Inflammatory Bowel Disease: 8 Ways to Manage IBD Symptoms

• Multiple sclerosis
• Psoriasis
• Rheumatoid arthritis
• Ankylosing spondylitis
• Celiac disease
• Lupus

“The pathways that lead to these inflammatory disorders overlap,” says Jordan Axelrad, M.D., board-certified gastroenterologist and director of clinical and translational research for NYU Langone’s IBD Center, in New York City. “And so it's commonplace that we do see these overlapping immune-mediated diseases.”

What Is IBD?

IBD is an umbrella term for health conditions, including Crohn’s disease and ulcerative colitis, that cause an immune response leading to chronic inflammation in the GI tract. Left unmanaged, this inflammation can lead to damage of the GI tract.

The causes of IBD aren’t fully understood, but having a family history of inflammatory bowel disease can increase your risk. Less is known about other potential risk factors, such as diet or where you live.

Common symptoms of IBD include:

• Stomach pain
• Diarrhea
• Frequent bowel movements
• Urgent bowel movements
• Bloody stool
• Fatigue
• Weight loss

IBD may also cause extraintestinal symptoms (those that occur outside the GI tract), including vision changes, joint pains, skin rashes, and liver problems.

“IBD is generally characterized by relapsing and remitting episodes of inflammation or flares,” explains Axelrad. That means symptoms may come and go based on disease activity.

You may experience just one of these symptoms, or you can have several. “It can vary based on the location of the disease,” says Faten Aberra, M.D., board-certified gastroenterologist and co-director for Transition-Inflammatory Bowel Disease Center at the University of Pennsylvania, in Philadelphia. Crohn’s disease can affect any part of the digestive tract, though it most commonly affects the terminal ileum, or the lower part of the small intestine. Meanwhile ulcerative colitis, the most common type of IBD, primarily affects the large intestine.

How Do You Get Diagnosed with IBD?

If you’re having symptoms, talk to your doctor about a potential diagnosis. There’s no single test that can diagnose IBD—rather, diagnosis may require a combination of:

• Medical and family history
• Physical exam
• Stool sample
• Blood work
• Colonoscopy with biopsies
• Imaging studies, like a CT scan, MRI, or X-ray

It can take time to either confirm or rule out IBD and get the right diagnosis. “My No. 1 advice for a high-risk patient noticing changes in their GI symptoms: Get evaluated soon,” Aberra says. “You want to pick up the disease earlier because it’s easier to treat it earlier than it is when people have complications.” People who are considered high risk include those who have a family history of IBD, loose and bloody stools, and weight loss.

8 Strategies for Managing IBD Symptoms

There’s no cure for inflammatory bowel disease, but there are steps you and your doctor can take to treat and manage it so you can mitigate its impact. Start with these strategies.

1. Get Diagnosed and Take Medication As Directed

If you have risk factors for IBD—like a family history and new, persistent symptoms—see a gastroenterologist for a full evaluation, Axelrad says. If you’re diagnosed with IBD, there are plenty of treatment options available.

IBD treatment options include:

• 5-aminosalicylic acids (5-ASAs)
• Immunomodulators
• Corticosteroids
• Biologics
• JAK inhibitors (for ulcerative colitis)
• Surgery

The approach to treatment is individualized and based on three factors: disease severity, prognosis (outlook), and personal preferences, Axelrad says. So stay in frequent communication with your care team about what is and isn’t working for you, and work with them to adjust as necessary.

2. Avoid Your IBD Triggers

Certain factors, or triggers, can bring on new or worsening symptoms of IBD. Triggers may vary from person to person, but common IBD triggers include:

• Skipping or forgetting a dose of IBD medication
• Smoking
• Stress
• Certain foods, like those that are spicy, fried, or sugary
• Certain medications, like antibiotics or nonsteroidal anti-inflammatory drugs (NSAIDs)

Try keeping a symptom journal, which can help you identify which triggers may be contributing to your flares. Then, avoid those triggers to the best of your ability. It’s important to remember that although stress and certain foods may make your symptoms worse, they don’t worsen the underlying inflammation like some of the other IBD triggers can.

3. Eat for Better Health

There’s no one IBD diet, but proper nutrition can help you manage IBD and promote overall health. When you’re in a flare, it may help to focus on foods that are easy to digest, like low-fiber fruits and refined grains.

When you’re feeling well, it’s important to expand your diet to get the nutrients your body needs, including:

• Fiber-rich foods, like oats, beans, and whole grains
• Lean sources of protein, like meats, fish, and eggs
• Calcium-rich foods, like yogurt, kefir, and milk
• Probiotic-rich foods, like kimchi, miso, and sauerkraut

You can work with your doctor or a dietitian to establish the right IBD-friendly diet for you.

4. Stay Active

Exercising regularly can boost overall health, but it also helps to:

• Reduce stress, a common IBD trigger
• Improve depression, which often coexists in people with IBD
• Promote bone health, as IBD can increase your risk of bone loss

Talk to your doctor about ways to implement an exercise routine that feels doable for you and your symptoms. Consider starting with low-impact activities, like walking or swimming.

5. Avoid Smoking

Besides being harmful to your overall health, smoking can worsen IBD symptoms in many people. It can also affect how well your IBD medication is working.

Talk to your doctor if you need help quitting smoking, or turn to resources such as Smokefree.gov.

6. Manage Your Stress

Taking steps to manage your stress levels may help reduce IBD symptoms. You may want to try stress-reduction techniques, such as:

• Deep-breathing exercises
• Meditation
• Yoga
• Tai chi
• Guided imagery

If you don’t find much benefit from these exercises, it may help reduce stress to have the support of others who understand your experience. You can try searching for events and local support groups from the Crohn’s and Colitis Foundation to get together with other people who have IBD.

7. Tend to Discomfort

Symptoms of IBD can lead to pain and discomfort. The Crohn’s and Colitis Foundation recommends using a hand shower or moist wipe instead of regular toilet paper after using the toilet to help ease any anal discomfort.

You can also talk to your doctor about taking acetaminophen, a pain reliever that is not an NSAID. Other over-the-counter (OTC) medications that may help provide symptom relief include antidiarrheal drugs, like Pepto-Bismol, though you’ll want to clear it with your doctor before using any OTC drugs. Other options that can help discomfort include peppermint and muscle relaxants.

8. Schedule Regular Checkups

Inflammatory bowel disease is a lifelong condition. Attending regular checkups with your doctor can help you manage and monitor the disease over time. Come to each appointment prepared to talk about how your IBD symptoms are affecting you, both mentally and physically. Together, you and your doctor can decide whether making changes to your IBD treatment and management plan may help.

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