Imagine waking up at an ungodly hour with an urgency to get to the bathroom ASAP. The sun isn't up, the birds aren't chirping, and your eyelids certainly are not cooperating. You're running to the bathroom, flinging the door open in a panic, and praying that an unlucky soul isn't on the other side. If so, they may experience a very rude awakening. You have a mild period of relief, only after you've flushed and are beginning the journey back to your bed. I'd say walk, but the fatigue you'll feel (especially if going through a "flare") is unlike any other. This may be the fifth or sixth time you've woken up in the same night. Hopefully, it will be the last and you can skip the morning cramps to get some more sleep in.
If your morning didn't start with rushing into the bathroom, it may have began with a bowl of cereal and a newspaper. Or, perhaps, you're more of a sunny-side-up egg and toast type of person. Anyways, no matter what you ate, if you can say you kept your breakfast down and actually enjoyed it, you're one of the lucky ones. For people like me, those with Crohn's Disease, we're not always so lucky. Our mornings almost always consist of lots of bathroom usage time, daily dosages of medicines, early doctor's appointments, or being too exhausted and ill to even get up to eat. In my case, I am typically waiting for my TPN (total parenteral nutrition, aka food that's pumped directly into my veins) to finish up.
For the Crohn's patients that spent a majority of the morning in the restroom, their long day has only just begun. These are the people that are most likely going through a flare. Crohn's flares can be brutal with a broad spectrum of symptoms, old and new. These symptoms include chronic diarrhea, rectal and intestinal bleeding, constipation, urgent bowels, horrid abdominal cramps, fevers, rapid weight loss, anemia and major fatigue. Flares take a huge toll on Crohn's patients. The symptoms can be controlled with various types of medicine. Biologics and steroids are the most common treatments. Remicade is the leading biologic at this time, while prednisone is the most used steroid. All medicines used to treat Crohn's have concerning side effects. However, risky side effects do not always outweigh the benefits of treatment. Remission is on the horizon for those who choose to use a medicinal approach.
Unfortunately, medicinal therapy is not always an option for everyone diagnosed with Crohn's. In some cases, the inflammation caused by Crohn's has damaged the colon too deeply and a bowel resection must take place. Bowel resections are a very serious type of surgery. The diseased tissue is removed and the healthy parts of intestines are reconnected. Recovery after surgery can take more than a month. Sometimes, complications form after the resection. One post-operative complication is fistula formation. Fistulas are abnormal tunnel connections between organs. They can form on their own in patients with Crohn's, but most are the product of a post-surgery problem in the bowel. Fistulas can heal spontaneously, be treated medically, or can be removed via another surgery.
There's also an "abnormal tunnel" that is man-made called a "stoma." Stomas are created when the two sections of bowel that need to be reconnected are too diseased to be put back together. A small hole will be formed to divert bowel movements into a stoma bag. The bag will be emptied once full. Most stomas will be "reversed" with another surgery after the diseased tissue is healed enough. Hopefully, most patients that receive surgery and bowel resections for Crohn's will never have to deal with any complications and can return to a good quality of living in remission.
Once remission is reached, treatment is usually discontinued and a "normal" life is pursued. While being in remission does not guarantee that Crohn's will never return, as there is no cure, it is a huge relief to not experience symptoms. Waking up in the morning is twenty times easier when you're not up half the night in the bathroom! I look forward to the day that I can proudly say that I fought the beast that is Crohn's Disease and emerged victorious, once and for all. I wish the same to all of my fellow Crohn's contemporaries.
