Crohn’s disease: should the same diet continue after a flare?

Call 15 or 112 in France without delay if abdominal pain is sudden and severe like a stab, spreads from the upper abdomen to the chest, neck or shoulders, occurs after trauma, accompanies vomiting blood or brown fluid, occurs with faintness and fever, or occurs with nausea and vomiting in a person with diabetes. Also call if the abdomen is very hard, painful and rigid, breathing is difficult at rest or worsening, or a new kind of pain occurs during pregnancy. Rectal blood flowing heavily with pallor, rapid breathing or heartbeat, sweating or faintness also requires an emergency call.

Outside these emergencies, seek care the same day if pain is accompanied by nausea, vomiting or fever, difficulty urinating, no stools and no gas, yellow skin or eyes, an unusually late period, or red blood or black stools; also seek care the same day for high fever or new persistent pain preventing usual activities. Otherwise, arrange a prompt appointment if pain or stool frequency increases or for an unusual symptom, including fever while taking corticosteroids.

When Crohn’s disease is quiet, Ameli recommends a balanced diet rather than a routine special diet. Energy, protein, iron, calcium and vitamin D needs deserve attention suited to your circumstances. Do not permanently remove food groups without medical advice: overly broad restriction can make adequate nutrition harder.

During a flare, a temporarily low-fibre diet may be suggested to limit digestive symptoms. Ask which foods to adapt, for how long and how to return to adequate nutrition.

If you have lost weight or malnutrition is identified, the team may suggest suitable nutritional support. Tell them about difficult meals, weight loss and how symptoms affect your food intake.

Prepare for follow-up with a list of foods you avoid and your questions. Ask the dietitian how to meet your needs during and after the flare, then keep the checks agreed with the team.