According to a 2020 study on the impact of IBD in the workplace, people with the disease reported needing time to go to medical appointments during work hours, easy access to a bathroom, allowances for breaks, and flexible schedules. For some, though, workplace accommodations can be hard to come by, which can take a toll on performance: A review published in September 2021 in the journal Disability and Rehabilitation found that many people with IBD continue to experience challenges at work, such as difficulties related to career planning and advancement, work performance, and managing physical and cognitive symptoms. By preparing for flare-ups and knowing your workplace rights — which are protected by the Americans with Disabilities Act (ADA) — you can return to productivity levels that work for both your Crohn’s disease and your career.

How the ADA Relates to Bowel Disease

The ADA, which defines disability as a condition that significantly impairs a “major life activity,” offers protection for workers with Crohn’s disease, according to the Crohn’s & Colitis Foundation. “The most promising thing for Crohn’s patients was that in 2008, the Americans with Disabilities Act was amended to include major bodily functions, including bowel and digestive functions,” explains Jacquelyn Spencer, the manager of educational resources at the Crohn’s & Colitis Foundation. Under the ADA, employers are required to provide “reasonable accommodations” — that do not create undue hardship for the company — and if requested, to help employees with a disability. Some examples of reasonable accommodations for Crohn’s symptoms, according to the Crohn’s & Colitis Foundation, include:

Allowing frequent bathroom breaksMoving your workstation or office closer to a bathroomAllowing a modified work schedule or telecommuting when symptoms are active

In turn, you must be able to perform the basic duties of the job, either with no accommodation or with reasonable accommodations.

Telling Your Supervisor and Coworkers

While it may seem embarrassing or difficult to talk about Crohn’s disease, it’s generally a good idea to have at least one confidant at work, Spencer says. How much information you share is up to you. When discussing Crohn’s with your employer, explain that you may need to take an unexpected leave of absence from work if your symptoms flare up. “You should speak to your employer about family medical leave before you have symptoms,” Spencer says. “You may not need it, but you don’t want to wait until the last minute.” In some situations, your job can be protected while you take extended leave under the Family and Medical Leave Act (FMLA). Talk to human resources about whether FMLA applies to your situation. You can also discuss other accommodations that will help you perform your job. Keep in mind that you may need to provide a note from your doctor, so consider having that on hand during your conversation. You may decide to tell coworkers about your condition as well. Just as you have a support system at home, try to build a support system at work, Spencer says — or at least one person you can call during an accident to say, “Please get my spare clothes or emergency kit from my desk.” Telling team members about your Crohn’s disease can also help them be more empathetic if you have flare-ups or need to take extra time off.

Workplace Strategies for Managing Crohn’s Symptoms

Besides sharing information about your Crohn’s diagnosis with your employer and coworkers, you can prepare yourself for situations that may develop. An important note to keep in mind when you talk about your condition at work: “You’re not required to disclose the name of your disease, only that you have a chronic condition that’s covered under the ADA,” explains Spencer. “It’s your option if you choose to disclose your specific disease.” Here’s what to do when your Crohn’s symptoms flare up. Keep an emergency kit on hand. Keep a small bag with a spare pair of underwear, wipes, and a change of clothing in a desk drawer or office locker. Tell a trusted colleague about it in case you need help. Take shorter, more frequent breaks. Talk to your boss about altering your regular break schedule when your Crohn’s symptoms are active. You may need to go to the bathroom more often, so you could ask for four 15-minute breaks instead of taking a typical hour for lunch. Change your hours. Consider talking to your supervisor about staggering your hours or working from home when you have a flare-up. For example, if your Crohn’s symptoms tend to be more active in the morning, request to start work a little later in the morning and continue past the normal closing time, if possible. And, just as you do with friends and family, pitch in and do something nice for helpful coworkers when your Crohn’s symptoms are quiet and you’re feeling better, Spencer says. By preparing for emergencies and telling your supervisor and coworkers about your condition, you will set the groundwork for better managing your Crohn’s symptoms and your career. — Additional reporting by Madeline Vann, MPH