IBD Flare: Signs, Self-Care And When To Get Help

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An IBD flare happens when symptoms become more active or worsen due to increased inflammation. The pattern can vary from person to person. 

What Counts As An IBD Flare

Reappearance of IBD symptoms is known as an IBD Flare. An IBD flare means that symptoms have become more active because of increased inflammation. Symptoms like abdominal pain, fatigue, changes in bowel habits, and other symptoms are signals that the disease is becoming active again. A flare does not always look the same each time. Symptoms can also overlap with infections, food-related problems, and other digestive conditions, so symptoms cannot tell you alone about an IBD flare.

Early And Worsening Signs

Early signs include frequent bowel movements, increased urgency, mild abdominal pain, blood or mucus in stool, increased tiredness, and mild appetite loss. Worsening signs include:

Dehydration Signs

Feeling very thirsty, having a dry mouth, passing less urine, often feeling dizzy, or unusual weakness. It can happen commonly with diarrhoea, bleeding, and vomiting.

Stool Frequency

Urgent need to pass stool even after not eating anything for a long period, especially with blood, cramps, or night-time bowel movements, could be a sign of worsening symptoms.

Bleeding

Passing visible blood in stool, which may appear bright red or make the stool look very dark. Heavy or ongoing bleeding needs urgent medical care.

Fever

A rise in body temperature, often occurring with infection or inflammation. Fever with worsening bowel movements needs serious medical care. 

Severe Pain

Intense or worsening abdominal pain that is difficult to tolerate, especially when it is sudden, persistent, or accompanied by vomiting, fever, or abdominal swelling.

Possible Triggers And Infections

These are the common patterns that provoke IBD flare-ups:

• Missing doses or stopping IBD medicines
• NSAIDs or pain reliever consumption, as they increase inflammation
• Eating high-fat foods, processed foods, or food that does not suit you
• High stress or poor sleep 
• Smoking even after IBD diagnosis
• Gut infections caused by bacteria can provoke the immune system.
• A sudden change in symptoms may need to be checked by a healthcare professional because it can worsen the ongoing problems.

What To Record

Keep a simple track of your bowel movements, including how often they happen and whether you notice blood or mucus. Note any pain, urgency, fever, or other symptoms. It can also help to write down what you eat, which medicines you take, any missed doses, your sleep, stress levels, and possible triggers. This gives a doctor a clearer picture of how your condition is changing and what changes in treatment may be needed. 

Food, Fluids And Rest During A Flare

During a flare, the focus should be on staying hydrated, eating foods you can tolerate, and giving your body enough rest. These are some important points you should remember:

• Choose foods that are easier to digest and avoid foods that clearly worsen your symptoms.
• Keep up with your fluids; drink water regularly, especially when you have frequent diarrhoea. Oral rehydration solutions may help if you are losing lots of fluids.
• Eat smaller meals because 5 or 6 small meals are easier to digest than larger meals when symptoms are active.
• Get enough sleep and take breaks when needed.
• Try to maintain adequate nutrition unless your doctor has advised specific dietary restrictions.
• Avoid high-fat meals, fried food, spicy food, raw vegetables, whole nuts, alcohol, sugary drinks, and heavy caffeine.
• Eat well-cooked foods; include ripe bananas, skinless carrots, and plain oatmeal in your diet.

Why Medicines Should Not Be Changed Alone

Don't stop, start, or change IBD medicines without consulting your doctor. Symptoms can have different causes, including infection and inflammation levels, and changing treatment without any assessment may make things worse. Dose adjustments may cause severe side effects and severe flare-ups. That's why only a healthcare professional should adjust your medicines based on your diet and medical diagnosis.

When To Call The IBD Team

Contact the IBD team if: 

• Your symptoms are getting worse or changing from the usual pattern
• Diarrhoea becomes more frequent
• You notice more blood in stool
• Abdominal pain increases
• You develop a fever
• Symptoms continue even after the treatment
• Your medicines are not working on the ongoing symptoms.

When To Seek Urgent Care

Seek immediate medical help in case of:

• Heavy bleeding from the rectum
• Severe abdominal pain
• A swollen or very tender abdomen
• Repeated vomiting or inability to keep fluids
• Severe diarrhoea and dehydration
• Severe dizziness, fainting, or extreme weakness
• High fever
• Rapid worsening of the symptoms

Reference

Case-control study of factors that trigger inflammatory bowel disease flares - PMC

When Should Therapy for Inflammatory Bowel Disease Be Stopped? - PMC

Medication Non-Adherence in Inflammatory Bowel Disease: A Systematic Review Identifying Risk Factors and Opportunities for Intervention - PMC

What Is a Flare? The Manitoba Living With IBD Study - PMC