Trigger for a relapse in Crohn’s disease

Many people mistakenly believe that a certain behavior would trigger a relapse of Crohn’s disease. However, the development of the disease and relapses is highly complex and not yet fully understood. Therefore, it is not possible at this time to make a reliable statement about the causes of relapses in Crohn’s disease.

For example, it is not possible to assume with certainty that certain foods will trigger an attack. It is only known that nicotine has a negative influence on the development of Crohn’s disease. It is therefore very important that people who suffer from Crohn’s disease do not smoke.

However, nicotine is the only known avoidable risk factor. Triggering factors such as specific genetic factors or similar cannot be influenced by the patient. According to studies, psychosocial stress is also believed to promote the occurrence of a relapse.

Duration of a relapse in Crohn’s disease

Experts are reluctant to make specific dietary recommendations for patients with Crohn’s disease. There is no scientific evidence that a specific diet helps with Crohn’s disease. For many patients, however, diet plays an important role.

Food allergies and intolerances should be clarified for patients with Crohn’s disease, as they can be partly responsible for gastrointestinal complaints. Foods to which an intolerance or allergy exists should therefore be avoided. Many people are lactose intolerant, so a low-lactose diet can be beneficial.

In general, adequate and balanced nutrition should be ensured in Crohn’s disease, as malnutrition has a negative effect on the regression of a relapse and on the overall health of the person affected. Patients with Crohn’s disease should seek individual advice from a doctor trained in nutritional medicine or a qualified nutritionist. General recommendations cannot be given without further discussion.

Various drugs are used to treat an acute episode of Crohn’s disease. As a rule, steroids are used for a mild to moderate relapse in order to achieve remission of the relapse. However, there are also cases in which a relapse does not respond adequately to steroids and the symptoms do not improve.

In such cases, other drugs are used, namely the so-called immunosuppressive drugs. These include TNF-alpha antibodies such as adalimumab (Humira®); and azathioprine. Why a relapse in some patients under steroid therapy shows no improvement is not certain.

Some patients have very high inflammatory activity and severe symptoms that respond poorly to medication. Other patients, however, respond very well to steroids. This can vary from relapse to relapse.

If a relapse does not respond to immunosuppressive therapy, more research is needed to find the trigger for the worsening of the disease. The cause may be an infection or a complication of Crohn’s disease. Such complications are fistulas, narrowing of the bowel (stenoses) or abscesses, i.e. encapsulated accumulations of pus in the bowel. These circumstances should be clarified diagnostically. Incorrect or inadequate administration of the medication by the patient is also conceivable if the relapse does not respond properly to the therapy.