Does Crohn’s Disease Go Away

One of the questions we get asked from our newly diagnosed crowd is – Does Crohn’s Disease go away? The same goes for UC and microscopic colitis.

Understandably, many of us want to know how much control we can have over the trajectory of the disease. Although Crohn’s, Ulcerative colitis and Microscopic colitis are not diseases that just disappear, they can go into remission.

However, many people aren’t aware that there are 4 types of remission IBD can go into. If you’ve never looked into the 4 types of remission for IBD – make this your first stop in understanding your IBD better.

For those that are new to IBD – Crohn’s Disease is a type of inflammatory bowel disease and IBD that causes chronic inflammation anywhere along the gastrointestinal tract, most commonly affecting the small intestine and parts of the digestive tract.

When someone is diagnosed with Crohn’s Disease, their immune system mistakenly attacks healthy tissues, causing inflammation and actual damage. This ongoing inflammation leads to a variety of complications that can be difficult to live with, but treatments have improved a lot over the last ten years and we know much more about how to help those with IBD.

Although Crohn’s Disease is chronic and does not completely disappear, many people achieve meaningful improvement with proper care. While flare-ups can still happen, consistent treatment and monitoring can reduce inflammation and risk significantly. Many individuals achieve periods of remission where symptoms become mild or disappear altogether.

Including IBD nutrition therapy as a part of treatment can help with inducing remission, maintaining remission and help your medications work better ¹,².

In terms of medical nutrition therapy for Crohn’s disease and IBD in general – dieitians skilled in IBD (like us) can help with:

• Providing tools for symptom relief for bloating, abdominal pain, diarrhea and constipation
• Giving you guidance around what we know increases and decreases risk of inflammation in IBD
• Helping you treat nutrient deficiencies and have a game plan to prevent them
• Treating and prevention malnutrition so medications can work better

Does Crohn’s Disease Go Away?

Crohn’s Disease does not fully go away in a curative sense but it can enter into periods of remission where the IBD is in deep remission and even not noticeable for some.

There are also nutrition strategies that can help reduce risk of flare-ups all together and treat current flares. Our recommended starting point for this is our Flare Guide + Meal Plan.

With the right treatment plan, many people can reduce symptoms and reach remission for long stretches of time. By learning to manage inflammation, triggers, and stress, individuals can improve their chances of reaching and maintaining remission. Effective symptom management can also help restore a sense of normalcy and improves quality of life.

If our e-book isn’t enough and you’d like customized to you guidance – reach out to work with us.

How To Put Crohn’s Disease In Remission

While there isn’t a magic formula to put Crohn’s in remission- you can focus on strategies that help improve the odds of getting to remission! One of the best things you can do is stay on your treatment suggested by your gastroenterologist – even when things feel better because you can still have inflammation even when symptoms are controlled.

Adding in nutrition therapy is another layer of care that can integrate well into current therapies. We already know how important nutrition is to helping your body be in a state that is more receptive to medications. Treating nutrient deficiencies is also key to making sure your body has the best chance of getting to remission.

The overall goal of both paths is to reduce inflammation in the gastrointestinal tract, support the immune system’s balance, and promote healing. Although each patient’s journey is unique, the right approach can also help minimize flare-ups.

Anti-inflammatory drugs & Biologics

Anti-inflammatory drugs are less commonly used in Crohn’s since Crohn’s can impact many areas of the digestive tract other than the large bowel. Biologics are more commonly the first line of therapy in Crohn’s disease.

Biologics tend to start working after several infusions. They target specific pathways that cause inflammation, making them one of the most effective therapies available for Crohn’s. They do come with risks and side effects, but so does uncontrolled inflammation.

Many biologics are safe in pregnancy as identified in the PIANO study, however pregnant individuals will want to discuss pregnancy with their doctor to make sure.

Medical Nutritional Therapy for Crohn’s

Medical nutrition therapy (MNT) for Crohn’s disease is done by a licensed dietitian specialized in IBD and is using nutrition to treat IBD. MNT is different than just providing basic nutrition guidance – it goes a step further and assists with treating nutrient deficiencies and using specific evidence backed supplements or food-based approaches to treat Crohn’s.

Using MNT we can also help you understand your triggers better. Often this means we can help you find ways to tolerate out of reach foods better and give you an understanding of what’s actually driving symptoms for you.

Medical nutrition therapy in our practice goes beyond just giving you a handout of foods – we get more hands on and individualized. We did into your labs, run nutrition related labs for you, help you troubleshoot nutrients that stay low, help you figure out your triggers and give you tools to reduce risk of flare-ups.

If this sounds like what you’ve been dreaming of – reach out and work with us.

Surgery

Surgery is typically considered when other treatments fail. It provides immediate relief by removing severely inflamed or blocked segments of the digestive tract.

Surgery may be necessary with complications like strictures, fistulas or severe inflammation.

What Are The Signs Of Crohn’s Remission

When it comes to remission – it’s important to distinguish if we are referring to inflammation relief or symptom relief since they are two different things.

When it comes to biochemical remission, lab markers like fecal calprotectin, CRP, lactoferrin and sedimentation rate are really the only way to understand if inflammation is present or not. Also, sometimes these markers alone are not enough and a colonoscopy will be needed to fully understand where inflammation is at.

Symptom remission is simply the absense of symptoms. In the absense of symptoms, inflammation may still be present so it’s important to still continue with treatments.

How Long Can Crohn’s Remission Last

Remission length varies greatly depending on the person and the treatment for Crohn’s disease they are using. Some individuals remain without inflammation and symptom-free for months, while others enjoy remission that lasts several years.

The best things you can do to get to remission and stay there longer is to stay on treatments, incorporate nutrition therapy with a dietitian, run nutrition related labs yearly and be sure to reach out to your healthcare team if you notice new symptoms right away.

How To Stay In Crohn’s Disease Remission

Follow your treatment plan consistently

Sticking to prescribed medications helps control inflammation and prevents future flare-ups. Skipping treatments can lead to worsening symptoms or sudden relapses. By staying consistent, you significantly boost your chances of maintaining remission.

Treat malnutrition with an IBD dietitian

If you find yourself skipping meals to avoid triggering symptoms more than twice a week, if you’ve experienced unplanned weight loss, if you’ve got one or more nutrient deficiences – you may want to get checked for malnutrition. Malnutrition is very common in IBD and can impact how well you respond to medications! Use our checklist as a starting point – HERE.

Most people we talked to do not think they are malnourished- but upwards of 75% with IBD experience being malnourished at some point. To treat it properly, you really need the skills of a licensed dietitian that has experience in IBD.

Use your diet to prevent flare-ups

Did you know that there are certain food patterns that increase and decrease risk of flare-ups and inflammation in IBD?

I often talk with people on inquiry calls who feel that they need to track everything they eat to figure out what works. However, this is not the case at all! In fact, that route can be very misleading.

If you are tracking food and noting which foods give you symptoms – this does not indicate that it makes the disease worse, or that it causes flares or inflammation. It simply indicates your tolerance – and tolerance can change with time, changes with the microbiome and with modications to food.

To really understand how to prevent flare-ups, we need to look beyond tracking symptoms. Some resources to check out on the topic are below.

E-book: What to Eat with IBD + Meal Plan

Blog: best foods for Crohn’s Disease.

References:

¹ Ghiboub M, Penny S, Verburgt CM, Boneh RS, Wine E, Cohen A, Dunn KA, Pinto DM, Benninga MA, de Jonge WJ, Levine A, Van Limbergen JE. Metabolome Changes With Diet-Induced Remission in Pediatric Crohn’s Disease. Gastroenterology. 2022 Oct;163(4):922-936.e15. doi: 10.1053/j.gastro.2022.05.050. Epub 2022 Jun 7. PMID: 35679949.

² Halmos EP, Gibson PR. Dietary management of IBD–insights and advice. Nat Rev Gastroenterol Hepatol. 2015 Mar;12(3):133-46. doi: 10.1038/nrgastro.2015.11. Epub 2015 Feb 3. PMID: 25645969.