7 Key Questions to Ask Your Gastroenterologist About Managing Crohn's Disease

Crohn's disease is a chronic condition that requires ongoing management and monitoring. It is crucial to feel comfortable and confident when discussing your condition with your gastroenterologist is vital. You are an essential member of your own care team, and your appointments should help you feel informed and assured about managing your condition.

Finding a doctor who is a good fit for you is a significant step toward effective disease management. Keep a journal to jot down any questions or concerns you have, and bring it to each appointment. You can start with the six questions listed below.

The more you know, the better equipped you'll be to manage your condition and understand your doctor's treatment approach.

1. What are my treatment options?

Your doctor should provide a clear overview of the treatment options available for Crohn's disease. Since Crohn's is incurable, treatment aims to reduce inflammation and put the condition into remission. Here are the main approaches:

- Medication: There are several types of medicines used to treat Crohn's:

- Aminosalicylates (5-ASA): These reduce inflammation in the colon lining.

- Corticosteroids: These suppress the immune system to reduce inflammation.

- Immunomodulators: These work by suppressing the immune system to control inflammation.

- Antibiotics: These treat infections such as abscesses.

- Biologics: These target specific components of the immune system to reduce inflammation.

- Diet: Diet plays a significant role in managing Crohn's disease. Certain foods can trigger flares and should be avoided. Common triggers include dairy, fat, and fiber. In severe cases, temporary bowel rest may be necessary, where you abstain from some or all foods and receive nutrients intravenously.

- Surgery: Surgery may be needed to repair or remove diseased sections of the gastrointestinal tract or to address emergencies like bowel obstructions. Ask your doctor about the criteria for considering surgery.

2. What can you tell me about biologics?

Biologics are a recent advancement in the treatment of Crohn's disease. These medications, made from living cells, work by reducing inflammation. Some biologics target tumor necrosis factor (TNF) to decrease inflammation, while others prevent inflammatory particles from reaching the gut, allowing it to heal.

Biologics can have side effects, the most common being suppressed immunity. Discuss the benefits and drawbacks of biologics with your gastroenterologist to determine if this treatment is proper for you.

3. What treatments are recommended for my symptoms?

The best treatment for Crohn's disease varies based on your symptoms and overall prognosis. Your doctor will consider the results of your medical tests to decide which medications are most appropriate for you. For severe Crohn's disease, a biologic might be recommended immediately. For milder cases, steroids may be the first medication prescribed.

Be ready to discuss all your symptoms with your doctor so they can help you choose the most effective treatment plan.

4. How do you manage remission?

Managing remission involves monitoring your condition and preventing new flares. Ask your doctor about the types of regular assessments you'll need, such as clinical observations, blood tests, and stool tests.

Traditionally, symptoms alone were used to gauge remission, but additional testing is now recommended when symptoms don't align with the level of Crohn's activity. Also, inquire about continuing medication during remission, as this is often the best way to prevent new flares.

5. Can alternative treatments help?

While alternative therapies like fish oil, probiotics, and herbal supplements have yet to be proven effective as replacements for conventional treatment, some patients find them beneficial. If you're considering alternative therapies, consult your doctor to ensure they won't interfere with your current medications. Remember, complementary approaches should not replace your prescribed treatments.

6. What lifestyle advice do you have?

Your lifestyle significantly impacts the management of Crohn's disease. Discuss with your doctor ways to reduce stress, incorporate exercise, and make other beneficial lifestyle changes, such as quitting smoking. Lifestyle adjustments can improve your overall health and reduce flares' frequency and severity.

7. How can I monitor my condition at home?

Monitoring your condition at home is vital for managing Crohn's disease. Ask your doctor about the signs and symptoms you should watch for that might indicate a flare-up. Learn how to track your symptoms, diet, and any changes in your condition. A detailed record can help your doctor make more informed decisions about your treatment plan. Additionally, ask about tools or apps that can assist you in monitoring your health.