2. You May Need More Time to Recover — and Have More ComplicationsPeople with Crohn’s may not only be more susceptible to catching infections but also take longer to recover and be at greater risk of severe sickness and hospitalization.Additionally, Crohn’s may predispose you to certain complications. According to a study published in February 2021 in the journal Gastroenterology Research, the storm of inflammatory cytokines (substances secreted by immune cells) that are a characteristic of IBD can also trigger acute respiratory distress syndrome (a buildup of fluid in the lungs).A study in the American Journal of Gastroenterology also found that people with Crohn’s disease were at significantly higher risk than the general population of pneumonia, a common flu complication that can lead to hospitalization. Dr. Qazi attributes this to the use of immunosuppressive medications, such as corticosteroids. Another study, published in 2022, found that taking anti–tumor necrosis factor medications and prednisone was associated with higher risks of pneumonia and hospitalization.“At least anecdotally, it seems my IBD patients take a couple more weeks to recover than patients without IBD,” says Qazi.3. You Need to Get the Flu Shot Every Year, Not the Nasal Flu VaccineThe most important way to prevent flu complications is to get the flu vaccine every year, which the Centers for Disease Control and Prevention (CDC) recommends specifically for people who take corticosteroids or other immune-suppressing drugs.But, that doesn’t mean everyone is following their doctor’s orders: In a study published in 2019 in The American Journal of Gastroenterology, the rate of flu vaccination among people with Crohn’s was about 25 percent. “I battle with patients routinely about vaccine status,” says Qazi.“The flu shot not only decreases the risk of contracting the flu, but if you do get the flu, it decreases the severity of the flu,” says Dr. Parian. He adds that because Crohn’s also puts you at greater risk of a secondary bacterial pneumonia infection, it’s important to get the pneumonia vaccine also.That said, if you’re on immunosuppressant drugs for IBD, you should never get a live vaccine, such as the nasal flu vaccine — which contains a modified live flu virus — because it can be more dangerous to people who have a weakened immune system. Instead, get the flu shot, which contains the inactive (killed) virus.A few other simple, everyday actions can help you steer clear of germs that can make you sick:Wash your hands with soap and water for at least 20 seconds before preparing or eating food and after using the toilet. If you don’t have access to soap and water, use a hand sanitizer that’s at least 60 percent alcohol.Try to avoid touching your eyes, nose, and mouth, which is how many people are exposed to germs.As much as possible, try to avoid close contact with people who are sick.In addition to getting the flu shot, Horwitz credits weekly acupuncture, a healthy diet, and workouts five days a week with helping keep her immune system strong.4. If You Do Catch the Flu, You Should See Your Doctor (and Possibly Start Antivirals) ImmediatelyThink you have the flu? Check in with your doctor right away to get tested and, if necessary, begin treatment. Antiviral medications for the flu are really only effective if started within 48 hours of the first symptoms, according to the CDC.“It’s important to catch it as soon as possible to prevent problems from escalating,” says Qazi.Symptoms of the flu include:FeverCoughSore throatRunny or stuffy noseBody achesHeadacheChills and fatigueVomiting and diarrhea (sometimes — more common in children than adults)Antiviral medications keep the flu virus from replicating, which helps shorten the time you’re sick and prevent serious complications. Be sure to take the full course your doctor prescribes.To protect others, stay home until your fever has been gone for at least 24 hours, and cover your nose and mouth with a tissue when you cough or sneeze.5. You May Not Need to Stop Taking Your Crohn’s MedicationsYou should always talk to your doctor about your treatment plan, but Qazi says people with IBD usually don’t need to stop taking their meds if they catch the flu. “There’s a reason you’re on medication therapy,” he says. “When you get off, it can make the disease course worse.”But, your doctor’s recommendations may vary. “Depending on how severe [the flu and your Crohn’s are], your doctor might recommend holding your medications,” adds Parian.6. It’s Crucial to Stay HydratedIf you get sick, it’s more important than ever to drink plenty of liquids. Fever commonly associated with the flu increases the risk of dehydration, which is compounded by Crohn’s symptoms such as diarrhea.Keep an eye on the color of your urine, which should be clear or pale yellow. If it’s the color of dark straw or amber, you’re probably dehydrated. Because the amount of water every person needs varies, talk to your doctor if you’re concerned you’re not getting enough. “If you feel dehydrated or light-headed despite drinking fluids, you should call your doctor immediately,” says Parian.Keep in mind, water isn’t the only way to stay hydrated: A warm cup of chicken noodle soup feels comforting when you’re sick and counts as a liquid.In addition to staying hydrated, eat as healthy as possible, rest, and follow up closely with your primary care doctor.7. You Might Experience a Crohn’s FlareAn infection like the flu can sometimes trigger a Crohn’s flare, and certain flu medications can lead to diarrhea. That’s why it’s so important to keep in touch with your GI doctor to help you manage your GI symptoms if you’re sick.“It’s not uncommon for many infections, including the flu, to have GI symptoms, such as nausea and diarrhea, that are not related to the underlying Crohn’s at all,” says Parian. “Your doctor may want to order some additional testing to determine if it’s a Crohn’s flare or not.”