Navigating Relationships with IBD

As someone chronically ill, feelings of guilt, FOMO, and loneliness can be all too familiar. The severity and unpredictability of IBD can take a toll on the relationships you have with others, including romantic interests, friendships, family members, and coworkers. When i was diagnosed with Crohn’s Disease at the young age of twenty one, i quickly became frustrated that my poor health was holding me back from participating in classic twenty something year old activities. My unpredictable and debilitating symptoms made it difficult to leave my house, to follow through with plans, and to eat and drink at restaurants and bars. At the beginning of my journey with Crohn’s Disease, I was overwhelmed with feelings of loneliness and guilt when I had to miss out on my college friends' activities. I kept my symptoms and diagnosis to myself, not really allowing any of my friends to understand how to include and support me. 

Sharing your IBD diagnosis with your partner, friends, and family is a terrifying and overwhelming experience. Naturally, we strive to hide our vulnerability, but I hope to deliver advice through my own personal experience to help nurture your relationships and ensure you receive the support you deserve. 

My best advice is to share your IBD diagnosis with the people you surround yourself with. We cannot control how others react to our diagnosis, but we can control what we share with them. I often tried to hide my illness from others, and then became frustrated when disagreements arose over my frequent cancellations from flares as well as feelings of loneliness from no one understanding what I am going through. It’s important to allow those close to you to know what you are dealing with. Remember, someone that loves and cares about you will not be scared by your diagnosis, they will want to support you and be there for you in times of need. The first thing you need to do is allow them the chance to show up and support you. Be honest about how your disease affects you, whether that be generalized as last minute cancelations or going in-depth about the symptoms you experience. 

Remember your self worth. You may have inflammatory bowel disease but IBD does NOT define you. You have amazing, unique and loving qualities that make you amazing with or without IBD. Whenever I have trouble separating myself from my IBD diagnosis, I write down 5 things that I love about myself, whether that be my passion for helping others, my love for animals, or anything else that makes me, me! 

Ask for help. Be honest about your needs as someone with IBD, especially when flaring or on colonoscopy, infusion, injection and surgery days. Your friend or partner might not know how to best help you. Try to be honest and communicate your needs and wants to your partner, friends, and family to be best supported.

Create boundaries. Every person with IBD has different needs. Be honest about what you like and don’t like. Create boundaries with friends and family, especially about unsolicited advice or anything that may bother you. Has everyone heard the ‘you should try ___ (sub: yoga, veganism, meditation, etc.) and you will be cured’? My advice to create boundaries without offending a loved one is to express your appreciation and thanks but highlight how every person with IBD is different and that advice like this negatively affects you. Again, put yourself first. If someones advice or actions are bothering you, speak up and share that with them. Most of the time, people are only trying to help and this will help guide them to most effectively support you. 

As someone dating with IBD, the psychological aspect that can join a chronic illness, along with physically feeling sick, can create obstacles in relationships. Communicating with honesty will allow all parties to a relationship to feel loved, wanted, and respected. I truly hope these tips will help you navigate and make the most out of your relationships.

Ostomates and Intimate Relationships

Imagine you are in a relationship with a person and you want to take that relationship to the next  level by taking the step towards being physically intimate. You take off your shirt and you hear a  gasp. “What is that?” You look at your partner’s face and follow their gaze to your  torso and you realize something at that moment: you had never told your partner what it means to be an ostomate. Ostomates live with a part of an organ exposed outside of their body but  usually secured in an ostomy bag for the rest of their life. Although at first it is difficult to adapt to  this visible change, ostomates soon became comfortable and adapted to their routine well.  However, this new life for ostomates brings some changes to their personal life, especially to their  physical relationship with their partner. Both ostomates and their partners should take steps to understand about ostomy life and give each other the benefit of doubt to further improve their  relationship in a more intimate sense. 

An ostomate should prepare themself physically and mentally to discuss their condition with their  partner. This is important and necessary because post-surgery will bring a major change to their  body. Along with it, an ostomate may feel anxiety, fear and concern about their body. Ostomates have to express their fear and worry to their partners to alleviate their distress of this new  situation. An ostomate should understand that they can never ignore and hide their stoma from their partner forever. They should initiate small talks with their partner especially when they are ready  to engage in physical intimacy after surgery. They can talk about what happened with the surgery,  how the post-surgery life looks like, what is a stoma and how it looks like, ostomy pouch and what  it does and how they change it and so on. These small conversations will directly educate their  partner about what kind of changes an ostomate is going through and give them insights into what  being an ostomy means to their relationship. An ostomate can take the following steps in order to  engage in sexual life with their partner. 

• Take time and slowly expose the pouch and stoma to your partner. Your partner may show  reactions such as shocked, scared, or even curious. Or they may not show any reactions  as they are not sure on how to react to a stoma. They may not be sure on how to react  also. Don’t get angry or disappointed with their reaction or lack of reaction in some cases.  Most of the time, a partner will worry that they may hurt the stoma and dislodge the equipment during intercourse. Be patient and tell them how it does not affect your sexual life and how they can help you so it does not hurt during intercourse. Give your partner  more time to ensure they feel safe, secure and comfortable to be together with you. 

• Take care of your pouch. The type of pouch plays a role in ostomate sexual life. It  will be good if you wear a non-transparent pouch. Non-transparent pouch prevents your  partner from seeing the exposed stoma and the contents of your pouch. The reason is,  they might be scared to engage in sex when they see your stoma. So try a non-transparent pouch or alternatively you can buy or design your own “pouch covers”. Pouch covers can  become a fashion statement and it can make you feel good too. Additionally, ensure your pouch is empty before engaging in intercourse. This is crucial to ensure there is no leakage  or unpleasant smell during intercourse. You have to keep everything clean and neat  beforehand to make it comfortable for both yourself and your partner.

• Monitor your diet before engaging in sexual activities. See which food helps you and which  does not. A good diet can lead to an improved sexual relationship between you and your  partner. Avoid foods that create gas and odor especially beans, broccoli, corn, cabbage,  and peas. Experiment about which food causes bad reactions and gas to you and avoid  them or at least eat them sparingly. This will prevent your stoma pouch filling with gas. To  keep it safe, try to use a gas filter pouch as this will keep your pouch flat and deodorize the gas. 

An ostmate’s partner can also take several steps to ensure their relationship with their ostomate  partner is healthy and good. As ostomates, they might go through a difficult time adjusting and even fear rejection. So, as a partner, be patient and give them time. As an ostomate’s partner, you can follow  the following steps to have a better intimate relationship with them. 

• Don’t jump into a sexual relationship right after their surgery. You should remember that  ostomy is considered major surgery and your ostomate partner needs time to adjust to  their new normal. The surgery does not only put stoma outside but there is a high  possibility of bowel and fistula track removal for those who have Inflammatory Bowel  Disease (IBD). Your partner definitely need considerable amount of time to heal and gain  back strength following their surgery. 

• Be mindful of your reactions and try not to create any distance with them. Your ostomate  partner may feel rejected and feel lonely. Communication is the key solution in any issue.  If your partner does not initiate their post-surgery life, try to initiate that conversation  yourself. For instance, discuss with your partner about physical intimacy and experiment  with different positions so that they may not feel uncomfortable. Keep in mind that most stoma patients will not engage in intercourse for weeks or months after surgery. 

• Seek professional advice from sex consultants, Enterostomal Therapy (ET) nurses, or IBD  advocates to educate yourself about your partner's sexual issues. Generally,  professionals will provide solutions to improve on both you and your partners’ emotions  and also how to manage your sexual life. Professionals may not solve the core problem  for you but they will be able to provide suggestions, or solutions from their research and  work with other patients. They can also talk about your concerns, make you understand  your feelings better and give meaningful and constructive advice for you. 

Being intimate is highly possible for an ostomate and their partner if both take time with their new  situation and be supportive of each other.  Be positive and engage in activities that make you happy and healthy. When you find a new  partner, talk to them about your ostomate life and be open to answer questions honestly.  Communicating with each other about your needs, wants, concerns and fears can go a long way  in ensuring a healthy and meaningful life together.

What to Expect When a Loved One Gets Diagnosed with IBD

Navigating an IBD diagnosis is not easy. It can be messy and emotional and very tiring. The person diagnosed with IBD will be feeling many emotions, probably all at once. But it’s not just hard on the diagnosed individual; it can be very hard on their loved ones as well. It can be difficult to figure out what to expect and what to say and how to act when you find out someone was diagnosed with Crohn’s disease or ulcerative colitis. Hopefully this article will provide some insight into what to expect when that diagnosis happens. 

The first few hours and days after your loved one gets diagnosed with IBD can be very confusing. You are processing their diagnosis, while trying to be there for them as well. While everyone processes it differently, there are likely some common reactions you can expect. Here are a few things to keep in mind:

• Be prepared to simply be there for them. Whether they want to talk about it or not; whether they want you to accompany them to appointments or infusions; whether they want someone to sit with them while they are sick. And even if they don’t want any of that, make sure that they just know that you will be there if/when they do. Be there for them when they are ready to talk to you. Tell them you are there if they need anything and be ready to back it up with your actions. There is nothing worse than empty words. 

• Be prepared for them to become experts on their own bodies. They will become very familiar with their symptoms and will likely know when something is not right. Learn to trust that. If they tell you they think something is wrong, don’t try to argue with it. 

• Be willing to learn with them. For me, I read up a lot on my diagnosis. I read others’ stories, I read articles, I read medical journals. And I wanted my friends and family to understand some of what I was learning. So, be willing to read the articles they send you. Educate yourself on their disease. Don’t be afraid to be educated. 

• Be ready for the hard days. The days when their medication isn’t working. The days when their Prednisone is making them miserable. The days when they are in the hospital. Not every day will be hard, but some will be. So be prepared when they come. Remind your loved one that it won’t last forever. 

• Also be ready for the good days! The days when they find out they’re in remission. The day when they try a food they haven’t been able to eat in a while and it goes well. The days when they feel like themselves. Just as the bad days come and go, the good days will come, too. 

• Be ready for the doctors’ appointment. Especially when your loved one is first diagnosed and they are working to get control of the disease, there will be a lot of doctors’ visits. There will be ER visits and hospital stays. There might be infusions they have to go to on a regular basis. They may or may not want you to come. Be ready to support them either way. With COVID, they may have wanted you to come and you may not be able to. If that’s the case, try to get creative with ways to make them feel like you’re there. FaceTime them, call them, text them. Do something to make them not feel so alone. 

• Ultimately, be ready for a journey. It isn’t always easy and there will be really hard days. But your loved one is now part of a community that is welcoming and ready to help when they want. There will be people that they can relate to and that can understand them in ways that someone without IBD can’t understand. Encourage them to reach out to people they see on social media. Encourage them to ask questions and not be afraid to speak up. The IBD community is a great one and people are always willing to help! 

Navigating a loved one’s IBD diagnosis can be a daunting thing. It is a lot to process and there is a lot of unknown. But by just being supportive and being attentive to your loved one, things will probably go a lot better than you expect them to. 

How to Support Your Friends with IBD

By Amy Weider

Growing up with Crohn’s Disease you tend to miss a lot of the action: birthday parties, hanging out with friends, and even going to school. It was either I was sick or stuck at another pediatric GI appointment that was 2 hours from my house. And to be honest, for most of my childhood I didn't really have friends. Because of my Crohns, anxiety, and depression, all of which were connected, maintaining friendships was not something I could do. The beginning of high school was just as rough and I lost a lot of friends over my unhealthy coping mechanisms for my depression and, while painful, it taught me a lot. Around my junior year of high school I got the help I needed and my Crohns began to go into remission. I was able to find friends and learn just what it means to have them. I have always been a bit of a weirdo and to find a solid pack of reliable folks that embraced me for my unapologetic behavior and I theirs was a lot more important than I had realized. My now chosen family (LGBTQ way of saying best friends) from college met me when my Crohns was very stable and I had to explain my disease to them. From this, I put together a few ways I found was a good way for them to show me their support  and that made me feel their love and commitment. 

1. Do your research!! 

When a friend opens up to you about their experience it is smart to do a little more investigating to have a medical understanding of the disease. Read some CCYAN articles or follow content creators who have IBD. Also, allowing for space for your friends to open up about their experience with it and understand no two persons have the same lived experience or symptoms. 

2. Be flexible 

IBD can be VERY unpredictable so if you are one of those friends who shame folks for needing to cancel plans or change them (or shame folks in general) reconsider why you do this! A friend’s health, mental or physical, should be your first priority! Be flexible and allow for change.

3. Think about where the group is going to eat before hand

Simple things like this can really make a difference in a friends restaurant experience a lot easier. Ask your friends their dietary restrictions and do not assume that someone who has IBD also has dietary restrictions. Dietary restrictions can really make folks feel like a burden so be transparent and pick a spot for everyone!

4. Support them on good and bad days

It can be rough some days and not pretty. If you haven’t heard from a friend with IBD in a while, reach out. Flares can cause a lack of energy but that does not mean we don’t still need love and community! 

5. Make room for correction and connection

Learning about IBD can be complex and everyone with it has very different experiences so create room for feedback and empathy if you say something wrong or hurtful. Allow for a bonding experience when someone shares their experience with you and love them more for it! I genuinely love when people ask me about my IBD and that allows me to feel whole.

How to Communicate Relationship Boundaries While Living With IBD: Texting Templates

By Amy Weider

I have been a sex educator going on two years now and a commonality you find between all progressive sex educator work is that there is a stress of the importance of communication. We advocate for having open and honest conversations around consent, boundaries, STI testing and much more. communicating boundaries can be intimidating and often times it makes you feel like you are coming off as needy and fear one might lose interest in you because of your needs. We must navigate the disclosure of our lives and our level of comfortability regarding different types of relationships for example, hookups, friendships,  dates, and long term relationships. communication is the key we say but many times we aren’t taught how to truly communicate our boundaries or limitations. In order to achieve successful relationships it is good to practice what we feel comfortable sharing with a person and how we want to do so. There is an Instagram sex educator @whatswrongwithmollymargaret who makes text templates for hard or nervewracking conversations. She touches on how to address being ghosted, how to ask someone on a date, and even asking a date about their accessibility needs!

I was so inspired by these posts and actions and it further made me acknowledge that communicating needs and boundaries becomes even more important when you are someone with a chronic illness. As a person with inflammatory bowel disease (IBD) my general energy levels can vary dramatically depending on the day. Because of this and my sex education work I wanted to share some of my tips and text templates for how to communicate boundaries around relationships and talking about IBD. These are all really individualized for me, a Crohn’s kid in remission who hasn't had any surgery. They obviously can be used and modified. If you have any of your favorite ways please share in the comments below.

Spoon theory

I like to introduce spoon theory very early on in my interaction with folks and continue to incorporate spoon check ins with every how are you what's up text. Spoon theory is an easy way to explain what's up with yourself without disclosing too much information about your disability/illness. It also gives me more room for an explanation of why I am canceling hook ups or dates without the interrogation of intentions or rudeness. 

“I have a chronic illness, which means my energy levels are different from those who do not have one. I start the day off with say 12 spoons when you may have an unlimited amount of spoons. So it is harder for me to do all the things that are easy for you!”

“Hey!! I just woke up and I am not feeling so hot oof. Have you heard of the spoon theory? For me, it means that I am unable to be as “productive” as others because of my chronic illness. So I like to measure my energy in spoons. Long story short I am low on them today. Anyway that we could change our date to something cute and low exposure maybe a movie and some snacks :-)”

“SPOONS LOW rip can't text you as much today as I must sleep for 10 hours lol. I will dream of you and text you when I wake up!”

Disclosing Disease

I tend to be light talking about my disease and progress towards deeper conversations around it with folks the longer I know them! Here are a few ways I have disclosed my boundaries around talking about my disease before. 

“I have Crohn’s Disease, which means my intestines and digestion can be unhappy a lot. I am in remission however though so it does not directly affect my daily life now and I don't love talking about it but hopefully one day we can get to the point where I could open up about it!!!”

“I have IBD which is inflammatory bowel disease, meaning basically because of all the inflammation I really can't digest anything. It has really affected my life and is an important topic I'm passionate about. Honestly, I'd love to talk deeper with you about it if you're down.”

“My health hasn't always been the best. I have IBD which affects my colon and I was diagnosed at a young age which affected my life. I am in remission now!! I get an IV every six weeks for a couple hours or so. I always say you know it's real when I take you to meet my nurses at the IV therapy appointments lol.

Asking for support

A big one for me is setting a boundary of disclosure transparency around when someone who I am going to see in person isn't feeling well so I do not risk my own health. I thought this was selfish for so long but I know it is not!! 

“Having IBD and being on immunosuppressant drugs means that I can easily catch a virus cold, maybe even a good lord. So if we are gonna see each other i'd honestly love it if you can just be honest with me if you aren't feeling well before we meet up. I can do the same for you if you liked!!”

Dating and IBD

By Rachael Whittemore

*I am writing from the point of view of a heterosexual, cis-gender woman.

Dating, romance, intimacy, relationships…All of these things can sound intimidating to anyone and even more so to someone living with IBD. There are the physical and emotional challenges we deal with every day to try to get to a positive place for ourselves. We get nervous before dates too, but instead of nervous butterflies, it feels like nervous knives wrenching your stomach. Worrying about not having a bathroom nearby or not making it to the bathroom is commonly in the forefront of our minds. Sometimes, we wonder, where does that leave any room for the thought of romance? As humans, many of us like to be in control of who we choose to interact with and count on this control to extend how we present ourselves to a potential partner, both physically and emotionally. When some of that control is lost as we navigate life with IBD, dating and romance may not seem attractive (pun intended). 

Though everyone’s experience with romance and dating is different, I think there are some great things to keep in mind when approaching it as someone who lives with a chronic illness. There can be a lot of pressure from friends and family to get out there and try to meet someone...I know I’ve felt it before. And sometimes we want connection and intimacy but not the label of a serious relationship - that’s ok too. In my experience, one of the most important things I’ve learned is that if you don’t feel ready to pursue dating/romance, you’re probably not ready. Sometimes something great comes out of the blue, but I have to feel comfortable with myself and my body to allow myself to be open to another person getting to know me on a more intimate level. 

“I have to feel comfortable with myself and my body to allow myself to be open to another person..”

Right after my diagnosis at 23. I had lost weight, but felt disconnected from my body and was in no way ready to date.

A big challenge for me when I finally *felt comfortable* was anxiety about if or when I should disclose that I have IBD with a guy I’m seeing. I felt this pressure because meeting someone usually involves going out to eat or drink, and this requires more preparation for us than the average person. Would they question why I can’t go to certain restaurants? Will they think I’m weird if I don’t want to drink? Will they make fun of why I can’t eat dairy or avoid other foods? Using food and drink as a backdrop for conversation and as a way to meet someone suddenly becomes another thing to worry about. A few days before a date, I try to have a few restaurants in mind that work for my needs but are usually well-liked by others as well. Having options gives you power to have choices for yourself and also give your date some fun options! I don’t have a magic formula for how you approach every date, but I usually try to be up front and open about any dietary restrictions or just say “I’m not drinking tonight” and leave it at that. If the guy I’m with seems genuine and wants to know more, sometimes this has opened up conversation to the “why.” I’ve definitely said: “It stinks I can’t try that awesome-sounding beer, but I have GI issues I deal with so am skipping that tonight.” Most are respectful and don’t question it. One time, I was even able to share about my IBD with a guy after we had spent hours talking. We just connected really well, I was in a safe space and he genuinely wanted to know more. I would say that was a rare instance, but this helped educate someone about real issues of living with IBD and having a social life. Even if guys I went on dates with didn’t really get it, I appreciated their willingness to hear me out and not make me feel guilty or like an outsider for needing accommodations. If someone does make you feel guilty, they probably aren’t worth your time. 

I’ve also been very lucky to feel secure and understood in my current relationship. An added plus is that my boyfriend works in the medical field and knew about my ulcerative colitis (UC) diagnosis prior to dating when we were friends. He was respectful whenever he asked questions about how I was feeling or about how I was diagnosed and being treated. He knows about my diet, what I have to avoid and doesn’t hold that against me. Bonus: he’s been a great partner in terms of helping me give up cheese and milk because he’s lactose intolerant too! Having open communication lets me feel comfortable sharing how I feel. If I’m flaring, he knows and understands when I have to shift my diet to bland food and stay away from alcohol and eating out. He checks in on how I’m doing mentally/physically in regards to IBD, but always in a supportive way. He also makes me feel beautiful and special inside and out, which is important to me since our bodies undergo lots of changes with IBD, from weight gain and loss to feelings of body disconnect and failure. 

And in terms of going through periods of disconnect and acceptance with your body, it’s so important to have someone who respects your wishes and your body. If you aren’t ready to be physically intimate with someone, that’s ok. The complex pathophysiological way that IBD affects us can cause sexual dysfunction as well (1). Not to mention things like medication side effects, surgery, living with an ostomy, pain, coexisting anxiety/depression, fatigue, other medical conditions or being in the middle of a flare. All of these things can have an impact on our sexual health and you should never be discounted for not wanting or being ready for physical intimacy. Personally, when I’m flaring, I feel gross, dirty and don’t want to be physically intimate. I usually just want to focus on getting out of my flare, resting and maybe getting a backscratch here and there from my boyfriend. Discuss with your partner any expectations, worries and what you know works for you in terms of physical intimacy. It can take time and patience to figure out what feels good for you and when, and doesn’t cause pain or anxiety.

“...you should never be discounted for not wanting or being ready for physical intimacy.”

27 and trying to live my best life! Happy and feeling so supported in my current relationship.

That being said, there’s so much you could talk about in the topic of dating and intimacy. Feeling ready and connecting with someone who is respectful of you as a person - not just a person with IBD - is so important. Your value is not diminished because you have a chronic illness. Sure, it brings challenges, but we all deserve partners who care about, support us and cherish us, IBD and all. The ability to be vulnerable and communicate openly with someone about the physical and emotional challenges of living with IBD is important, and a vital part of any relationship, regardless if it’s casual or serious. When you do feel ready though, dating and healthy relationships takes time and work, but it can be a beautiful way to connect with someone else, share adventures, enjoy intimacy and even learn about yourself. 

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What to Know When You Care About Someone With Crohn’s Disease

By Erin Ard

Chronic illness can be easy to ignore if you aren't the one living with it, but when you start to see how it affects a person you care for, it can strike a cord in you too.

When you meet someone with a chronic illness, it's natural to be curious about their life. You may even feel compelled to a) make their day easier, b) ease their pain, c) see their worth, or d) just help them feel comfortable. And if you want to lift the weight of living with a disease, choose all of the above.

Having IBD myself, it is THE. MOST. AMAZING. feeling in the world having someone who wants to know more and take care of you. So I must commend you for making it as far as reading this post.. You are ONE of FEW who would stick around someone with such a debilitating disease!

This topic has been on my mind for a while now. And when I started writing, I noticed how challenging it was to explain how this disease can affect someone. Experience with IBD is so diverse and can change so fast! For instance, in this moment I would say, "You really don't need to worry about me!" Because in reality, my own Crohn's has been in remission for years with only a few minor complications and I've made big strides in accepting my disease. I can go without thinking about my Crohn’s most days, but that doesn't mean these feelings of security have always existed and won't change in the future. Maybe your person is in the same boat, still it is invaluable to know what could happen. Whether you are a friend, family member, or lover, I want to help you understand the fundamental struggles, how it can affect someone (mainly by using myself as an example), and what you can do.

The first thing to know is that every person with the disease is unique and handles it differently. Some people want to be taken care of, while others may hide their struggles from you; so it's kind of up to you to know your person - I'm sorry I don't have all the answers! Thought, I can promise that anyone with a chronic health issue does not want to be characterized by their disease nor feel like a burden. It poses a challenge to balance helping them feel better and making the disease a big deal. If they choose to let you into that part of your life, that's great! It is too easy to discredit the harm it can impose. My first piece of advice is to have an open mind. Even though you won't be able to fully understand how it affects their body, mind, and lifestyle after reading this; you can keep learning.

 Before I jump into the nitty gritty of it all, we should go back to basics. Whether you just met someone with IBD, have know about the disease for years, or have it yourself it can be helpful to know how the disease works. With Inflammatory bowel disease (IBD), our immune systems get a little confused and end up attacking the healthy tissues causing inflammation along our digestive tract. IBD is a blanket term for the two most common forms: Crohn's disease and Ulcerative colitis. There are many commonalities between individuals who live with IBD. The most common symptoms are abdominal pain, fatigue, fever, and the infamous diarrhea. IBD can be classified from mild to severe depending on symptoms, e.g. frequency of diarrhea, abdominal pain, fever, weight loss, anemia, bowel obstruction, and more! IBD itself does not limit your life expectancy, however, it can lead to some life-threatening complications. And symptoms can be kept under control with medication, thankfully, allowing people to live normal lives whilst their disease is in remission.

The day-by-day symptoms and risk for complication in combination can be very draining for someone, both physically and mentally. Not only are these symptoms tiresome in their own right, but can bring about mixed feelings - fear of flare-up recurrence or inability to find a bathroom, worry over not knowing what you can or can't eat, embarrassment of symptoms, and maybe denial of the pervasive hold it can take on your life. Even though my disease is in remission, it takes constant maintenance to feel in control of my body's health.

Much of my knowledge comes from learning about my own Crohn's symptoms and how it has impacted my day-to-day life. So I will try to describe what to look out for when caring for your person and their IBD.

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It's a daily struggle.

IBD is a hidden illness, making it hard to understand what kind of struggles we endure because they can't be seen. If your loved one says they don't feel okay but look fine, trust them. They know their bodies better than anyone. I know for myself, every once in awhile I have shooting abdominal pains, discomfort from something I've eaten, unreliable energy levels due to fatigue, joint pain, sensitivity to temperature, and recurrent symptoms close to my Remicade infusions. Usually on bad days, I take it easy on food I prepare for myself and the activities I do.

Tip: Have patience and learn to enjoy a few more Netflix movie marathon nights than usual.

It's a love and hate relationship with food.

With Crohn's we have our own food triggers, which can be devastating to our digestive systems and send us running to the bathroom. Unfortunately for us, there is NO SINGLE ALL CURING DIET PLAN that can help us. We really just have to figure it out on our own since triggers differ from person to person. I get a lot of questions like, "Can you eat this?" "Or what can you eat?" and the answer isn't very simple. I can eat just about anything I want most days, but if I'm feeling off or it's getting close to my next infusion appointment - I take it easy on the hard to digest foods. I try to eat as healthy and balanced as I can while still getting the same sense of satisfactory indulgence as anyone else. For instance, I would love to eat an entire pan of brownies (and have gotten close a few times) but this would lead to me feeling like sh** the next day; as it would with anyone I feel. If you switch this desire I hold for brownies during a flare-up, it gets a bit more complicated and pretty much impossible. During a flare-up, however, my indulgences subside and I only crave foods that will sustain me without bringing about more harm.

Tip: Expect a mix of eating habits, since our health can change pretty fast. If they are on a strict diet plan, say gluten-free for someone with Celiac or gluten intolerance, get to know what they can and can't eat! It will be a whole lot easier for them if you have a good understanding and they can stop answering the "What can you eat?" question, at least coming from you :). A lot of people also take supplements to make up for the nutrients lost in their diet or from not being able to absorb an efficient amount through the gut. The biggest thing to understand, like with me, is that there are foods we just can’t eat AND there are foods, though you wouldn’t think so, we are still able to indulge in!

Flare-ups are hard to overcome.

When the disease is active, you'll see all of the main physical symptoms taking root. A flare-up can last several days to a few years and can limit our ability to perform daily activities; sometimes even landing people in the hospital. During my own flare-ups, my limitations were somewhat subtle. I was still able to attend school and join sports, but my performance level was not where it could have been (this became clear once I achieved remission). After school I would too often fall onto the couch, exhausted from the day. I didn't have a solid bowel movement for months. I would give up and have emotional break downs in the bathroom. I became afraid of food because my body couldn't digest it properly anymore. I missed a lot of school, plans with friends, and family get-togethers. What I did attend, I would be withdrawn, wanting to lay down or be at home. Flare-ups are very socially isolating and can force us to miss out on a lot of what makes life fun :(

Tip: Be your own person and don't feel like you need to spend every occasion we miss out on with us, because we don't want you to miss out either! If your person is not feeling 100% and tries to dip out on plans, be heartfelt and ask, "Are you sure? What is making you not want to go?" Reassure us that not every day will be a bad one. Sometimes we have to stick it out to reach the good moments. In time, when we are healthy again, we will be able to push through what limits us. And help us see the value of little things, even if it's just an evening of Cards Against Humanity  or binging The Office.

We have some tricky immune systems.

Many of us take medication to suppress our immune systems to fight inflammation. Some people may get sick more or less often, depending on their medication. When I first started Remicade, it was rare to find me sick with the common cold. However, since my dosage was increased I seem to get sick more often and have a harder time fighting the sickness off. *Insert disappointed emoji *

Tip: Help us take precautions when going out - use hand sanitizer, disinfect grocery carts, and mind your sneezes. Especially during cold and flu season! Maybe consider bringing over a box of tissues and some chicken noodle soup when these efforts fail :)

Everyone has their own self-esteem issues and insecurities.

IBD makes us feel a loss of control over our bodies (quite literally sometimes) and can indirectly cause visible changes (e.g. weight fluctuations, inflammation of the skin or eyes, mouth sores, etc.). Complications with IBD may involve j-pouch construction surgery - a major cosmetic change with added stress over maintenance and potential leakage - or bowel resections and scarring. This can also extend to social interactions, like when we have to explain why we can't eat certain foods, obsess over the details with travel plans, or being conscious of our frequent bathroom visits.

Tip: Depending on the person, procedures causing cosmetic changes may not sit very well. All that we ask is you be open and accepting of every scar or medical device. Each one tells a story of our struggles and what we had to face to find strength again.

IBD has it's own added mental health challenges.

People with IBD are at higher risk of having anxiety or depression. It is all too easy to get down on yourself when you deal with constant set-backs. With IBD, a lot of the symptoms happen behind closed doors.. Usually bathroom doors. Or in the scope of mental health, you can envision the mental wall that keeps others from seeing your thoughts, feelings, and worries.

Tip: I implore you to keep an open mind. We might need a little extra encouragement when it comes to self-worth, seeing the positive, and enjoying life when our IBD gets in the way.

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Being available and accepting of what we deal with can make such a difference to us. Like I said before, IBD can be socially isolating and I hope this post has helped you to understand why that is. I also want to say that people with Crohn’s or Ulcerative Colitis are the strongest, most ambitious people I know. They deal with keeping their health in check while juggling school, work, friends and family, their goals, AND everything else!

Your person may or may not deal with what I've laid out. Honestly, there is way more that could be discussed on "taking care of someone with Crohn’s" than what I know. Getting to know your person with their Crohn’s lifestyle will have a learning curve. It’s going to take some time and a considerable amount of observational skills to become an expert and if you aren't sure, ask! Just know that you can't do everything for us. You can't take all the pain away or make us healthy. What you can do is keep an open and accepting mind around our abilities. Be patient with our limitations. Help us feel comfortable and emotionally supported when we miss out. And get to know our many qualities in addition to being fighters. To go even further, I respect someone willing to challenge me when I hesitate on getting out of my comfort zone.

Finally, remember to take care of yourself too. Not only can the symptoms be draining on the person with Crohn’s, but seeing your loved one endure such bodily torment could drain you as well. Take time to rest, focus on the good, and keep fighting for your person!

What advice would you give to your loved ones?

Comfort, Charisma, and Confidence: 3 Tips to Make Dating with IBD Work For You

By Erin Ard

Recently, I've been learning about the many strong women who have made a difference in this world. Those who have lead movements, progressed research, fought their adversity, spoke their truth, and lived their life with passion. In honor of #WomensHistoryMonth, I've been trying to find what this means for me. A single, white, cisgender woman with a voice, a mild physical disability, and a latent identity. What do I have to say?

I've been doing a lot of reflecting lately about what I can offer the #IBD community. I've been trying to think of what tips and/or tricks I live by that could make your day to day life easier. I explored my reflections but I sadly couldn't come up with many. Then I was kindly reminded of something. Though I have lived this fight with Crohn's for some time, I am still amidst my own journey. I might not have the answers because I haven't resided long enough in this level of comfort, which seems to grow every day. I am still figuring out how to catch up from the emotional setbacks Crohn's disease has caused for me and it's okay if you are too. Welcome friend! We can figure this out together.

In truth, I have had a lot of interesting experiences I could speak to, but today I will settle on one I've learned a lot about lately. #Dating.

While this topic might not be central to the life of an IBD patient, it has the potential to really impact our self-esteem and mess with our emotions. I can't say I have extensive experience with dating or have ever made it to the "sweet spot" (when you get past the "What are we?" stage and finally make it official). However, since I've been out of the game I've been using time to learn. I've subscribed to a few newsletters and watched way to many "How To" videos! How to get the man of your dreams, How to not push him away, How to get him back, How to.. How to.. It sounds silly, but it has been SO eye-opening! What was a topic I had zero input in, I now have a LOT to say about.

It's a little humorous how much we struggle over the little things in dating that should be easy. For instance, figuring out how to say the right things or act a certain way to keep someone's interest. I've realized the less we worry about these trivial things, the more successful we could be. You might be thinking, worrying "less" is easier said than done, but shouldn't being our natural selves rather than putting on a façade be the easy part?

This is just one of the many revelations I've had recently about how intuitive the dating world is and how easy we can make it work in our favor. As a woman with Crohn's disease I've had other challenges to contemplate, like how to talk about having a chronic disease to someone I barely know and how to phrase positively so I don't look like damaged goods. Because in reality, we have all learned tremendous strength with having IBD so there is no need for anyone to think this about us.

IBD is a multi-facetted disease that touches many parts of our life. It impairs some of our basic every day functioning, like being able to sit for extended periods of time without needing to use the bathroom. Personally, Crohn's disease has transformed how I go about my day. I've had to make necessary changes for my health, learn to accept my limitations as they are, or find the motivation and means to push past them.

Well, here it is my little ladybugs! Here is what I have learned about dating AND dating with IBD.

First, open up about your IBD when you feel comfortable.

Opening up about your life with IBD can get pretty personal and you might not want to get too personal too quickly. If your date asks you questions about having IBD, be honest, but don't feel pressured to divulge all your deep emotional baggage. Ultimately, deciding when you should talk about life with IBD is up to your comfort level. If you are comfortable with someone and trust their compassion, then feel free! Getting close to someone emotionally is all about balancing each other's efforts. If they give a little, you give a little and vice versa.

Opening up about your life with IBD is different for everyone. Some people are entirely comfortable with airing out their experiences, while others may be hesitant. Some people dwell on the negative, while others would rather focus on positive. It may be easier for others, but we don't need to criticize ourselves for how behind we may feel. Rather we should accept where we are, honor how far we've come, and progress at our own pace.

Second, cancelling a date doesn't have to be a headache if you are charismatic.

Dating is stressful enough and when you add IBD into the mix it can get complicated.

Imagine this: You met someone who seems perfect! They are family-oriented, charming, sensitive, and cute. You are really excited about getting to know them so you set up a date. You talked them into touring the art museum downtown and getting ice cream afterwards. But, you wake up the morning of feeling a little off. Maybe that handful of popcorn at the movies last night wasn't the best idea.. You forgot how much popcorn can set you back and you've been reaping the consequences all morning. So, what do you do?

When you have IBD, situations like this can happen often. This has happened to me quite a few times since I always forget how much my body loathes popcorn. Although my dates were never this adorable!

So, say your date doesn't understand your situation and you aren't comfortable with sharing that part of you yet. If the person is as great as you make them out to be, then they will understand if you need to cancel. Even so, there are ways to cancel a date that won't reflect poorly on your interest. Here is my personal tip, whether you decide to tell them the truth minus the details (you aren't feeling well) or make up a believable excuse (you have an assignment to finish), be cute about it! Tell them you won't be able to do tonight and add something playful, like Hey, I don't think I can meet tonight anymore. Any way we can reschedule for Thursday? I promise I'll make it up to you ;)

This way you still convey interest, make the cancellation pleasant, and give them something to look forward to - seeing your cute self :) If you have to cancel many times, it probably won't continue to work in your favor. You have to figure out what you want to tell the person. If they don't respect that some actions are difficult for you, then they probably weren't the one for you anyways. You deserve someone AS amazing and understanding as you.

Third, it's all about being confident.

If you think about it, what kind of personalities are YOU attracted to? Those who seek out gratification for their insecurities or individuals who are comfortable with themselves and radiate positivity?

Here is my personal tip on getting started with confidence. Practice talking about how IBD affects you. Have this conversation with yourself, open up, be honest and focus on what value it has brought to your life. For me, having Crohn's has brought me closer to my family and friends, it has taught me strength and perseverance, and has given me a purpose. Since being diagnosed I have focused on my overall health and sought out knowledge to help others be healthy and embrace their whole self.

The notion of confidence became more inviting for me once I realized it can be learned. Being confident is an attitude and it is relatively easy to implement if you are proactive in changing your mindset.

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I hope this article can help shift your perspective of dating with IBD to a positive headspace. If you take one thing away from this, I want you to know the key to successful dating is knowing and appreciating yourself. Once you learn how to do this, all of the tedious details we tend to wrap ourselves in won't seem as unmanageable. I can't say enough about how the simple act of being compassionate with myself has helped me grow. I hope to become as strong as the women I've been learning about this month and to pass this strength to all of you.

Each of us is strong in our own way. IBD challenges us to be even stronger.

With love,

Erin