“Diarrhea is one of the most mentally and physically challenging symptoms of Crohn’s,” says Jamie Knowles-Griffiths, a nonprofit executive who has been living with the condition for nearly 30 years and writes about her experiences at MyCrohnsAndColitisTeam.com. “When my disease is flaring, my entire schedule is based around bathroom access.” Diarrhea can also come with serious health consequences. “It can be severe, to the point where people lose weight or become malnourished over time,” explains Joseph Cassara, MD, a gastroenterologist at Kaiser Permanente in Lafayette, Colorado. To better manage diarrhea, follow these dos and don’ts. Since you don’t want to spend each and every day worrying about diarrhea, prevention is necessary for a good quality of life, Dr. Cassara says. “Develop a good partnership with your gastroenterologist. It’s essential.” From over-the-counter to prescription medications, there are many possible treatments to manage diarrhea. Work with your gastroenterologist to find the right combination to help prevent diarrhea and manage a flare when it strikes.
2. Don’t eat foods likely to trigger diarrhea.
Although every person’s body responds differently to food, there are certain ones known to be common diarrhea triggers. “In general, avoiding dairy can be helpful during a Crohn’s flare,” Cassara says. The Crohn’s & Colitis Foundation also suggests staying away from greasy and fried foods and warns that some people find that high-fiber foods cause problems. One study published in 2020 found that people with inflammatory bowel disease (IBD) were more than twice as likely to have lactose intolerance than those without the condition. If you can, try to keep track of your food sensitivities by logging what you eat and how you feel in a food diary, and then connect the dots to see if any foods tend to trigger diarrhea for you. “Keep in mind that it varies from person to person,” Cassara adds. “Have a conversation with your gastroenterologist to find out what’s best for you.” At the same time, work with your gastroenterologist or a registered dietitian to make sure your diet isn’t too restrictive. It’s important to get the nutrients you need and stay hydrated during a bout of diarrhea.
3. Do trust your instincts.
Listen to the cues your body gives you and respond accordingly, Knowles-Griffiths advises. If you think you’re going to have a flare and you’re on your way to work, see if you can work from home that day until the symptoms pass, she suggests. Even if it turns out to be a false alarm, it’s better to be safe than sorry, she adds.
4. Don’t forget to plan ahead.
When leaving your home or other safe havens, it’s a good idea to search for toilets in advance so you’ll know where to go if you feel diarrhea about to strike. “Carry a map of available public restrooms in your area, along your commute, or at your travel destination,” Knowles-Griffiths recommends. Or download a toilet finder app on your phone. “Come up with a strategy at work,” Cassara adds. “If you’re taking a flight, go before you get on the plane.” It’s also a good idea to adjust your diet to minimize risk when you’re on the move: Avoid large, greasy meals, high-fiber foods, and caffeine. Medications to calm your intestinal tract can also help, so talk with your physician about treatments and stash the medication in your carry-on.
5. Do pack an emergency kit.
Knowles-Griffiths describes her Crohn’s emergency kit as “vital.” Hers contains:
Hand sanitizerCleansing wipesA change of clothes and underwear (sometimes multiple changes)Adult diapersPlastic bags for sealing soiled clothingToilet paperExtra medication
When traveling internationally, she uses a language translation app on her phone to ask for restrooms during emergencies. If you don’t have a translation app, you can always ask a local to write the necessary phrases on a piece of paper, she says. Other essentials to stock up on in your car, tote, or desk drawer include disposable gloves, baby powder, and air freshener, the Foundation says.
6. Don’t leave home without this card.
The Foundation offers a “Restroom Access Card,” a discreet way for you to communicate to a store or restaurant employee, for example, that you urgently need a restroom. “I recommend practicing using your card when the situation is not completely urgent, so you become comfortable and empowered to speak up for your needs,” she adds. “Discussing bathroom needs and urgency is extraordinarily discomforting, and it’s okay to take time to practice. The more you become comfortable asking for help, the more you will be able to speak up for yourself during times of need.”
7. Do stay hydrated.
Keep a bottle of water handy if you have a bout of diarrhea, which can lead to dehydration. “When severe, diarrhea can cause you to lose large amounts of fluids quickly,” Cassara says. “It’s important to replenish what you’ve lost.” According to the Foundation, you can help prevent dehydration by drinking at least 64 ounces (8 cups) of water per day. During a prolonged bout of diarrhea, your doctor may recommend drinking sports drinks that contain both water and electrolytes; in serious cases, treatment with intravenous fluids may be necessary.
8. Don’t dwell on an accident.
If the worst happens while you’re out in public, try not to panic. “Accidents when living with Crohn’s are inevitable,” Knowles-Griffiths says. When faced with a mishap, try your best to clean up, move on, and not dwell on it. Face it “with grace, self-compassion, and a dash of humor,” she advises. Being prepared and having your emergency kit handy also helps, she adds.
9. Do take time to de-stress.
Stress may worsen Crohn’s symptoms, according to the Mayo Clinic. To de-stress, exercise regularly and consider practicing relaxation techniques such as deep breathing, yoga, meditation, and biofeedback. According to a study published in November 2020 in Frontiers in Psychology, mindfulness and yoga were effective at reducing depression and anxiety and improving the quality of life for people with inflammatory bowel disease.
10. Don’t give up what you love.
Knowles-Griffiths makes accommodations for her Crohn’s disease, and that means there are days when it’s just easier to stay home than risk being too far from a bathroom. But she doesn’t let Crohn’s completely stop her from doing what she loves, such as traveling and swimming. Although she can’t always be spontaneous, she prepares for a day of activities with fluids, scopes out a spot close to the bathroom, and enjoys her day without worry.
