Crohn’s Disease: 10 Daily Dilemmas Solved.


One of the frustrations of Crohn’s disease is its unpredictability. It can be tough to pin down when — or where — you’ll feel a flare of the symptoms of Crohn’s, such as diarrhea, abdominal pain, and fever. Diet, medications, and other Crohn’s treatment strategies should help you manage the disease well most of the time. But inevitably, there will be occasions when you have to stop whatever you’re doing to tend to your Crohn’s needs. Here are some common dilemmas people with Crohn’s may face and ways to deal with them.


Getting to work can mean a trip in a car or on a bus, subway, or train without a bathroom. John Nesco, 44, of Connecticut, who has Crohn’s and who facilitates support groups for the Crohn’s & Colitis Foundation of America, recommends choosing your breakfast foods carefully. Avoid foods and beverages that are more likely to cause you symptoms of Crohn’s. Coffee is often a big no-no because its caffeine content can be a trigger. If your Crohn’s treatment plan includes medications, talk to your doctor about timing them so you’re in good shape for your commute. Also discuss taking medications that help firm your stools if you experience frequent diarrhea. And, it helps to know the location of any public restrooms along your route, should you need one.


Managing Crohn’s at work may not be a problem most of the time, but it’s a good idea to keep an extra set of clothing in your desk or a locker just in case, Nesco says. You can ask that your desk be moved closer to the restroom and discuss the possibility of telecommuting on days you can’t leave home because of flaring symptoms. Crohn’s is covered by the Americans With Disabilities Act, says Raymond Cross, MD, co-director of the Digestive Health Center at the University of Maryland Medical Center in Baltimore. That means your employer must make reasonable accommodations for you if needed.


With Crohn’s, you can look perfectly fine on the outside even though you may feel terrible on the inside. So, if you don’t say anything about having Crohn’s, your boss and co-workers may wonder why you take more bathroom breaks than others, or why you call in sick more often. It may help to let them know you have a digestive disorder. However, you needn’t go into too many details about the symptoms of Crohn’s or other aspects of the condition, Nesco says. If you’re too scientific, their faces may just glaze over. Offer just enough information to be clear you have a medical condition, and chances are they’ll be understanding.


Having Crohn’s may cause you to miss work for frequent doctor’s appointments or, if you’re having a flare and not feeling well, you may need to take some extended time off. It’s a good idea to fill out a form for a medical leave under the Family and Medical Leave Act and have it on file with your employer, suggests Miguel Regueiro, MD, co-director and clinical head of the University of Pittsburgh Medical Center’s Inflammatory Bowel Disease Center in Pennsylvania. You may never need to use it, he says, but “Many people with Crohn’s find that once this is in place, it’s as if a weight has been lifted and they’re not as stressed.” And that’s a great benefit, because stress can make managing Crohn’s even harder.


Being a student with Crohn’s can present challenges, like when you have to sit for a long lecture or take a timed test without bathroom breaks. It’s important for teachers and the school nurse to be informed about you or your child having Crohn’s. You’ll have an easier time asking instructors to let you take a test off the clock or break it into sections with a bathroom break at the end of each one, as well as any other accommodations you might need.


Dating can be a minefield all on its own, but add the symptoms of Crohn’s to the equation and dating becomes even more complicated. When you’re just getting to know someone, it can be hard to judge how much to say about your Crohn’s. You may feel the need to say something early on about why you’re ordering certain foods at a restaurant or limiting alcoholic beverages. Nesco’s advice is the same for a potential romantic interest as a co-worker — start with the basics and don’t get too scientific. One suggestion: “I have Crohn’s disease, which means my digestive system doesn’t work as efficiently as other people’s.” If your date is turned off by your having Crohn’s, he or she probably isn’t right for you.


You may need a special strategy for social occasions, especially those that involve food. If controlling what you eat is vital to managing your Crohn’s, follow up a party invitation with a call, offering to bring a dish or appetizer that’s a “safe” food for your Crohn’s diet. Depending on the start time, you may need to eat something before you go to avoid eating off schedule, which can aggravate symptoms of Crohn’s. Once you get there, do your best not to overindulge. If you find that you’re having a flare on the day of an event and aren’t up to going, call the host and, without guilt, explain that you’re having a symptom flare and will be unable to attend. Look out for yourself during these difficult moments — true friends and family members will understand.


Whether you’re traveling for business or pleasure, when managing Crohn’s it’s important to plan ahead. Bring medications in a bag that you carry with you at all times and never put them in checked luggage. Tell your doctor about your travel plans and make sure you’ll have enough medication for the entire time you’re away. Take a list of all your medications as well as your doctor’s and pharmacy’s phone numbers in case you need a refill at your destination for any reason. Also be sure to bring a few extra undergarments and, if you use them, travel-sized moist wipes.


Managing the symptoms of Crohn’s while travelling is easier when you do your homework before you go. If foreign travel is on the itinerary, part of your assignment should be learning the local lingo. Be sure you know how to say, “I need to use the bathroom and it’s urgent,” or have key phrases printed on an index card that you can show. You can look up the words in a travel guidebook, get them from a mobile app on your phone, or use an online translation Web site. You should also research nearby restrooms for sightseeing days and other travel destinations.


No matter how well your Crohn’s treatment is working, there will be times when you find that you urgently need to use a restroom. Restrooms in restaurants are often for patrons or employees only. However, if you become a member of the Crohn’s & Colitis Foundation of America, you can get an “I Can’t Wait” card to carry with you at all times. The card says that you have Crohn’s and cannot physically “hold it.” Show this card and you should be granted access to a restroom, wherever it may be.

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