Living with Crohn’s disease

Most Crohn’s disease patients can live a fairly normal life. Average life expectancy is same as in other people. During flare-ups, the illness may limit the ability to study and work, but it rarely leads to long-term disability. The illness should be considered when choosing a career: heavy physical work and irregular shift work may cause problems. When changing jobs, it is important to mention the illness. The occupational health physician will estimate whether the illness affects the work ability. Not telling about the illness can even lead to termination of contract, if the illness significantly disturbs working.

Intestinal bacterial infections may activate the illness. Especially when travelling it is important to avoid traveler’s diarrhea. Good hand hygiene decreases the risk also if someone in the family has a stomach flu.

Smoking doubles the risk of recurrence and surgery and weakens the efficacy of e.g. biologic medications. Crohn’s disease patients need to take care of their immunization and booster doses. As medicines that affect the immune system weaken their efficacy, vaccines should be taken before the medication is begun. “Living” vaccines must not be given to those on biologic medications.

Stress may worsen symptoms. Stress and pain management can be learned through different relaxation methods. The efficacy or harms of various alternative treatments have not been shown in scientific studies, and their use should be mentioned to the doctor. The treatments and medications prescribed by the doctor must be taken as prescribed and should not be stopped alone. Medication must be taken care of also during remission to prevent symptoms from recurring.

Pregnancy runs usually as normal, but is it good to discuss such plans first with the doctor. Severe inflammation may make it difficult to get pregnant and increase the risk of miscarriage, and pregnancy should be timed during a remission period. Ostomy is not an obstacle. Medication can usually be continued throughout pregnancy.

If the illness is under control, it does usually not prevent military service. If the disease is in a difficult phase, it is possible to postpone military service or even be exempted from it. It is good to bring a doctor certificate to the drafting event.