Tips for dealing with Crohn's disease

1) Chew your food to a pulp! If you have strictures (i.e., narrowed portions of the intestine), it's important to avoid getting a blockage. One simple thing that can help is to chew your food to a pulp, and to discretely spit out into a napkin anything that cannot be chewed to a pulp.

2) Overcome fatigue. A large percentage of Crohn's patients experience fatigue. Exercise can help improve stamina, strengthen bones and muscles, and elevate mood (thanks to the endorphin rush). The key to regular exercise is to develop a routine, and you may want to leave yourself a daily reminder to exercise. Having home exercise equipment (I use the Bowflex Xtreme 2, which is great) will make it easier to exercise when you're short on time. Supplements and diet also can help battle fatigue. People with Crohn's can be deficient in vitamin B-12, and vitamin B-12 deficiency can contribute to fatigue, so I take a daily B-12 vitamin. I avoid coffee because it can be pro-inflammatory, and instead get a caffeine boost from green tea (including a lightly-caffeinated green tea extract supplement). I found that sugars and other simple carbs also contributed to fatigue, so I try to avoid them as much as possible during the day. DHEA is an inexpensive supplement that many people take in the morning to help boost their energy levels. During a prior period of extreme fatigue, I also took Provigil (by prescription), which was a tremendous help. Of course, getting a good night's sleep can also help prevent fatigue. Ambien is a common sleeping pill that helps many people, and I have found that melatonin (an inexpensive supplement) also helps me sleep through the night. (There is some controversy, however, regarding the use of melatonin in patients with auto-immune disorders, so you need to weigh melatonin's benefits against the potential downside. Below is a link to an article about this controversy.)

3) Minimize stress. Many Crohn's patients (like me) find that stress exacerbates their symptoms. Make it a high priority to identify the sources of stress in your life (e.g., work, relationships, health), and brainstorm ways to minimize your stress. There are many self-help books that are useful, and therapy can also be quite helpful. For many, anti-anxiety medication can also do wonders (and can improve sleep, as well). The bottom line is that you should not just accept stress (especially high levels of stress) as a normal part of your life -- take steps to minimize your stress.

4) Be kind to your bottom. Many Crohn's patients have fissures and find it very painful to have a bowel movement. Lubricating the irritated area with Vaseline immediately in advance of the bowel movement can make the experience much less painful, and can help avoid further irritation (allowing the area to heal). In addition, the use of flushable wet wipes instead of toilet paper is also helpful for cleaning the area thoroughly without causing irritation. Both Vaseline and flushable wipes can be purchased in travel-friendly sizes.

5) Strive for bathroom regularity. Crohn's patients typically are plagued with bathroom irregularity. After much experimentation, I found that eating a bowl of oatmeal each morning helped keep me regular. If oatmeal doesn't work for you, try experimenting with other food items until you find something that works for you. For constipation, external stimulation of your intestine via heating pads and gentle manual pressure (i.e., massaging your belly) can also help to get things moving along, and (in a pinch) laxatives may be of help.

6) Protect your immune system. Crohn's patients may start out with a weakened immune system, or might develop a weakened immune system as a side effect of medication. It is important to take this into account. For example, people experience a dip in their immune system when they are tired. It is therefore important for Crohn's patients to get adequate rest and not to push themselves too hard to work through fatigue. Air travel can be taxing even to a strong immune system, and so Crohn's patients should take precautions when traveling. For example, when possible, travel in the morning when fully rested, rather at the end of a long day. And try not to travel two days in a row; rather, give your immune system a chance to bounce back. There is an interesting and discrete (albeit unusual) product -- nasal filters -- that can help minimize the number of germs inhaled during a flight. I buy them at www.breathe-ezy.com.au, and I use them every time I fly. There are some reports that vitamin C may also be helpful. There is also some truth to the old wives' tale -- you can catch a cold if you let your body get cold, so bundle up when the temperatures drop.

7) Don't be too fearful of powerful medication. A number of new drugs for Crohn's have come on the market in recent years. Many people overly focus on the potential side effects, and do not give sufficient consideration to the benefits. One of the new drugs, Humira, was approved by the FDA for Crohn's in 2007. I started taking it shortly after it was approved, and for the first time since my diagnosis my SED rate (a measure of inflammation) is in the normal range. For many like me, the alternative to medication is much worse than the potential side effects; if their Crohn's is not kept in check with medication, they face the prospect of repeated surgeries and the attendant risk of short bowel syndrome.

I wish you the best of luck!

Perry

P.S. -- Here's a bonus tip: Nourish your bones! Many Crohn's patients have or are at risk for osteoporosis. Taking a daily calcium supplement can help, and my favorite form of getting calcium is through Adora dark chocolate calcium supplements.