Acute, Chronic, & Everything in Between

Mar 15, 2018 by

You can have me read this article to you instead of reading it yourself…



Or you can read it the old-fashioned way below…



Many of you have reached out to me in recent months to request that I talk about what it is like to handle a GI condition in addition to having another medical condition. Having one condition seems bad enough – what happens when you have more than one?

This topic is actually a lot larger than it seems on the surface, so this will be a multi-part series.

Having only recently recovered from a nasty GI virus myself, I thought we’d start off with talking about why it seems so much worse to get “sick” when you already have a chronic condition. Understanding all of the different pieces has made a world of difference for me in managing my own health.

I’ve also found that learning the doctor-speak for some of these things is very helpful when I’m presenting my case in the doctor’s office or in the ER. So let’s do this.

Acute Conditions

This is what most people associate with “being sick”.  These conditions usually happen suddenly, and they don’t last very long. They can also cover a wide range of issues, including an infection, a bodily injury such as a sprained ankle, or even a migraine.

An acute condition is not very hard to step back and evaluate when all is said and done.  Its impact on quality of life is usually limited and the clear majority of people will return to normal after an acute condition has gone away.  Treating or understanding the condition may only take one visit to the doctor, or even no visit at all for the more minor cases, such as a cold.

Chronic Conditions

These are not the illnesses that come to mind for most people when they think of “being sick”.  These are the conditions that, once they develop, will be sticking around in some form or another for a very long time, if not permanently. And if you’re reading this article, you probably have one! (If you’re recently diagnosed, check out this article)

Interestingly, chronic conditions can begin rapidly or slowly.  For instance, a case of IBS may develop slowly over time, with you becoming slightly more aware of frustrating symptoms as they grow stronger.  In other cases, they can smash into your life with dramatic force, with all of the symptoms presenting at once in full form.

Because they’re here to stay, chronic conditions embed themselves into our lives whether we like it or not.  They become the “new normal”. Unlike acute conditions, where we just kind of deal with them until they go away, we actually have to learn how to adjust our lives around a chronic condition.

When Chronic and Acute Collide

There are many ways in which chronic and acute conditions can collide, and it’s crucial to understand each of them and how they play into our lives.

Acute Becoming Chronic

For some people, they will realize that what started as an acute condition somehow decided to stick around for the long-term.  For instance, my gastroparesis actually started out as a terrible flu.  But after the flu went away, I never stopped throwing up.  And as my food continued to come up, the rest of the symptoms of gastroparesis set in.  For some people with ulcerative colitis, they may have had a terrible GI infection (an acute condition) that went away, but the severe diarrhea and urgency never actually stopped.

Although this is obviously a one-time event, it’s important for anyone that is newer to their GI condition to recognize the difference between the acute event that started it all and the chronic condition itself.

The symptoms present in the acute condition will likely be quite different from those within your chronic condition.  It’s important not to hold on to any fears related to those original symptoms, or to confuse them with the ones that will be around most of the time.  For example, the achy joints that I experienced with my flu went away, and the fatigue that I experienced with the flu took a very different form in relation to my gastroparesis.

A Chronic Condition with Acute Symptoms

And then there are the times that a chronic condition gets a whole lot worse all at once. In the case of a GI condition, these episodes are often referred to by those of us that experience them as ‘flares’.  These are the times that those symptoms that we are oh-so-familiar with on an everyday basis suddenly have the volume turned all the way up.  Life as we know it seems to be put on pause and our chronic condition seems to be jumping up and down, screaming “LOOK AT ME!!”.

There is actually a medical term for these flares – acute-on-chronic.  This term is more commonly used for conditions like heart failure, where someone can have chronic heart failure but experience a very severe, acute event of heart failure that can be life-threatening.  A similar example is with asthma.  Asthma is a chronic condition that must be kept under control or it can result in a severe, acute form, such as an asthma attack.

These are important to recognize because they are often caused by some type of trigger.  Recognizing triggers and how to avoid or respond to them can lead to huge improvements in quality of life. But it is also important to remember that these flares, while painful, uncomfortable, inconvenient, and more, are acute.  They will die down and things will return to our new GI status quo.

Acute AND Chronic Symptoms Combined

While there may be times where we have a ‘flare’ of our GI conditions and all our symptoms seem to be magnified, many of us will also notice that our “chronic” symptoms fluctuate over time as well.

Some of our symptoms may be chronic, ever-present symptoms, as we might expect with a chronic condition.  A constant abdominal pain or a constant nausea could be an example.  In the same way, diarrhea or constipation that is always there, every day, is also chronic.

But some symptoms will occur acutely even though they are a part of your chronic condition.  For example, chronic IBS for some people may mean that they will have bouts of diarrhea or constipation that occur pretty regularly, but not all of the time.  Chronic gastroparesis may involve sudden bouts of pain or nausea that are not always there.

Just as it is important to recognize triggers to a disease ‘flare’, it is important to understand the nature of your symptoms and whether they are chronic or acute.  Chronic symptoms are the ones we must all learn to manage on a daily basis. Acute symptoms are the ones that can be prevented or minimized by recognizing triggers and developing lifestyle changes.

An Acute Illness & A Chronic Condition

Just as with any other human, those of us with chronic GI conditions will continue to experience those acute illnesses that we had before.  We will break bones, develop colds, and contract food poisoning.  The difference for us is that some of these acute illnesses may disrupt the symptoms that we experience from our chronic conditions.

With my recent GI virus, it made every single gastroparesis symptom worse. And it made it that much harder for me to stay hydrated and fed. Some people may experience migraines that lead to the same issue – if the migraine causes you to throw up, how do you stay nourished and hydrated?

Sometimes the symptoms of our chronic condition won’t be impacted, but our strategies to control them will. Spraining an ankle may get in the way of a much-needed exercise regimen; getting a head cold may keep you from being able to prepare the foods that you rely on.

Again, even though our chronic conditions are here to stay, acute conditions and all their unpredictability will continue to occur.  They may be a non-issue, or they may be stressful and dangerous to our health. But it’s important to remember that they are temporary, and that remaining calm and taking things one day at a time will help carry you through.

Why this knowledge matters

It helps to think of our conditions in this way because it provides a very different perspective on managing our health (and I’m all about new perspectives!).  As we come to terms with the fact that we have a condition that is here to stay, we must think in the long-term, with sweeping and long-lasting solutions that can improve our daily lives over time.

Recognizing that our chronic conditions can sometimes result in particularly difficult acute situations is also something that can be tackled through a long-term approach.  Prevention strategies and plans can be put in place to make these acute issues occur less often and make them more livable and tolerable when they do occur.

However, when we are experiencing an acute flare or symptom, we can tackle it with exactly that mentality – something that we can manage or control in the short term while we wait it out.  Being mentally prepared for these acute issues will come with recognizing and defining them, and the mental preparation alone can be helpful in keeping them under control.

What Next?

We’re just getting started! We still need to talk about…

What happens when you have two (or more) chronic conditions at the same time

Why a GI condition might make it harder to take your medications

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