can provide personalized guidance based on your specific situation.

Remember that experiencing flares doesn’t mean you’ve failed or done something wrong. IBD is a chronic condition with an unpredictable nature, and flares are unfortunately part of the journey for many people. What matters most is how you respond: seeking appropriate care, taking care of yourself, and working with your medical team to get back to feeling better.

Keep your healthcare provider’s contact information easily accessible, maintain an updated list of your medications, and don’t hesitate to advocate for yourself if you feel your concerns aren’t being adequately addressed. You know your body best, and your input is valuable in creating an effective treatment plan.

With proper management and support, most people with IBD can achieve remission again after a flare. Stay hopeful, stay informed, and remember that you’re not alone in this journey.