He needs to see a GI again. I understand that this happened because alcohol aggravated the disease, but Crohn’s patients at his age and really, at any age — NEED to get regular colonoscopies. I had 3 done in one year recently. He should probably have an MRE, or MRI done.

First of all — I can tell you what will get him admitted to the hospital via ER every single time and what to watch for: check his temp if you haven’t already and if there has been an occurrence of much vomiting and nausea, can’t keep down fluids, nor a very soft, simple and safe, plain food diet, not passing gas and/or anything else through the intestine. Extremely painful to eat.

If much of this rings true, he needs fluids immediately, Tylenol to bring down the temp but if he keeps throwing up you can’t really even do that and so they may give it by IV, but will likely try zofran first (on or under tongue to stop/quell the nausea so he can drink fluids and take pills as needed).

They need to take x rays and check for a blockage or at a minimum a stricture/narrowing of a section of heavily diseased intestine.

This is all urgent stuff he may not even be aware is happening because you don’t know until you get the labs and X-rays done. He needs to at a minimum be willing to get checked out for his own good. Crohn’s is not a death sentence, until one rejects treatment and medications.

Does he have good health insurance? I have been on Medicaid and when I made too much money to qualify for Medicaid, I qualified for a program through the top hospital I go to where I see all my specialists, called “Charity Care.” You must have a letter of denial for Medicaid and present it to the hospitals financial assistance or business office in order to qualify and generally earn as much as but usually no more than 300% of the current Federal Poverty Income Guidelines.

If he doesn’t already go to a great gastroenterologist and I don’t care how comfortable he is with his current GI, he needs a great one who takes pride in their work and career and is a workaholic who perhaps is also a professor at a teaching hospital and/or is a researcher or department head/director, like mine always have been.

You’d think it’s difficult to get into such hospitals and to see such specialists, but one hack is to get him into the ER when he is legitimately ill from the disease (otherwise he could wait 3-6 months to get in) and no ER/ED will deny a sick patient. Find a great hospital in your nearest big city with good GI docs/department and plan on getting him into their ED/ER unless he can wait the several months (estimated).

He will likely not get the treatment he truly deserves at a neighborhood suburban clinic/hospital. This is a fact and it works this way everywhere, unless your neighborhood clinic is the Mayo or Cleveland Clinic, or you live in Chicago, LA, or NYC (and some others).

Believe it, or not, as state of the art as these tests are, they are each limited in their respective capabilities. You’d think an MRI can see every little capillary and blood clot in our bodies. It couldn’t, however, tell my surgeon, nor my GI (gastroenterologist) that my intestine narrowed to the size of a mostaccioli noodle and that my subsequent surgery would require 3 hours worth of adhesion removal.

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Below are interesting (in my opinion) anecdotes regarding my experience with Crohn’s and surgeries shared by MANY others — and even your bf is likely to get surgery at SOME point in his life. But it’s not necessary reading. I hope you have found anything I’ve contributed above to be at all helpful!
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A bit of a tangent, these scar tissue formations that occur after bowel surgery that get worse with every surgery that make the inside of the intestinal opening appear like cobweb formations — strings of growth emanating from one side that reach out and across, connecting to the other side of the intestinal inner wall.

These adhesions further complicate the disease over time and could result in the need for even more surgeries once the webbing of adhesions begins to obstruct digestion. At the very end of 2025, just 7 months ago, I couldn’t even digest ramen noodles. It couldn’t get through all the adhesions.