How To Get Through A GI Symptom Flare | A Plan That Works

This episode introduces a simple but powerful tool to support you during flares of digestive symptoms - The Flare Recovery Plan.
This personalized, written guide helps you know what to do when you’re in a flare, offering structure & clarity when you need it most.

Transcript

Welcome to the Rest and Digest podcast where we help people with digestive issues to understand their symptoms and explore effective science-based tools to calm their symptoms and feel better. I'm Dr. Scott Rauer. I'm a clinical psychologist and I'm also someone who personally knows the challenges of living with the GI condition. Today in this episode I'm going to talk about a very practical resource that's one of the most important tools that I personally use to get through flares of my digestive disease. I have something called Crohn's disease and unfortunately I went through a flare of symptoms recently. So if you're listening to this podcast you likely have GI issues yourself and you know what that can be like, You know, Especially at the beginning. You can maybe rack your brain trying to remember what's that last number of things that you've eaten that could potentially be causing these symptoms, Something maybe you shouldn't have eaten. There can be anxiety looking forward, You know, On the other way. How bad is this going to be? What do I eat now? There's just so much uncertainty and it can be so stressful to have another flare come up. So it's rough to go through this, Right? There's the physical symptoms but there's also the anxiety and the helplessness of not feeling in control of our body. What has made a huge difference for me though is when this recent flare started for me I wasn't caught off guard. I was able to lean on a go-to resource that really helps me to get through these flares as best as possible, As quickly as possible. That tool is something I call my flare recovery plan. And so today I'm going to give you a quick overview of what that is and specifically how it helps. A flare recovery plan is like a life raft. It's something that's already pre-made and it's ready to go when you need it most. I'm going to go through some of the main parts of my flare recovery plan with you but before we go through those details I want to start with why. Why having a flare recovery plan is a smart idea for you. When flares hit, Anxiety can hijack both our mind and our body. It's incredibly common to default to a mental rut of reacting when we have this kind of hijack of stress and anxiety. We can go into the reaction of either trying to control everything, Which looks like excessive googling, Overthinking, Obsessing, Overly planning and preparing. Or on the other side it can look like shutting down and being hijacked into a victim mindset. Becoming negative, Cynical, Pessimistic, Hopeless. Whatever stress reactivity pattern you personally have, Decision-making gets hard either way. And we need something that's easy. It's a plan. It's a playbook. Something that makes it just really simple. Do this, Don't do that. And it just makes logical sense that when things are hard for us physically and emotionally when we're in a flare like this, We're needing some hand-holding. We're needing some guidance to know how to respond rather than our default of reacting. Okay, Let's get into some specifics. The plan starts with mindset and it needs to start with a shift in mindset because that sets the stage for the whole plan. So the shift in mindset is I'm in a flare. This means that I need to approach things differently. It's not about fighting or overcoming the symptoms but it's about creating the best environment for my body to recover. So setting that as the new priority for myself. You know, So my top priority right now while this flare last is creating a better healing environment for myself. Clear and simple. When I shift my mindset by acknowledging I'm in a flare right now and I really need to take self-care seriously, What follows is approaching some core areas of my life differently. How I approach food, How I approach work, How I approach rest, Scheduling. It's just all the expectations that I have for myself need to get updated. And so I make this as simple as possible by breaking it down into four main pillars of my life. The first is changes to my lifestyle. The second is changes to diet. The third is medical, Which is medication, Supplements, Herbs, All that. And then the final one is really using my toolkit of mind-body tools for as long as this flare lasts. So let's go through each of these and I'll briefly explain what's in each of these pillars. So the first pillar is lifestyle. This part of the flare recovery plan is all about simple rules and guidelines for yourself that you want to shift. I make this section very clear-cut for myself. It's an outline, It's a bulleted list of hard rules and permissions that I want to give myself for this period right now as long as this flare lasts. There's hard rules for myself of what I need to say no to for this period of time and some hard rules of how to adjust my priorities and expectations that I was just pointing to in the mindset section. So this includes how I want to approach sleep differently, How I want to deal with movement and exercise while I'm in a flare, Changes that I want to make on my information diet, You know, Because taking in information is something you are taking in and because anyone that's paying too much attention to the details of the news is just getting overstimulated and that's an important thing to factor in as well. And this section for me especially includes how I want to shift approaching work while I'm in a flare. I'm someone who personally can struggle with overworking and not taking enough time to rest normally and so this section is particularly important to be clear and simple for me and just some really clear-cut hard rules for myself. So to give you some examples of rule I have for myself is that I'm not allowed, I'm not allowing myself to take on any new clients during this time even if I have an opening because I know I just would get tempted, I'll just squeeze them in and it'll probably be fine. I could easily just kind of push myself and then pay for it later. So to go along with these rules I also have some clear-cut permissions like giving myself the permission and the reassurance that it's fine to not get back to people as quickly as I normally would maybe on email or text. I give myself explicit permission, You know, In writing in this section to let myself be okay with letting email pile up a little bit more than is comfortable for me, You know, Just for now, Just for this period of time. And there are other parts of the lifestyle changes that are helpful in my plan and but that gives you a snapshot at least. The next pillar in the flare recovery plan is diet. How do I want to approach food differently during this flare? So I make this again really simple and easy to follow of what I want to eat less of right now, What are simple, Easy to make and nourishing things I can eat more of right now, And also some reminders on how to eat differently. Not just what I'm eating but how I'm eating, Which I'll tell you what I mean by that in a moment. So to tell you an example for my personal flare recovery plan, Which could very well be different than yours, I have some bullet points to remind myself to. Number one, Just cut out processed foods, Cut out raw foods right now. Number two, Stay diverse. It's very easy to narrow down too much and eat only the safest foods and that's really not good for a sustained period of time. For me it can be really helpful also in my list to know that I can consult some phases of the specific carbohydrate diet. That makes it really easy for me. I just look up what phase am I in right now based on my symptoms and there it is pretty clear cut for me and it'll kind of help me understand, Are grains okay right now? Is it okay to have zucchini with the seeds or not? Do I need to cook everything? You know, All that kind of thing. The third bullet point in this section for me is reducing caffeine. So what I'll start with often is I'll switch from coffee to tea. And then the fourth area for me in the diet section is specifics about how to eat differently. So there's two points to this for me. There's the slower eating, The mindful eating, Which the hack of this is if you put the fork down, Put the utensil down in between bites, That is getting you 80% of the way there. You know, It's just really helpful, Especially while eating, To have less of that activation, That kind of overstimulation. It just makes a lot of logical sense to be slowing down and prioritizing digestion by doing that. And then there's intuitive eating, Which is really listening to what is my body wanting to eat. I know, You know, Butternut squash is going to be safe and probably be fine, But is there a part of me that's, You know, Hungry for this or that? You know, So really kind of listening to what the body is wanting, And that helps stay diverse as well. All right, So we're on to the third pillar, Which is the medical. You know, So the medications, The supplements, And the herbs. So in this section, I list out all my go-to medications, My supplements, My herbs that help me when I get symptomatic, So I don't have to think about it. I just follow the plan. And this is really helpful because a lot of the times when I'm in a flare, I'm either too tired or too anxious or overwhelmed to think clearly. And things that can seem obvious to me when I'm feeling fine just get easily missed. So the list of meds and supplements and herbs are an organized collection of all the things that I found over time working with a lot of different medical providers of what works for me personally based on what symptoms I'm having. For example, It seems obvious if you're having diarrhea that Imodium can be really helpful, At least in the short term, But I can't tell how many times I just plainly forgot that when I'm in the middle of it. So I have a lot of options based on what symptoms are most present for me, Like diarrhea or insomnia or arthritic pain. All right, On to the final pillar, Which are mind-body tools. In this section of the plan, Mind-body tools are the specific tools and resources that I actively want to lean into and use more to help me not just to deal with the symptoms, But to be proactive in my healing and really build resilience. There's a lot that we could unpack in this pillar, This section. And as a psychologist, This is really the area that I have the most expertise around. And so if there's enough interest out there, I'd be happy to make future episodes or blog posts or videos to get into the details of all the different mind-body tools. But I'm just going to keep it brief for this episode, Keep it simple. So if you want to know more about this pillar, Drop a comment, Drop an email, Let me know. Happy to be of service. In my mind, There are two areas of tools that I want to focus on. The first are tools that are effective at activating the parasympathetic nervous system, The rest and digest response, Which helps to regulate the nervous system and upregulate digestion. So if you're not familiar with these concepts, You can listen to some of the previous episodes to get an overview. But I'll just say briefly that we know from the science of the gut-brain connection that activating the parasympathetic branch of the nervous system, Activating the vagus nerve, It plays a big part in helping to heal and regulate the digestive system. So the most helpful tools for me personally in this area are number one, Meditation, And number two, Slow diaphragmatic breathing. In my daily life, I try to prioritize meditation more days than not, Because personally for me, It just is quite helpful. It keeps me sane. Even when my Crohn's disease is in remission, I'm doing well. I'm someone that just really benefits a lot from meditation. So I certainly want to lean into that more. And then number two, Slow diaphragmatic breathing. This often, Especially if I'm really not feeling well, Becomes my main tool in this area, Because frankly, It's just much easier to do the meditation, And because it can just be quite helpful and effective way of activating that rest and digest part of the nervous system. If you want to explore diaphragmatic breathing, A lot of the previous episodes of this podcast are devoted to that, Orienting you to what diaphragmatic breathing is, Why it's helpful, And more importantly, How to do it. So that's a little bit about the first area of tools, The tools that are about activating that parasympathetic nervous system. The second area of tools are all about focusing on attending to the mental and emotional challenges of being in a GI flare. When we're able to be skillful in working with this stress that comes with not feeling well, It makes it much easier to be resilient and to get back to your baseline faster. So there's a lot of different options of what would be helpful for different people based on all the different types of therapies and the tools in those types of therapies. One really simple and helpful framework that can help you to acknowledge and to work with the anxiety that often comes with the flare is the acronym RAIN, R-A-I-N, Which stands for Recognize, Allow, Investigate, And Nurture. So if you were to do this, One way of doing it would be, You know, I would encourage you to do it in writing, Really taking pen to paper and slowing down enough to write and make it real by writing it is a good way of doing this. So if you want to do it, You can just start with the R, Recognize. So in writing, I'm acknowledging, I'm recognizing that I'm anxious, I'm recognizing that I'm scared. And you can just begin after that to use a sentence stem, I'm scared that, And just see what follows, You know, We're made of parts. And so there's an anxious part of you that's scared, And it makes a lot of sense that there would be some anxiety or kind of fretting going on in really starting to not feel well, Or continuing to not feel well. And so just capturing what that anxiety, What the story is that goes with anxiety, That's a really good start. And then there's the allow, Which is taking a pause and allowing yourself to feel the feelings, Letting yourselves to drop the resistance to the anxiety. And I can't tell you how important this is. If this doesn't make sense to you, We'll have to do another podcast on this. You know, It makes sense to some people, Not others, But you just take my word for it as a psychologist, This is important. And then there's the I, Investigate. What am I believing? What anxious, Fearful, Or catastrophic thoughts might have taken over? When you're under stress and anxious, It's very common to default to a lot of what we call cognitive distortions. I mean, One of them is all or nothing thinking. So anytime our thoughts start to include words like always or never, We're getting hijacked into distorted thinking. Just investigating, Not trying to fix anything. We're just seeing what am I believing? What thoughts are really taking over? What's the story here? And then finally there's nurture. And there are lots of ways we can emotionally nurture ourselves and be able to regulate our emotions. For me, The anxiety I often experience in a flare comes with lots of worries about how bad is this flare going to get? Worrying that this flare is going to be the one that really brings me back, Sets me back to those horrible places I've been before in this disease. When I'm in that place, It's really helpful to have an already made plan that recognizes I'm needing reassurance for myself when I'm in this place. I'm needing to reconnect to the knowing that I've been through many, Many of these flares before. I almost always feel this way when I'm in them and that they almost always go away on their own. A reminder that it's very, Very unlikely that my worst case fears are actually happening or they're going to happen. Rather than just the positive thinking or rational thinking, That plays a part. But I'll tell you just from my personal experience, Going through this and capturing it, Writing it down. The flare that I had, Recording this in April of 2025, That flare I had was in March. And so I just had a little section in the plan, March 2025. And I went through, Right? And I went, Recognized, Allowed, Investigated, Nurtured. And I captured the different parts of that. And just seeing over and over in all these past flares that what I was thinking is very similar to what I'm thinking right now. And then I also have a little after the flare section and I have a little thing of what would I have wanted to tell myself now looking back that the flare's done. And just seeing that in my own writing can be really reassuring. And then finally, While we're just on the topic of reassurance, It's also really helpful to remind and reassure myself that all these changes in the whole plan, Right? I don't want to make these changes. I'd rather just kind of power through, Right? That's my kind of autopilot. And so just the changes themselves can bring anxiety because I don't, You know, Resting is hard for me or letting emails pile up or all these kinds of things, They can bring on their own amount of stress. So there's a really helpful reassurance kind of scattered throughout this, That this is just a little season. This is just for right now that I'm making these changes and it's not forever. All right, To bring this episode to a close, Let's recap. A flare recovery plan is a lifeline. It's a great tool for being proactive and to reduce the anxiety and stress that comes with living with the uncertainty of having a health condition. Having a plan like this is also helpful because it can be a useful cheat sheet, Not just for yourself, But if you live with anyone else, It can easily fill them in on the kind of help you're going to be needing or to just adjust expectations they might have of you while you're not feeling well. My flare recovery plan is something that I've personally been working on for years, Adding some parts and taking away others. And it's just things that are changes I learn what's most helpful for me. One final and really maybe most important benefit of having a flare recovery plan is it really provides a security of just knowing that I have it. I know that when GI symptoms come, I have a plan. I know what to do. I don't need to figure anything out. I just follow my plan. Finally, If you know anyone that also struggles with the GI condition, Please consider sharing this podcast with them.

Reviews

This is a wonderful guide to help us come up with individual flare-up plans. I appreciated learning a little about RAIN and reminding ourselves this is temporary

Great way to aproach flair ups. Useful information. Where can I find all of your podcasts? I found a few on insight timer but would like to listen to more