Managing Crohn's Flare-Ups and New Symptoms
I’m a 30-year-old female diagnosed with Crohn’s disease and ankylosing spondylitis two years ago. Currently, I’m on Skyrizi and received my latest injection just a week back. This past week has been incredibly challenging. Between work stress and inadequate sleep, I've been struggling. Yesterday, I experienced a severe panic attack accompanied by a migraine, leading me to take three Advil, which, in hindsight, was not a wise decision. After finally managing to catch up on rest—sleeping a staggering 15 hours—I still woke up feeling drained. To make matters worse, I have been dealing with significant rectal bleeding accompanied by constipation, which is alarming as it feels like blood is just flowing without any stool. While my doctor suspects that this could be a result of a fissure or hemorrhoid—conditions I’ve previously experienced—the intensity of the bleeding this time is unlike anything I’ve encountered before. I’m feeling rather lost and unsure of how to proceed. Although my physician suggested that the bleeding and fatigue could be attributed to the fissure or hemorrhoid, I have come across information that raises doubts about that theory given the volume of blood. To tackle the constipation, my doctor recommended using Miralax, but I’m hesitant to take it if I’m experiencing a flare. A couple of months back, I briefly took 10 mg of prednisone for four days to mitigate my AS pain during a climbing and hiking trip. In retrospect, that may not have been the best idea, and it leaves me wary of resorting to steroids again. My biggest fear is that I might experience a severe flare this weekend when I won’t have anyone available to assist me. What steps should I take next?
Answers (1)
7/9/2025, 7:50:41 PM
OpenHealth AI
It's understandable to feel overwhelmed with the combination of Crohn’s disease, ankylosing spondylitis, new symptoms, and the stress of daily life. Your concerns about the rectal bleeding, fatigue, and the situation worsened by panic attacks are valid. Here’s a structured approach to address your situation thoughtfully and effectively.
Main Points:
- Monitor Rectal Bleeding: The intensity of blood loss you're experiencing requires close observation.
- Managing Constipation Safely: It's essential to address your constipation appropriately during a flare.
- Stress Management: Anxiety can exacerbate your physical symptoms; managing stress is crucial.
Explanation:
- Rectal Bleeding: While your doctor may suggest that the bleeding is due to a fissure or hemorrhoid, the volume you're describing is concerning. Crohn’s can cause inflammation and ulcers, which may also contribute to bleeding.
- Constipation and Medications: While Miralax is generally safe, during a flare is an especially sensitive time. Your discomfort may influence how you choose to manage this condition, especially if you're worried about worsening your symptoms.
- Panic Attacks and Sleep: Stress and sleep deprivation can significantly impact your conditions. A panic attack may manifest due to the stress of your symptoms, and it's important to address these aspects to alleviate your overall distress.
Next Steps:
-
Immediate Monitoring: Keep track of the bleeding. If it intensifies or if you experience dizziness or significant changes in your condition, prioritize a medical evaluation, even if it means seeking out urgent care.
-
Address Constipation with Caution:
- Dietary Adjustments: Focus on hydration and eating high-fiber foods such as fruits, vegetables, and whole grains. Increase your fluid intake to help soften your stool naturally.
- Miralax (if necessary): If constipation persists and your situation allows, consider using a smaller amount of Miralax (as directed). Monitor your symptoms closely. If in doubt, it's better to consult with your healthcare provider about adjusting the dosage, especially if you have concerns about how it interacts with your current condition.
-
Stress Management:
- Relaxation Techniques: Practice deep breathing, mindfulness, or gentle yoga to help reduce anxiety. Consider utilizing mobile apps or online resources that guide you through relaxation exercises.
- Prioritize Sleep: Continue to ensure you are getting enough rest. Create a bedtime routine that helps signal to your body it's time to wind down.
-
Prepare for Flare Management:
- Emergency Plan: Have a plan in place for when you experience a flare-up. This might include having medications on hand to manage pain or inflammation and identifying someone you can contact for help if symptoms worsen.
- Stay Informed: Know the signs of when to seek immediate medical assistance (increased bleeding, high fever, severe pain, etc.).
Reassurance:
It's okay to feel concerned, and you’re taking worthwhile steps by seeking guidance. Remember to prioritize your well-being, and don’t hesitate to reach out to your healthcare provider with any changing or worsening symptoms. You’re not alone, and there are pathways to support you through this time.
Related Questions
Nodular Melanoma or Blood Blister: Seeking Insight
Subject: Nodular Melanoma or Blood Blister? Hello, I am a 23-year-old female, weighing 210 pounds and standing at 175 cm tall. I only have partial knowledge of my family's medical history, and cancer has never been mentioned before. I spend time outdoors and do not have any known allergies. The only medication I am currently on is Ozempic. Recently, I've discovered a lump on my left buttock. I first noticed this swelling a few months back, but it wasn’t painful and was in an area I didn’t frequently observe, so I initially dismissed it. However, I've observed it has increased in size. When I took a closer look using a mirror, I was startled to see its very dark coloration. As a paramedic, I should have been more cautious, but I mistakenly assumed it was just a typical blood blister and, using an IV needle, I poked it. Unfortunately, this was unhelpful; it bled but did not reduce in size, and it seems to have become more pronounced since then. The mass feels hard, has irregular borders, and exhibits a dark red to purple hue, with a touch of pink. Due to its location, it’s difficult to assess the size accurately, but I estimate its circumference resembles that of a penny and it protrudes about 4 mm. It is immobile and causes slight discomfort when I sit down. I could really use some guidance on this issue as I wait for my doctor's appointment on Wednesday.
Persistent Ear Infection: Seeking Over-the-Counter Solutions
At 22 years old and without any significant medical issues or current medications, I find myself dealing with an ear infection that has persisted since at least December of the previous year. I've consulted numerous physicians at various walk-in clinics, yet none have successfully resolved the problem. Initially, some doctors misinterpreted my condition, suggesting I simply needed to reduce exposure to loud music. The most recent doctor has placed me on a waiting list to meet with a specialist, but frustratingly, I haven’t received any antifungal treatments or drops. I previously tried fluconazole, which was prescribed, but it proved ineffective and led to an allergic reaction. For some time now, I have been unable to hear from my affected ear, and I experience pain along with peculiar vibrations in my head throughout the day. I'm at my wits' end. Are there any over-the-counter remedies I could try? After waiting for a month on the specialist list with no updates, I’m eager for some helpful suggestions.
Could This Be FSGS?
Hello everyone, I'm a 24-year-old male, and three months ago, I experienced a sudden and drastic loss of appetite; I could go several days without eating. Alongside this, I noticed irregular stool and other complications. Initially, I suspected it was a flare-up of my IBS, despite having never lost my appetite due to it before. I consulted my gastroenterologist, who performed an endoscopy, colonoscopy, various blood tests, and everything came back normal. Following this, I underwent an ultrasound. Most organs appeared healthy, including my liver and pancreas, except for my right kidney. It measured 11.6 cm in length and was 0.2 mm taller than normal, presenting a patchy texture and increased echogenicity in the upper region, but no hydronephrosis was detected. My left kidney appeared normal.Beyond that, I've been noticing foam or bubbles in my urine every time I use the restroom, and it can occasionally look cloudy, though that's not consistent. Additionally, I have experienced some headaches, canker sores, occasional mild nausea, and strange sensations on my side or upper right back—though they are not painful, they do come and go. I've had three urine tests (none were 24-hour collections), all of which returned negative results for blood and protein. However, the most recent dipstick test showed trace amounts of protein and a urobilinogen level of 2 mg. I have not had any fever or pain during urination. My glomerular filtration rate (GFR) was recorded at 108, with my red blood cell count exceeding 5, creatinine levels at 1, and a BUN/creatinine ratio of 14. I'm feeling somewhat lost with these findings since, to my knowledge, there's no family history of kidney problems. I maintain a healthy weight, exercise regularly, and follow a balanced diet. I also consulted with a urologist who expressed similar confusion and has requested an MRI for a closer examination of my kidney. Although I understand it's not the most reliable source, my interactions with GPT suggested the possibility of FSGS based on my blood tests and imaging. (My blood work was conducted two months ago.) This situation has made me quite anxious, and I would appreciate any insights from those with similar experiences or symptoms. Thank you!
Experiencing Numbness on the Left Side of My Body
I'm a 32-year-old male and I'm attempting to articulate a troubling situation that has left me feeling quite distressed. For several years, I've been coping with discomfort in the region of my left shoulder blade. This pain would diminish temporarily when I released gas, only to return again. Over time, the discomfort began to spread to my left thigh and occasionally to other areas on my left side. I assumed it was linked to digestive issues, potentially from excessive stomach acid, leading me to think that the trapped gas might be irritating some nerves—an issue that should be relatively easy to resolve. When I consulted my physician, she prescribed omeprazole to alleviate my stomach acid problems, which has proven effective; however, the back pain persists and appears to be expanding. We've conducted X-rays, CT scans, and I'm scheduled for an MRI on my left shoulder blade to investigate further, but so far, results have been inconclusive. A recent colonoscopy and endoscopy for an unrelated matter showed no significant findings. My doctor has brought up the possibility of a nerve injury but prefers to explore other avenues before referring me to a neurologist. She also cautioned that there might not be a clear diagnosis at all, which has been disheartening. Recently, I've noticed increasing numbness on the left side of my face, which includes my throat, tongue, and eye socket. The numbness seems to be affecting various parts of my left side. I've engaged in some personal research, and it aligns with my doctor's suggestion about nerve damage; however, I'm uncertain. While I don’t suspect it's a stroke, I’m curious if anyone else has experienced similar symptoms. Could this be indicative of nerve damage? I’m striving to convey my situation clearly, but the chaos of it all is overwhelming, and I'm hesitant to visit the emergency room due to financial constraints. Currently, I'm taking three medications: Adderall, lithium carbonate, and omeprazole. The symptoms I’ve been describing were present before starting any of these treatments.
Understanding the Dotted Scabs on My Foot
I’m a 24-year-old male, and I've recently discovered some unusual dotted scabs on my foot that I hadn't noticed until I accidentally touched it. Interestingly, these spots did not emerge from any obvious injury or cut. A few weeks back, I noticed similar scabs on my leg, which I initially dismissed as a minor scratch. However, the recurrence of these little dots resembling dried blood on a small section of my foot has raised my concern about what might be causing this condition.