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.