During a flare-up of Crohn’s disease, symptoms like diarrhea, pain, weight loss, ulcers, bleeding and anemia return. Medication can help prevent these recurrences, but often can’t prevent them completely. Factors that can trigger a flare-up include stopping or even tapering off disease-controlling steroids; periods of stress (which doubled risk in one study); smoking (which doubles risk for Crohn’s disease); and even taking oral contraceptives or pain-relieving nonsteroidal anti-inflammatories like aspirin or ibuprofen. For mild flare-ups, your doctor may prescribe a steroid (prednisone) or an aminosalicylate drug [mesalamine (Rowasa), sulfasalazine (Azulfidine)] plus antibiotics.

• A half-hour walk three times a week kept people with Crohn’s disease flare-up free during one 12-week-long study.
• Aminosalicylate drugs help 55% of people with Crohn’s disease go into remission and can prevent relapses if your disease level is mild to moderate.
• Immunosuppressants such as mercaptopurine (Purinethol) and methotrexate (Rheumatrex) can prevent flare-ups of severe Crohn’s disease.
• These drugs can also help break or reduce dependence on steroids, which are effective at preventing flare-ups but have serious side effects.
• Taking two antibiotics together--metronidazole (Flagyl, Protostat) and ciprofloxacin (Cipro)—can cool off a Crohn’s flare-up about half the time.

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