What exactly is considered a Crohn's "flare" anyway?

[DadMan]

I've been spending all morning doing Crohn's research since I'm not feeling well, and kind of depressed about it and all, it occurred to me that I've never really understood what a "flare" means when I see it referenced.

Is a flare when you when you have a sudden urge -- to go, and that's the flare?

Or is a "flare" when you're not in remission?

In my case, I've had diarrhea or loose BM (i.e., anything but a normal one-a-day BM) for over a year...so does that mean I've had a flare that's lasted over a year?

Or is when wake up at 2am out of bed to race to the toilet...that's the "flare"?

 

[Astra]

Hiya Dadman

I think everyone is unique with their symptoms, for me a flare is frequent explosive diarrhea up to 15 times a day, urgency, nausea, fever, vomiting, joint pains and general malaise.
I was like this back in January, and went to hospital, I was blocked and infected.
I've never been like this before, and my gastro called it a major flare!
On a daily basis, I can go up to 5 times a day, this is normal for me, and I'm in remission!
My gastro once told me that it's not the amount or frequency of D he's looking for, it's inflammation, that constitutes a flare!
I don't have any inflammation or joint pains etc, but I still have loose bowels, so therefore, I'm not flaring!
hope this makes sense?
xxx

 

[Crohn's 35]

Flare for me pain :yfaint: bloat and gas....

 

[Entchen]

Hey, DadMan. Great name! Like Joan's gastro, mine says Crohn's is inflammation. Pure and simple. The rest comes alongside. He was pretty insistent on this point, so I didn't ask for any qualifying info.

 

[mykdsmomy]

For clarification purposes, can I ask then if you are not flaring when you have a colonoscopy (for dx) then how can they diagnose Crohns?

(don't mean to hijack Dadman )

 

[Entchen]

Hi Mykds: My understanding is that evidence of past disease is often present. That's a great question, though, and I think it's why sometimes people can have a difficult time getting diagnosed.

 

[Astra]

Yes I agree with Kelly!
they can sometimes see scarring caused by inflammation, which can cause strictures, but the inflammation is not always present! Therefore making a diagnosis very difficult, and just cos it's not there during a scope, doesn't mean to say it's not there??
If that makes sense!

 

[Balgeary]

It's been my understanding that a flare up is when, after feeling as close to normal as possible, your symptoms return with a vengeance. Whether that be your bowel movements, aches and pains, or overall malaise, it constitutes a flare. At least that is how we use it 'round these parts to convey the general situation between me and mine so as to be on the same page. It helps to know the basics of the current condition so as to steer toward the proper procedure for the day (week, month...) and enable a better understanding and level of support that may be needed.

 

[mykdsmomy]

Thank you, Joan and Kelly

 

[DadMan]

Thanks for all the replies...

so....based on others' experiences, is it unreasonable or atypical for me to say that I've had a "flare" for over a year?

 

[Entchen]

Using the language that my GI (and Joan's, apparently!) use, remission is absence of inflammation, so yes, if you've been inflamed for a year then you could say you have been in a flare for a year. I'm still trying to get it all straight myself, though, and others will pitch in if they know differently.

If you had blood work done and CRP/ESR were elevated, and if something was found on a colonoscopy, for example, then you'd have firmer evidence. However, my GI (oh, I do like him!) says that it's reasonable to sometimes judge by changes in symptoms rather than by visualization once it is initially established that IBD is present. [Or that could just be because I'm un-scopable and it's easier to report symptoms than get knocked out for a longer procedure, lol.] So your D, your running to the bathroom, could indicate that inflammation continues to be present. [Mind, sometimes those things are caused by something else, such as by medication side effects, so this isn't a perfect system.]

I consider myself as having been in a flare since last September. The D started long before that, but the constant pain, throwing up, etc., started in Sept '09, and I continue to show signs of inflammation.

 

[MapleLeafGirl]

I have been in a flare since April 2009 (almost a year and a half) and others have had similar experiences so I would not say it is unreasonable to say you have been in a flare for that long. The only time my ESR/CRP markers have not been sky high have been when prednisone was keeping the inflammation in check, but it just keeps coming back as soon as a taper off. I am on my third round now and am hoping third times a charm.

 

[Pirate]

There are differant severities of flares. I believe that daily D is more the mild to medium flare. Abdonimal discomfort w/ D to me is medium to serious. Major abdominal pain w/ lack of bowel movements is severe. Indicates a blockage and needs immediate attention.

This is how I classify my symptoms in order to determine what steps I need to take. My last flare was moderate pain w/ very thin stools (thick as a pencil). Since the area is not accessible by scopes we knew that it was a great chance for inflammation and that led me to Remicade. We tried Entocort, but it wasn't working so we went with the big gun.

 

[Regular Joe]

Hi Dadman,

The way a "flare" or "flare-up" has been explained to me is that there is "active inflammation" taking place somewhere in the digestive tract and/or other organs and systems.

The first physician to explain "flare" to me was my ortho surgeon. He could tell by touching my knee joint, that I was in the midst of an "autoimmune" flare. He saw the visible evidence of systemic inflammation. He examined my knee joint when my gut wasn't flaring, then after it was flaring. He knew it was Crohn's disease because he had replaced 3000 knee joints, many of them belonging to Crohn's patients. He insisted that I get the "flare stabilized" before he could do surgery. He insisted I persist with my GI, and for me to tell my GI that "he said so".

Well that, quite naturally led to my Crohn's diagnosis because the evidence of the "flare" - the "inflammation" was visble and tactile for my GI in the colonoscopy, in the bloodwork, and in the lab pathology (biopsies).