Surviving Holiday Stress with IBD

Here’s how to navigate all the social events focused on food and alcohol while keeping stress and fatigue to a minimum.

When I think about the holidays, I think about how magical they were when I was a kid. But as an adult with Crohn’s disease — a form of inflammatory bowel disease (IBD) — and an ostomy, I find the magic of the holiday season can be overshadowed by its stresses.

For example, I often find I need to manage the fatigue that arises from the extra busyness of the season, tactfully navigate alcohol- and food-based social events, and figure out what to wear with my ostomy.

Over the years, I have learned a few strategies that have helped me to recapture some of the holiday magic that I remember from childhood. I’m here to share them with you.

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Navigating food-based social events

Between colleagues bringing baked goods into work and invitations to holiday parties with food and drinks, those of us with food restrictions have a lot to navigate.

It’s tempting to go off my diet during this time of year, but I’ve learned how critical it is to stick to it as much as possible. The following strategies have helped me with this goal:

1. When I attend parties, I bring a dish to share that I know complies with my food needs.
2. If the event is catered or at a restaurant, I read the menu in advance to determine which items I can tolerate. If I have a question about an ingredient, I call the restaurant or caterer directly to ask in advance.
3. If I’m attending an event where I can’t determine in advance what the menu will be and I can’t bring a dish to share, I eat a large snack before I attend. I also plan to eat a fuller meal afterward if I find there’s not much I can safely eat.

Sometimes even these strategies aren’t enough. I sometimes encounter social pressures to eat foods that don’t agree with me. Someone might offer me a cookie with nuts in it, saying, “You can have just one; it’s Christmas.”

My response to that kind of pressure depends on who’s doing the pressuring.

If it’s someone I don’t want to disclose my illness to, I keep things simple and either say that I don’t care for a certain ingredient (such as nuts) or that the specific food doesn’t agree with me.

When I feel more comfortable with someone, I will disclose my IBD diagnosis, which sometimes leads to greater empathy and new allies. My relatives now provide low-roughage foods at gatherings because they know I have adhesions that leave me prone to bowel obstructions.

Declining alcohol during holiday events

Some people with IBD find that alcohol can exacerbate their symptoms. Others take medications that interact poorly with alcohol.

Just as with food, simply saying “no” to alcohol should be a complete answer. Unfortunately, some people will still exert pressure to drink.

I have found the following strategies are helpful when navigating events with alcohol:

• I ask the bartender for soda water and lemon or another festive-looking nonalcoholic drink so people see me holding a beverage and are less inclined to ask me if I want a drink.
• I bring sparkling juice or tea to events as an alcohol-free option for toasts for myself and all other guests who may not be consuming alcohol.
• I state that I’m on medication that interacts poorly with alcohol. It provides a clear and simple reason for anyone asking why I am choosing to abstain.

Managing fatigue

People with Crohn’s disease can experience intense fatigue caused by inflammation, anemia, nutrient deficiencies, sleep disturbances, emotional stress, and medication side effects.

It’s challenging enough to manage this at other times of the year, but when you add in the constant event invitations and the general busyness of the holiday season, it becomes a major consideration.

To cope, I implement several tactics:

Managing my schedule

First, I manage my schedule so I don’t have too many commitments in one weekend. If I’ve been invited to a holiday party on a Friday night and a community event on a Saturday, I will choose one or the other to attend.

Outsourcing chores and errands

I outsource chores so I don’t have to focus as much on the tasks of daily living.

If my budget allows me to hire a cleaning or laundry service this time of year, I do it. Likewise, I find scheduling grocery deliveries is extremely useful for freeing up time and energy for holiday events and preparations.

When it’s not in the budget to hire these services, I ask for more help from household members this time of year. I also find that combining social activities with holiday preparations (for example, getting together with friends and doing our holiday baking together) can help.

Staying up to date on medical needs

I make sure I’m up to date on my routine monitoring blood tests. These blood tests can detect inflammation, anemia, and nutritional deficiencies.

If one of them turns up with abnormal results, I can easily add supplements or interventions as needed, which can help to decrease fatigue.

Taking care of my emotional needs

To handle added emotional stress during the holiday season, I increase the frequency of my therapy sessions. If I can’t get an appointment, I make sure to include more self-care like baths, reading time, and walks into my daily routine.

Dressing for the occasion with an ostomy

While people with ostomies can wear any item of clothing they wore before surgery, sometimes adaptations to an outfit help to make it work.

For example, some sheath-type dresses or dresses that are gathered at the waist can’t hide the bulge of a full bag. If this type of dress is otherwise perfect for an event, I might tuck the bag into leggings. Another option is to add a wrap — either one made specifically for ostomies or a pregnancy wrap — to help prevent bulging.

I also always bring spare ostomy supplies and a change of tights or leggings to events in case I experience a leak and need to change.

The takeaway

Managing IBD during the holiday season, with or without an ostomy, can be tricky. With careful planning and adaptation, you can celebrate and enjoy the holidays.