Your child had a flare of Crohn's disease. A flare (or flare-up) is when the symptoms of Crohn's disease return or get worse. The health care team talked with you about what to do to try to get the disease into remission (when symptoms of Crohn's are better or gone) and keep it that way for as long as possible. Follow these instructions to help get the flare under control.

• Be sure your child takes all medicines exactly as prescribed, including any vitamins or nutritional supplements.
• Because some medicines used to treat Crohn's make it harder to fight infections, it is important for your child to get all recommended vaccines on time. The health care provider may recommend a blood test to make sure that the vaccines are protecting your child.
• Check with the care team before giving your child over-the-counter or herbal medicines. Never give your child ibuprofen (such as Advil^® and Motrin^®) or naproxen (such as Aleve^®).
• Follow the care team's instructions on healthy eating:
  • Help your child avoid foods that make symptoms worse.
  • Make any recommended changes in diet, such as eating small meals several times a day instead of three large ones.
• Teach your child not to smoke or be around smokers.
• Go to all follow-up medical visits. Be sure your child gets all tests the health care team recommends.
• Find ways for your child to deal with stress. Exercise, deep breathing, or talking to a counselor are good ways to cope.
• Help your child find activities to enjoy. Encourage them to talk with you and share their feelings about living with Crohn's disease.
• Tell teachers, the school principal, and the school nurse that your child has Crohn's disease. Explain that your child may need lots of bathroom breaks and might miss school at times.

Your child:

• is not taking the prescribed medicines
• does not want to eat or is losing weight
• has new or worse symptoms, such as diarrhea, blood in the poop, or belly pain
• has a fever of 100.4°F (38°C) or higher
• throws up more than once or twice
• has hard or painful poops
• has sores or drainage near the anus (the hole where poop comes out)
• has vision changes, eye pain, or headaches

Your child:

• has very bad belly pain
• has a lot of blood in the poop
• passes out or feels weak, lightheaded, or dizzy
• is throwing up and can't keep anything down
• appears dehydrated; signs include:
  • dizziness or drowsiness
  • a dry or sticky mouth
  • sunken eyes
  • peeing less often
• is not passing gas or poop

What happens in Crohn's disease? People with Crohn's disease have inflammation (swelling and irritation) and sores in the digestive tract. The digestive tract includes the mouth, esophagus, stomach, small and large intestines, rectum, and anus. Crohn's usually happens in the intestines.

What are the signs of Crohn's disease? Kids with Crohn's may have belly pain, diarrhea, blood in the poop, tiredness, weight loss, fever, rashes, and/or joint pain. They may go through puberty later and grow slower or be shorter than other kids their age. The symptoms of Crohn's come and go, but it is a lifelong condition.

Why do kids get Crohn's disease? The cause of Crohn's disease isn't clear, but it's probably a combination of:

• genetics: Crohn's disease tends to run in families.
• the immune system: It normally fights infections, but the immune system can sometimes make a mistake and attack the lining of the digestive tract, causing inflammation.
• the environment: Things in the environment can sometimes trigger inflammation in the digestive tract.

What tests are done to diagnose Crohn's disease? To diagnose Crohn's disease, health care providers:

• do blood tests
• check the poop for blood and certain germs
• order imaging tests, such as an MRI, CT, or X-ray to look inside the intestines
• do an endoscopy or colonoscopy to look inside the digestive tract with a tiny camera connected to a long tube
• do a biopsy, taking a small piece of tissue (for example, the lining of the intestine) and sending it to a lab for testing