Crohn’s Flare Action Plan: What to Do in the First 24–72 Hours
Last Updated Jan 15, 2026
Crohn’s symptoms can change fast during a flare, and the first 24 to 72 hours often set the tone for what happens next. Having a simple Crohn’s flare action plan can help reduce panic and support safer decisions. This overview is educational, not medical advice. Individual guidance from a gastroenterology (GI) team should take priority, especially when symptoms are severe or different than usual.
First 24 hours: stabilize, simplify, and track the flare
When thinking “Crohn’s flare, what to do,” many plans start with two goals: prevent dehydration and capture clear information for the care team. A flare checklist for Crohn’s can include a quick snapshot of symptoms and daily functioning, because details often blur together during pain, fatigue, and frequent bathroom trips.
Helpful items to track (paper notes, phone notes, or a tracker) include:
- Number of bowel movements, urgency, and any blood or black-looking stool
- Abdominal pain level and location, plus bloating or cramping
- Fever, nausea, vomiting, and appetite changes
- Fluid intake and signs of dehydration (dark urine, dizziness, confusion, urinating less) [1]
- Weight changes and energy level
- Recent medication changes, missed doses, or new over the counter products
Some people like using a structured bathroom or symptom tracker to make patterns easier to share with a clinician. The Crohn’s and Colitis Foundation offers printable tools that can support this kind of tracking. [2]
Food choices can feel urgent during a flare. In reality, there is no single “flare diet” for Crohn’s that fits everyone. Some hospital diet handouts suggest temporarily shifting toward lower-fiber options and avoiding foods that often worsen diarrhea, gas, or cramping (for example spicy or high-fat foods), then slowly broadening intake as symptoms settle. Major diet changes, especially cutting whole food groups, are best discussed with a clinician or registered dietitian. [3]
Next 24 to 72 hours: coordinate with GI and watch for “urgent” signs
If symptoms continue or escalate, the next phase is often about communication and safety. Calling the GI office may be more productive when the flare steps are organized into a short summary: what changed, when it started, what symptoms are most limiting, and whether dehydration is developing. Common questions for the GI team include:
- What warning signs mean urgent care is needed?
- Should lab work or stool testing be done to check for inflammation or infection?
- Should any current medicines be adjusted, and what should be avoided right now?
- What is the plan if symptoms do not improve within a set time window?
Treatment changes during a flare should be clinician-directed. For example, clinical guidelines describe corticosteroids as effective for reducing signs and symptoms of active Crohn’s disease, but they also stress limiting use and moving toward steroid-sparing strategies because side effects and risks can add up. [4]
Urgency is also part of a flare action plan. Many health systems recommend contacting a provider promptly for symptoms such as blood in stool, fever, severe abdominal pain, uncontrolled diarrhea, nausea or vomiting, or inability to pass gas. [5] In addition, public guidance flags bloody diarrhea or very dark red stool as needing urgent assessment. [6] If fluids cannot be kept down, confusion develops, or diarrhea persists for 24 hours or more with worsening weakness, urgent evaluation may be needed to prevent dangerous dehydration. [1]