7 Things You’re Doing That Are Actually Making Your Crohn’s Disease Worse
Updated on February 25, 2026
The loss of control that you feel during a Crohn’s disease flare can be frustrating and sometimes even debilitating. Many factors that lead to inflammatory bowel disease (IBD) flares are out of your hands, but adopting healthy lifestyle habits and ridding your routine of the not-so-healthy ones can help you take back some control when it comes to managing Crohn’s.
Diet is a major issue in IBD, and people have been telling their doctors for years that certain foods trigger their flares. Despite this, there is still not enough evidence to conclude that specific foods cause active inflammation (flares) in everyone with IBD. That doesn’t mean your triggers aren’t real — they may very well be worsening the symptoms of your illness. And much of the research into how lifestyle habits affect Crohn’s disease during both flares and remission is preliminary, and more in-depth investigations are needed to confirm the findings, says Keith Sultan, MD, the director of the inflammatory bowel disease program at Northwell Health's Long Island Jewish Medical Center in New York.
A research review backs this up, finding a lack of consistent results on an anti-inflammatory diet that restricts carbohydrates and certain fatty acids, which is sometimes recommended for IBD.
But other research has shown a clear connection between inflammation in Crohn’s disease and some lifestyle factors, says David S. Lee, MD, a gastroenterologist at NewYork-Presbyterian in New York City.
Breaking bad habits will increase your sense of control and can ultimately lead to better health. Here are some of the lifestyle factors that experts recommend rethinking.
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7 Things Making Your Crohn's Disease Worse
While there is no cure for Crohn's, here are some ways to manage your condition and not make it worse.
1. Smoking
“Smoking is strongly linked to the inflammation in Crohn’s disease,” Dr. Lee says. It increases the risk of developing Crohn’s disease in the first place and makes symptoms worse once you have it. “It’s very important that smokers with Crohn's disease stop smoking if they can, because continuing to smoke is associated with disease activity, and patients who smoke after surgery have a chance of getting surgery again,” says Madalina Butnariu, MD, a gastroenterologist at Ohio State University's Wexner Medical Center in Columbus.
A research review found that current smokers with Crohn’s experienced flares more often and were more likely to be hospitalized than nonsmokers. It also found that relapse (flare) rates in people with Crohn’s who quit smoking were about the same as nonsmokers.
And a Taiwanese study found that smokers had increased rates of strictures (narrowing of the intestines) and inflammation that reached deeper into the layers of the digestive tract, and were more likely to have surgery for Crohn’s disease than nonsmokers.
2. Eating Foods That Trigger Symptoms
Eating a well-balanced diet may help manage Crohn’s symptoms. While food triggers are highly individual and vary from person to person, many people with Crohn’s find that foods high in fiber and fat, dairy products, and beverages with added sugars (such as soda) can trigger symptoms.
The best option is to stick to fresh fruits and vegetables, along with lean meats, says Dr. Sultan.
When it comes to other foods, choose minimally processed versions. Processed meats are connected to inflammation, and processed foods containing additives like carrageenan, maltodextrose, sulfites, and guar gum, among others, are suspected of having a connection to inflammation as well, though more research is needed to know for sure.
“Something that doesn't get enough attention is the potential negative of preservatives in the food supply and how they may affect the intestinal lining and disease activity,” Sultan says.
A study pointed to the lack of data on whether food preservatives had a direct impact on people with IBD. Researchers observed that some preservatives can lead to an imbalance in the microbiome (dysbiosis) and make inflammation more likely, and they called for more studies examining the topic.
Some experts also recommend a low-fat diet. “Fatty foods are more difficult to digest and can increase diarrhea in people with Crohn’s,” says Richard P. Rood, MD, a professor of medicine in the division of gastroenterology at Washington University's School of Medicine in St. Louis.
But avoiding certain foods can increase the risk of malnutrition. Guidelines from the European Society for Clinical Nutrition and Metabolism urge healthcare practitioners who are treating people with Crohn’s disease to check for micronutrient deficiencies at least once a year, as essential nutrients can be lost when cutting certain foods from your diet to alleviate symptoms. People with Crohn’s also face malabsorption due to diarrhea and damage to the digestive tract, causing them to become malnourished over time.
It can be tough to replace vitamins and minerals in your diet, says Kim Braly, RD, an IBD nutrition consultant with a virtual private practice, but it is doable. Iron from animal proteins like lean meat is best, and fish and low- or nonfat dairy are still the best form of calcium. Fatty fish can help put some vitamin D back into the body.
If you’re eating a plant-based diet or are lactose intolerant, you still have options. Beans and lentils contain iron, although the body does not absorb it as well as iron from animal protein. Many nondairy milks are fortified with calcium, but pay attention to additives and preservatives. For vitamin D, which is typically produced when the sun causes your body to generate it, rather than sourced from plant foods, supplements may be necessary.
“It might be multivitamins or individual supplements, depending on the patient,” says Lyndsay Hall, RD, of JM Nutrition in Mississauga, Ontario. “But we always try and take a diet-first approach where we can maximize [nutrition] through food when possible.”
3. Not Managing Stress Adequately
It can be stressful not knowing when your next flare will occur. It’s fair to say that not managing your stress and not taking care of your mental health can be triggers for Crohn's disease flare-ups, according to Yezaz Ghouri, MD, a gastroenterologist at SSM Health in Bridgeton, Missouri.
Ways to manage stress include mindfulness meditation, breathing exercises, progressive muscle relaxation, and exercise. You can get help developing coping skills by seeing a therapist.
4. Sleeping Poorly
Dr. Ghouri says that people who are stressed can have sleep problems that further worsen health.
Research suggests that about 70 percent of people with IBD experience disturbed sleep. Poor quality sleep has been connected with a higher risk of flares, surgery, hospitalization, depression, and use of opioid pain medications. Talking to your doctor about your sleep habits is the best way to course correct and discover whether your sleep issues are caused by behavioral factors or biological ones, such as sleep disorders, which research suggests are common in people with IBD. It can help to keep a sleep diary to track how you sleep, symptoms, and medications that may be interfering with your rest, such as steroids or opioids.
5. Drinking Too Much Coffee
Good news for coffee lovers: You don’t have to eliminate coffee altogether — just make sure that you’re not drinking too much caffeine.
“Everybody can get gut symptoms from having too much caffeine, and the reason for that is it speeds up every part of our body, including our small bowel,” says Sophie Medlin, RD, a consultant dietitian at City Dietitians and the chair for the British Dietetic Association for London. “As a result, things rush through our small bowel a little more quickly, so patients with Crohn's disease may notice that their symptoms are a bit worse if they have excess caffeine.”
What is considered too much caffeine depends on the individual, says Sultan.
“The data would suggest that there's no hard evidence that it will aggravate your Crohn's,” says Sultan. “It's a question of limiting Crohn's complaints or issues. Caffeine is a balancing act.”
It’s true that research has delivered mixed results. Some studies connected coffee with an increase in IBD symptoms and flares, while others found no association. But if coffee bothers you, consider limiting the amount you have per day or switching to caffeine-free beverages.
6. Overdoing It With Alcohol
Alcohol can interfere with medication used in managing Crohn’s disease, in addition to causing nausea and vomiting. This is especially true if you’re taking metronidazole (Flagyl), a medication used to treat bacterial and parasitic infections, Dr. Rood says.
A research review reported that heavy drinking with IBD was connected to poorer disease outcomes and triggering inflammation. The authors note that the sugar and sulfur in alcohol are more connected to symptoms and flares than the alcohol content of drinks, and that more research is needed to make recommendations about whether people with IBD should abstain from alcohol altogether or if there are types that can be consumed without harm.
No matter what, alcohol in excess is bad. And major health organizations say that everyone should restrict drinking for optimal health. The American Heart Association recommends limiting alcohol to two drinks per day or fewer for men, and one drink or fewer per day for women.
7. Skipping Your Doctor’s Visits
“The most important thing is understanding that Crohn’s disease is a lifelong condition and that patients will need to be followed by a healthcare professional. It’s not something that they have one time, and then it’s gone,” Dr. Butnariu says.
Crohn’s has no cure, but it can be managed, so getting consistent care is important. The frequency of doctor visits depends on the person and the course of their illness.
For most patients, “I recommend popping in at least once a year, just to maintain the narrative and not lose the relationship,” says Sultan. “But depending on the medicines and their own personal history, they may visit much more frequently. After a hospital admission, they can be here every week until we're sure that they're recovering.”
The Takeaway
- While Crohn’s disease isn’t something you can fully control, there are some things you can both do and not do to avoid worsened symptoms and poor disease outcomes.
- Lifestyle factors like smoking, poor diet, and uncontrolled stress can negatively affect your health when you have Crohn’s.
- Making sure to avoid the things that exacerbate your illness and increase your healthy behaviors can help give you the best chance at effectively managing Crohn’s.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
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Rabia de Latour, MD
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Rabia de Latour, MD, is a therapeutic endoscopist and gastroenterologist at NYU Grossman School of Medicine, where she serves as the director of endoscopy and chief sustainability officer at Bellevue Hospital. She is the host of Sirius XM Doctor Radio Internal Medicine Show.
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