How Colds and Flu Affect People With Crohn’s Disease — Plus Prevention Tips

Kiara Horwitz, 34, a publicist in New York City, experienced this firsthand. She’s never taken immunosuppressant drugs to treat her Crohn’s, but she still caught the flu in the summer of 2019, which triggered a flare-up. “I landed in the ER,” Horwitz says. “My doctor put me on steroids until [I recovered].”

Horwitz adds that even the common cold sends her to bed for days and causes her symptoms to flare. “I think this is linked to anxiety about being sick,” she says. “Whenever I have high anxiety or stress, which can also lead to a cold or flu, it can affect my stomach.”

While everyone gets sick from time to time, there are ways you can reduce the severity of your illnesses and keep your Crohn’s symptoms in check. Here’s what you need to know about colds and the flu if you have Crohn’s.

1. You May Be More Likely to Get the Flu — Even if You’re Not on Immunosuppressants

“Crohn’s disease is an autoimmune condition that can lead to higher susceptibility to infections, even if [you aren’t] on any medications,” says Alyssa Parian, MD, a gastroenterologist who specializes in inflammatory bowel disease (IBD) at HMH Center for Advanced Gastroenterology in Hackensack, New Jersey. “[This could be] due to alterations in the immune system, which has a decreased ability to fight off bacteria and viruses.”

2. You May Need More Time to Recover — and Have More Complications

People with Crohn’s may also take longer to recover and have a greater risk of severe sickness and hospitalization.

Taha Qazi, MD, a gastroenterologist and IBD specialist at Cleveland Clinic in Ohio, attributes this to the use of medications that turn down your immune system, such as corticosteroids.

“At least anecdotally, it seems my IBD patients take a couple more weeks to recover than patients without IBD,” says Dr. Qazi.

3. You Need to Get the Flu Shot Every Year, Not the Nasal Flu Vaccine

“The flu shot not only decreases the risk of contracting the flu, but if you do get the flu, it decreases the severity of the flu,” says Dr. Parian. She adds that because Crohn’s also increases the risk of a secondary bacterial pneumonia infection, it’s important to get the pneumonia vaccine as well.

A few other simple, everyday actions can help you steer clear of germs that can make you sick:

• Practice good hygiene. Wash your hands with soap and water for at least 20 seconds before preparing or eating food and after using the toilet. If you don’t have access to soap and water, use a hand sanitizer that’s at least 60 percent alcohol.
• Keep your hands away from your face. Try to avoid touching your eyes, nose, and mouth, which is how many people are exposed to germs.
• Reduce contact with people who are unwell. As much as possible, try to avoid close contact with people who are sick.

Along with getting the flu shot, Horwitz credits weekly acupuncture, a healthy diet, and workouts five days a week with helping keep her immune system strong.

4. If You Do Catch the Flu, You Should See Your Doctor (and Possibly Start Antivirals) Immediately

Think you have the flu? Check in with your doctor right away to get tested and, if necessary, begin treatment. You can also purchase an at-home flu test over the counter, but you’ll still need a prescription from your healthcare provider for flu medication.

“It’s important to catch it as soon as possible to prevent problems from escalating,” says Qazi.

Symptoms of the flu include:

• Fever
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headache
• Chills and fatigue
• Vomiting and diarrhea (sometimes, more common in children than adults)

Antiviral medications keep the flu virus from multiplying, which helps shorten the time you’re sick and prevents serious complications. Be sure to take the full course of medication that your doctor prescribes.

To protect others, stay home until your fever has been gone for at least 24 hours, and cover your nose and mouth with a tissue when you cough or sneeze.

5. You May Not Need to Stop Taking Your Crohn’s Medications

You should always talk to your doctor about your treatment plan, but Qazi says people with IBD usually don’t need to stop taking their meds if they catch the flu.

“There’s a reason you’re on medication therapy,” he says. “When you get off, it can make the disease course worse.”

But your doctor’s recommendations may vary. “Depending on how severe [the flu and your Crohn’s are], your doctor might recommend holding your medications,” says Parian.

6. It’s Crucial to Stay Hydrated

If you get sick, it’s more important than ever to drink plenty of liquids. Fever, commonly linked with the flu, increases the risk of dehydration, which is compounded by Crohn’s symptoms such as diarrhea.

Keep an eye on the color of your urine, which should be clear or pale yellow. If it’s dark yellow or amber, you’re probably dehydrated. Because the amount of water every person needs varies, talk to your doctor if you’re concerned you’re not getting enough.

“If you feel dehydrated or light-headed despite drinking fluids, you should call your doctor immediately,” says Parian.

Keep in mind, water isn’t the only way to stay hydrated: A warm cup of chicken noodle soup feels comforting when you’re sick and counts as a liquid.

In addition to staying hydrated, eat nutrient-dense meals as much as possible, rest, and follow up with your primary care doctor as needed.

7. You Might Get a Crohn’s Flare

“It’s not uncommon for many infections, including the flu, to have GI symptoms, such as nausea and diarrhea, that are not related to the underlying Crohn’s at all,” says Parian. “Your doctor may want to order some additional testing to determine if it’s a Crohn’s flare or not.”

The Takeaway

• People with Crohn’s disease have a higher risk of catching a cold or the flu due to immunosuppressants and alterations in the immune system.
• They are also more likely to get flu complications, like pneumonia, and need extra time to recover.
• To reduce your chances of getting sick, get the flu shot every year and take standard precautions to prevent the spread of infections.
• If you’re feeling sick, get tested for the flu with your healthcare provider or buy an at-home flu test (no prescription needed).

Additional reporting by Andria Park Huynh.