Friday, April 3, 2009

Reducing pain from Crohn's Disease

NB: This is an article I wrote for Helium a few years back. It's a little bit generic and needs some fixing up, but it does cover the basics so I thought I'd re-post it here.

Reducing pain from Crohn's Disease

Crohn's disease is an inflammatory bowel disease that can occur in any part of the digestive tract from the mouth to the anus. While the cause is unknown it is thought to result when the immune system attacks the body causing inflammation and swelling. Pain results from various types of disease activity, from side effects of medications, from muscle strain, from complications, from surgery, from investigations and more. The most common types of pain are that from the swelling caused by the inflammation and obstructions resulting from scar tissue that builds around the intestine causing narrowing.

Crohn's disease pain can be anything from a mild discomfort from bloating to cramping, sharp stabbing pain, dull achy pain right up to an intense pain that comes in waves and includes nausea and vomiting.

Pain relief comes in many forms, there are those that provide instant relief such as medications and ice packs/heating pads and those that aim to reduce pain progressively over time such as guided imagery meditation and yoga.

Painkillers are probably the first thing to come to mind when thinking about pain relief, however not all painkillers will relieve the pain associated with crohn's disease. In fact some types of painkillers can actually increase the symptoms causing the pain. Likewise as the condition is chronic, dependence on painkillers can become a reality.

Narcotic pain relievers such as codeine or Vicodin can slow down the bowel. This can be helpful in cases where diarrhea is severe however they can mask symptoms of disease activity and can be addictive. Avoid non-steroidal anti-inflammatory drugs (NSAID) such as aspirin and ibuprofen, as they can exacerbate the already inflamed intestines. NSAID's can worsen the bleeding in the small bowel and can contribute to the development of ulcers. Always consult your doctor before taking any painkiller and consider the short and long term effects of using pain relief medications.

There are many natural therapies, which can aid in the reduction of pain, as Crohn's disease is a chronic condition it is well worth considering alternative methods of pain relief to drugs.

Cold packs/Heating pads are an effective and natural method of pain relief. Like medication they provide instant relief at the time of pain and are especially helpful for the cramping pain and muscle ache associated with crohn's. These can also be combined with aromatherapy.

While there is still much debate in the medical world about the impact of diet on Crohn's disease, anyone who has the disease will quickly tell you that diet makes all the difference in the world. One of the most efficient ways to manage the pain associated with Crohn's disease is to monitor and limit foods that can exacerbate symptoms.

There is no specific diet for Crohn's disease. Many sufferers believe that limiting specific types of foods such as starch or sugar have a positive effect on the symptoms. Others have found that low fat, low fibre diets decrease the likelihood of flare-ups. Low-residue diets are seen to be gentle on the bowel and are often used during acute phases of the illness.

Most people agree that avoiding things such as alcohol, caffeine and nicotine that stimulate the bowel and aggravate symptoms and increasing things such as yoghurt, and fish is a good start. A pain journal is a good way to monitor pain and correlate possible exacerbating foods.

Gentle massage has been used for centuries as a way to soothe muscles, relieve pain, and reduce inflammation and swelling. In many cases massage is as effective as medication for pain relief. Massage can be used at the time of pain for immediate relief or on a regular basis as part of a long-term management plan.

Progressive muscle relaxation is a method whereby each muscle is relaxed one by one and can aid in both the immediate reduction of muscle pain and spasms and more general pain reduction over time. It takes anywhere between 15 and 30 minutes to perform and is very effective.

Living with conditions such as IBD can lead to feelings of depression, anxiety and hopelessness. Meditation, the use of guided imagery and relaxation techniques such as breathing exercises have been a proven method of relieving pain. These techniques also aim in improving the emotional aspects of living with chronic pain. Likewise participating in gentle exercise such as Yoga or Thai Chi can be extremely beneficial.

Pain relief is a very individual thing, what works for some may not have any effect for others. It's important to try as many methods for reducing or eliminating pain as possible to develop the best overall management plan and ALWAYS discuss pain relief with your doctor.

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