How to help your child through a difficult flare

Watching your child go through an IBD flare can be one of the hardest parts of living with Crohn’s disease or ulcerative colitis.

They may be in pain, exhausted, running to the toilet, missing school or activities, eating less and feeling frustrated that their body isn’t cooperating.

And as a parent, you may feel like you want to make it better immediately.

While your child’s IBD team is responsible for assessing and treating active inflammation, there are many things you can do to help your child feel safer, more comfortable and supported while they recover.

❤️ Start with reassurance

A difficult flare can be frightening for a child.

They may wonder:

“Why is this happening again?”

“Am I going to get better?”

“Will I have to go to hospital?”

“Will I be able to go back to school?”

Try to keep your explanations simple and reassuring.

You might say:

“Your IBD is having a difficult time at the moment. We’re going to work with your doctors to help you feel better.”

Remind them that the flare is not their fault.

They didn’t cause their IBD, and they aren’t doing anything wrong.

🩺 Stay connected with the IBD team

If your child’s symptoms are getting worse, don’t feel that you have to manage everything at home.

Contact their IBD team and let them know what is happening.

They may want to assess:

• How often your child is having bowel movements

• Whether there is blood or mucus

• Abdominal pain

• Appetite and food intake

• Weight changes

• Hydration

• Energy levels

• Fever

• Medication use

• Whether tests such as blood tests or faecal calprotectin are needed

Your child’s treatment may need to be reviewed during a significant flare.

Don’t change, stop or increase IBD medication unless your child’s healthcare team advises you to.

💧 Focus on fluids

Frequent diarrhoea and vomiting can cause children to lose fluids and electrolytes.

Encourage your child to drink regularly, particularly if they are having frequent bowel movements.

Depending on your child’s age and medical advice, this may include:

• Water

• Oral rehydration solutions

• Other fluids recommended by their healthcare team

If your child is struggling to drink, vomiting repeatedly, passing very little urine or showing signs of significant dehydration, seek medical advice urgently.

Your child’s IBD team may have specific hydration advice for them, particularly during a severe flare.

🍽️ Keep food simple and manageable

There is no single IBD flare diet that works for every child.

During a flare, some children find that large meals are difficult, while smaller, more frequent meals are easier.

Your child may temporarily prefer foods that feel more comfortable for them. The important thing is to avoid unnecessarily restricting their diet without guidance from their healthcare team or an IBD dietitian.

Try to focus on:

• Foods your child can comfortably tolerate

• Regular opportunities to eat

• Enough fluids

• Adequate energy and protein

• Their individual nutritional needs

If your child is eating very little, losing weight or struggling to maintain growth, speak with their IBD team or dietitian.

🥣 Don’t create a long list of “forbidden foods”

When a child is already worried about their body, it can be easy for food to become another source of anxiety.

You may notice that certain foods seem to make symptoms worse. Keeping a simple food and symptom record can help you identify patterns.

But remember that a food causing symptoms does not necessarily mean it is causing inflammation.

Some foods may temporarily worsen symptoms without causing an IBD flare.

Before removing major food groups or putting your child on a restrictive diet, talk to their IBD team or a dietitian experienced in paediatric IBD.

🚽 Make the bathroom easier

When your child is having frequent diarrhoea or urgency, getting to the toilet quickly can become a huge part of their day.

You can help by:

• Making sure the bathroom is easy to access

• Keeping spare underwear and clothes nearby

• Having wipes or toilet paper available

• Using a gentle barrier cream if recommended for sore skin

• Keeping the bathroom warm and comfortable

• Giving your child privacy when they need it

f accidents happen, try to respond calmly.

Your child may already feel embarrassed or upset.

A simple:

“It’s okay. These things happen when your tummy is unwell.”

can make a big difference.

🛋️ Let them rest

Fatigue is a common IBD symptom and can become particularly difficult during a flare.

Your child may need more rest than usual.

That doesn’t mean they have to stay in bed all day.

Instead, let their energy guide the day.

They might:

• Sleep more

• Read

• Watch a movie

• Play quietly

• Draw

• Listen to music

• Spend time with family

• Do a small amount of schoolwork when they feel able

There is no prize for pushing through a flare.

Rest is part of taking care of an unwell body.

🏃 Don’t pressure them to exercise

Physical activity can be a normal and important part of life with IBD, but a difficult flare is not the time to pressure your child to keep up with their usual activities.

If they’re exhausted or experiencing significant abdominal symptoms, give them permission to slow down.

Once they’re feeling better, they can gradually return to their usual activities based on advice from their healthcare team.

🏫 Talk to the school

A difficult flare can affect much more than your child’s physical health.

They may miss school, struggle to concentrate or worry about having an accident in front of classmates.

Speak with the school about what your child needs.

This might include:

• Easy access to toilets

• Permission to leave class without waiting

• Reduced workload temporarily

• Extra time for assignments

• Flexibility around attendance

• Rest breaks

• Support catching up after absences

• Understanding from teachers about fatigue

Your child doesn’t necessarily need to explain their IBD to everyone.

Work with them to decide who needs to know and what information they are comfortable sharing.

📚 Don’t make school the priority during a severe flare

It’s understandable to worry about missed work.

But when your child is experiencing significant IBD symptoms, their health comes first.

Trying to complete a full school day while dealing with pain, diarrhoea and extreme fatigue can be exhausting.

Ask the school about a temporary plan rather than expecting your child to simply catch up later.

Sometimes a small amount of schoolwork completed when they feel well is enough.

💬 Give them some control

IBD can make children feel like their bodies are making all the decisions.

Small choices can help restore a sense of control.

Let your child choose:

• What comfortable clothes to wear

• Which foods they would like to try

• Where they would like to rest

• What activity they feel up to

• Who they want around them

• Whether they want to talk about their IBD

For older children and teenagers, involve them in conversations with their healthcare team as much as possible.

Even small decisions can help them feel more independent.

🧠 Look after their emotional wellbeing

A difficult flare can affect your child’s mood as well as their body.

They may feel:

• Frustrated

• Embarrassed

• Angry

• Sad

• Worried

• Lonely

• Different from their friends

• Frightened about another flare

• Tired of appointments and medications

You don’t have to solve every feeling.

Sometimes listening is enough.

Try:

“That sounds really hard.”

rather than:

“Don’t worry, you’ll be fine.”

Giving your child space to be upset without immediately trying to fix it can help them feel understood.

If your child’s mood, anxiety or behaviour is becoming a significant concern, talk to their IBD team about additional psychological support.

🤝 Keep life feeling normal where possible

When your child is flaring, it can feel like the whole family’s life revolves around IBD.

Try to keep small pieces of normal life going.

Watch their favourite movie.

Play a game.

Sit outside.

Talk about something completely unrelated to IBD.

Have a sibling movie night.

Let them know that they are still your child first — not just someone with IBD.

📝 Keep track of what’s happening

During a difficult flare, it’s easy to lose track of symptoms.

A simple record can help you and your IBD team understand how things are changing.

You could record:

• Bowel movements

• Blood or mucus

• Abdominal pain

• Urgency

• Vomiting

• Temperature

• Fluids

• Appetite

• Energy

• Weight, if advised

• Medications

• Other symptoms

You don’t need to record everything forever.

The goal is to identify changes and give your healthcare team useful information.

💊 Keep medications organised

When your child is unwell, medication routines can become more difficult.

Try to keep a clear record of:

• What medications they take

• When they take them

• Any recent changes

• Missed doses

• Side effects

• Questions for the IBD team

If you’re unsure whether your child should take a medication during a flare, illness or vomiting, contact their healthcare team or pharmacist.

Don’t make medication changes on your own.

🚨 Know when a difficult flare needs urgent help

A difficult flare isn’t necessarily an emergency.

But seek urgent medical attention if your child has symptoms such as:

• Severe or rapidly worsening abdominal pain

• Heavy or ongoing rectal bleeding

• Repeated vomiting or inability to keep fluids down

• Significant dehydration

• Fainting or severe dizziness

• A very swollen or unusually tender abdomen

• Extreme weakness or difficulty staying awake

• A high or persistent fever with your child appearing very unwell

• A significant change in alertness or behaviour

If you believe your child is seriously unwell, seek emergency medical care rather than waiting for the IBD team to respond.

What if you feel overwhelmed too?

Looking after a child through a difficult flare can be exhausting.

You may be:

• Worrying about every symptom

• Sleeping poorly

• Trying to manage medications

• Communicating with school

• Rearranging work

• Caring for siblings

• Travelling to appointments

• Trying to keep your child calm

It’s okay to ask for help.

If someone offers to bring dinner, pick up another child, sit with your child or make a phone call, let them help if you can.

You don’t have to manage every part of an IBD flare yourself.

❤️ Remember: this won’t always be how things feel

When your child is in the middle of a difficult flare, it can be hard to imagine them feeling like themselves again.

But a flare is a period of active disease — it isn’t your child’s whole life.

Work with their IBD team, focus on what your child needs today and take things one step at a time.

Your job isn’t to fix the IBD.

Your job is to help your child feel safe, supported and cared for while their healthcare team works with you to manage their treatment.

You don’t have to get through the whole flare today. Just focus on the next step.