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
Strange Jelly-Like Substance Observed from Wound
I’m a 21-year-old female living with an auto-inflammatory condition known as hidradenitis suppurativa (HS). Recently, I've experienced a concerning issue with one of my wounds. This particular wound causes significant pain and excessive bleeding. However, whenever I attend to it, I tend to find this unusual jelly-like substance present within it. Interestingly, this phenomenon has only occurred with this one wound and not any of the others I have. The bleeding seems to persist until I manage to remove this jelly substance, after which it typically slows down and comes to a halt completely. I’m seeking insights into what this might signify so that I can effectively discuss it with my healthcare provider.
Battling Chronic Nausea and Vomiting for Over Two Years
For the past two years, I (age 26, female) have been enduring an incredibly challenging health situation. I experience intense nausea daily and find myself vomiting numerous times, with almost nothing providing relief. To provide some background, I’m from West Texas and I currently weigh around 190 pounds, standing at 5’7”. Initially, my weight was about 211 pounds when these symptoms began, and it fluctuates frequently between 190 and 225 pounds. I engage in vaping and consume THC. Previously diagnosed with hypothyroidism, my condition seemingly resolved, according to my healthcare providers. Additionally, I have polycystic ovarian syndrome (PCOS). I have consistently faced irregular bowel movements, with stools that are loose and sometimes appear to have mucus. Compounding my struggles, I've also suffered from migraines. I have had an IUD for over five years, experiencing two insertions of the Kyleena device. In December 2022, my battle with health took a severe turn when I was diagnosed with stage 4 Hodgkin’s Lymphoma, requiring chemotherapy treatment, specifically AVBD (Apologies for not recalling the exact medication names). By July 2023, I had fortunately achieved remission. However, after reaching remission, my vomiting worsened, transforming from primarily white foam to a mixture of 80% bile, any food I attempt to consume, and still white foam. This intense vomiting, accompanied by significant pain in my upper back, escalated to more than eight episodes daily by November 2023. At that time, THC seemed to be the only avenue for me to retain any food. During this tumultuous period, I consulted various doctors who, after confirming I wasn’t pregnant, attributed my symptoms to Cannabinoid Hyperemesis Syndrome (CHS). Immediately, I ceased THC consumption for over six months, yet the vomiting continued unabated. Each time, doctors would prescribe ondansetron, regardless of my claims that it provided no relief. I experimented with various diets recommended by medical professionals, but there were no improvements in my condition. Eventually, I obtained a referral to a gastroenterologist who intended to perform an endoscopy. However, the procedure was prohibitively expensive even with insurance, and thus was never conducted. This doctor also ordered blood tests to rule out several gastrointestinal disorders, such as Crohn's disease, Irritable Bowel Syndrome (IBS), and gluten sensitivity, but all results came back normal. Afterward, I had another appointment with a different gastroenterologist, but the doctor failed to meet with me. Instead, a nurse informed me that the doctor had merely recommended promethazine without conducting any tests or scheduling further visits. When I mentioned the possibility of gallbladder issues, the doctor laughed dismissively at my suggestion. Discussing my situation with my oncologist, he suggested that my heightened sensitivity to food odors stemmed from my chemotherapy experiences while I was working in fast food. While food smells indeed affect me, I'm primarily triggered by medical scents such as rubbing alcohol and cleaning agents. This ongoing ordeal has been overwhelmingly distressing. I now experience episodes of vomiting accompanied by bright red blood, presumably due to a throat tear. When I first encountered this troubling symptom, I consulted a doctor who appeared unfazed and prescribed a promethazine suppository, which does help but makes me extremely drowsy. My nausea persists nearly around the clock, often feeling as if there’s a heaviness in the upper part of my abdomen. I frequent urgent care facilities when my symptoms intensify, only to be met with minimal assistance since this is a chronic issue. Currently, I lack a primary care physician. Whenever I sought one, I encountered skepticism regarding my condition, with some healthcare professionals implying that I was exaggerating my symptoms. Though many physicians who do take my situation seriously seem baffled, I've lost count of the diverse medical experts I've consulted about these ongoing issues. If anyone has insight or suggestions, I would genuinely appreciate it. I can share my latest bloodwork results if that would be helpful—just let me know!
Strange Stomach Sensation Leading to Waking Up
Greetings. I'm a 36-year-old male, standing at 172 centimeters and weighing 90 kilograms. I don't take any medications, nor do I smoke. I've been living with diastasis recti for several years now, and I may also have irritable bowel syndrome (IBS). Additionally, I deal with fatty liver and kidney stones, though I assume these last two conditions are not related to my current concern. Occasionally, I experience a peculiar sensation that jolts me awake; it feels like a quick pulsing in my stomach. I’ve noticed it tends to affect the left side when I’m lying on my left side and the right side when on my right. Remarkably, it can occur even when I’m on my back. This strange feeling often escalates into a surge that fully rouses me. Alongside this, I sometimes feel prickling sensations throughout my body and fleeting lightheadedness. When this sensation disturbs my sleep while I’m turned to my side, shifting onto my back or the opposite side might alleviate it, but not always. In instances where I awaken while lying on my back, I discovered that gently pressing my hands on either side of my stomach can help, as can rising to a sitting or standing position. However, during my last two episodes—one a couple of weeks ago and another tonight—those techniques weren’t effective right away, which made me feel a bit anxious, prompting me to seek advice. Does anyone have insight into what might be going on? By the way, I’ve undergone routine ultrasound examinations of my abdomen by two different physicians during check-ups, both of whom assured me that everything appears normal, including my abdominal aorta and internal organs. They didn’t identify any issues at that time.
Healing Progress Post-GBS: Toe Concerns
I am a 28-year-old male, measuring 5 feet 10 inches and weighing 131 pounds. My current medications include Fomadatine and Zyrtec, prescribed due to my ongoing battle with Chronic Gastritis and SIBO. I maintain a healthy lifestyle, abstaining from both smoking and alcohol. My health concern revolves around the toe adjacent to my pinky toe on my left foot, as well as my pinky toe on the right foot. Since August of last year, I have been on the mend from Guillain Barre Syndrome. Recently, I've noticed that at night, the skin on my feet tends to turn a reddish pink, although this usually improves after I walk around. However, two of my toes have remained red, with one appearing slightly swollen. Generally, my pinky toes are quite thick, but the condition of my left foot's toe is worrisome for me. It seems that I'm unable to upload an image to illustrate my issue.
Swelling Beneath My Chin Near the Jawline
18-Year-Old Male: I'm reaching out to any medical professionals who might provide insights into my situation. I've been using marijuana since I was 14, but now, at 17, I'm making an effort to stop and have been clean for 18 days. Recently, I've discovered an unusual swelling located just beneath my chin, behind my jaw. It causes some discomfort when I move, yet it doesn’t feel painful continuously. I'm somewhat anxious that this could be indicative of a more serious issue, especially considering it's positioned near my chin's lymph nodes. Any advice or information would be greatly appreciated as it might help alleviate my worry.