Stopping a Crohn’s flare typically requires a combination of medication changes, dietary adjustments, and supportive care to bring inflammation under control. Most flares won’t resolve on their own, and the faster you act, the easier they are to manage. The specific approach depends on whether your flare is mild or severe, but the core strategy is the same: reduce inflammation, rest your gut, and prevent dehydration while your treatment takes effect.
Contact Your GI Team Early
The single most important step when a flare starts is reaching out to your gastroenterologist’s office. Many people try to ride it out, but early intervention leads to faster control and less intestinal damage. Your doctor can adjust your existing medications, prescribe a short course of corticosteroids, or escalate to a stronger therapy if your current regimen isn’t holding.
If you’re already on a maintenance medication and still flaring, that’s a signal your treatment plan may need to change. The most recent American College of Gastroenterology guidelines recommend against requiring patients to fail older therapies before moving to advanced biologic treatments, because early intervention with these drugs produces better outcomes than a slow, stepwise approach.
How Corticosteroids Work During a Flare
Corticosteroids are the most common tool for shutting down a flare quickly. For mild to moderate disease affecting the end of the small intestine and the beginning of the colon, budesonide at 9 mg daily is the typical starting point. It acts locally in the gut with fewer body-wide side effects than traditional steroids. For more widespread or severe flares, systemic steroids like prednisone may be necessary.
These medications tend to provide rapid symptom relief, often within days, though full improvement can take a few weeks. The critical rule with steroids is that they’re for induction only. Current guidelines strongly recommend limiting use to fewer than three months and starting a structured taper as soon as symptoms improve. If your symptoms return every time your dose drops, that’s a sign you need a different long-term strategy, not more steroids.
One older drug class, mesalamine, is now strongly discouraged for Crohn’s disease due to limited effectiveness. If that’s what you’ve been relying on, it may explain why your flares aren’t well controlled.
What to Eat (and Avoid) During a Flare
When your gut is actively inflamed, the goal is to reduce the mechanical work your intestines have to do. That means shifting toward softer, lower-fiber, easier-to-digest foods while avoiding anything that could irritate an already damaged lining.
Foods that tend to be well tolerated during a flare include:
- Cooked and soft starches: white rice, oatmeal, potatoes, sweet potatoes
- Tender cooked vegetables: carrots, squash, green beans
- Low-fiber fruits: bananas, applesauce, blended fruit
- Omega-3 rich foods: salmon, tuna, walnut butter, flaxseed oil
- Leafy greens if cooked thoroughly, cut small, or blended into smoothies
Foods to avoid or minimize include:
- High insoluble fiber: raw kale, apple skins, sunflower seeds, popcorn, raw salads
- Gas-producing vegetables: Brussels sprouts, cabbage, cauliflower
- High-fat foods: fried foods, butter-heavy dishes
- Dairy with lactose: milk, cream, ice cream
- Sugar alcohols: sorbitol, mannitol, xylitol (common in sugar-free products)
- Caffeine, alcohol, and spicy foods
One important caution from the Crohn’s & Colitis Foundation: resist the urge to follow highly restrictive diets recommended by friends, family, or social media. Overly restrictive eating during a flare can lead to nutrient deficiencies, unplanned weight loss, and even disordered eating patterns, all of which can make your disease harder to manage.
Liquid Nutrition as a Treatment Option
Exclusive enteral nutrition, where you consume only a specialized liquid formula for several weeks, is an established treatment for inducing remission in Crohn’s. It’s most effective in children, where remission rates reach roughly 83%, comparable to steroids. In adults, remission rates are lower (around 45% compared to 73% with steroids), which is why it’s used less often for grown-ups. However, it produces better actual healing of the intestinal lining than steroids do. Studies show mucosal healing rates with steroids range from just 0% to 29%, while liquid nutrition performs significantly better on that measure. If you’re interested in this approach, it requires guidance from your GI team or a dietitian.
Stay Ahead of Dehydration
Frequent diarrhea during a flare pulls water, salt, and minerals out of your body faster than you might realize. Don’t wait until you feel thirsty to start drinking. Aim for at least six to eight glasses of fluid a day, favoring water or diluted drinks over anything caffeinated or alcoholic, which worsen fluid loss.
Plain water is fine for most people, but if your diarrhea is severe or you have a stoma or short bowel syndrome, oral rehydration solutions are more effective. These are powders or tablets dissolved in water that replace both fluid and the specific salts your body is losing. You can find them at most pharmacies, or your GI team can provide a recipe to make your own. If you have an ileostomy, you may also benefit from adding about a teaspoon of extra salt to your meals daily.
Rest Your Body, Not Just Your Gut
Flares are physically exhausting. Inflammation triggers fatigue at a systemic level, and the combination of poor nutrient absorption, disrupted sleep from nighttime symptoms, and pain compounds it. Reducing physical demands during a flare isn’t laziness. It’s giving your body the resources to heal. Scale back exercise intensity, prioritize sleep, and reduce commitments where you can. Stress doesn’t cause Crohn’s, but it can amplify flare symptoms and make it harder for your body to respond to treatment.
When a Flare Becomes an Emergency
Most flares can be managed with your GI team on an outpatient basis, but certain symptoms require immediate medical attention:
- Inability to keep liquids down due to nausea, vomiting, or pain
- Rectal bleeding with blood clots in your stool
- Constant, unrelenting abdominal pain
- Fever above 100.3°F
These can signal complications like an abscess (a pocket of infection), a fistula (an abnormal tunnel between your intestine and another body structure), or a bowel obstruction. Abscesses and fistulas often require antibiotics as part of treatment, and severe fistulizing disease may need biologic therapy to heal.
Preventing the Next Flare
Once your current flare is under control, the conversation with your doctor should shift to what went wrong and how to prevent it from happening again. The most common reason people flare is inconsistent use of maintenance medication. Biologic therapies and other advanced drugs work by keeping inflammation suppressed continuously. Skipping doses or delaying refills creates windows where inflammation can reignite.
Your doctor may also use a stool test called fecal calprotectin to monitor your inflammation levels between flares. This test measures a protein released by inflamed intestinal tissue. Levels below about 40 suggest remission, while levels climbing above 150 to 300 can signal that inflammation is returning before you even feel symptoms. Catching a flare at this stage, before it becomes symptomatic, allows for treatment adjustments that may prevent a full-blown episode entirely.