10 Facts About Crohn’s Disease

iStock.com/Carlo107
iStock.com/Carlo107

Crohn’s disease is an inflammatory bowel disease in which the immune system attacks the lining of the intestine, usually the ending of the small intestine (called the ileum) or the colon. But it's more than just a case of irritable bowels. Crohn's disease symptoms range from abdominal cramps to ulcers that eat through the intestinal wall, and the complications—including pain, diarrhea, and malnutrition—can be sometimes be fatal. But with a proper diagnosis and the right medical care, managing the condition is possible for patients with Crohn’s. Here are more facts about Crohn's disease, from testing to treatments.

1. Crohn's disease causes are unknown, but genetics may be involved.

The exact causes of Crohn’s disease haven’t been identified, but for many people, family history plays a role. About 15 percent of Crohn’s patients share the diagnosis with a first-degree relative (parent, sibling, or child). Whether the family cluster patterns have more to do with genetics or environment is still unclear, though environmental factors appear to have more of an impact on the development of Crohn's disease symptoms. Scientists have also identified more than 200 gene variants that could influence Crohn's disease risk, mostly affecting genes related to immune system function.

2. Crohn's disease symptoms can come and go.

Crohn’s disease is characterized by inflammation of the digestive tract, and common signs include abdominal pain, rectal bleeding, diarrhea, fatigue, and fever. In severe cases, the inflammation can cause ulcers in the intestinal wall that prevents nutrient absorption, which can lead to weight loss and malnutrition. The intensity of these symptoms can be unpredictable. Flare-ups of gastrointestinal distress can last weeks to months, and there can also be long stretches of time when patients live symptom-free. Anti-inflammatory treatments can encourage the symptoms to go into remission, but the disease can never be cured completely.

3. Your diet can make Crohn's disease symptoms worse.

Doctors used to think of diet as one of the main causes of Crohn’s disease, but now it’s just thought to be a factor that exacerbates the symptoms. Certain foods can aggravate the digestive systems of people with Crohn’s. High-fiber foods, such fruits, vegetables, and whole grains, are some of the worst culprits, though cooked fruits and vegetables are generally gentler on the GI tract than raw ones.

4. Crohn's disease and ulcerative colitis are not the same.

People commonly confuse ulcerative colitis (UC) and Crohn’s disease. The two conditions are both inflammatory bowel diseases (which are different than irritable bowel syndrome, or IBS, which involves intestinal muscle contractions rather than inflammation). Both UC and Crohn's disease share symptoms such as weight loss, rectal bleeding, and diarrhea. But they differ in important ways: UC is limited to the large intestine, while Crohn’s disease can develop anywhere on the gastrointestinal tract between the mouth and anus. UC inflammation is also concentrated on the innermost intestinal lining, whereas can Crohn’s can penetrate the entire bowel wall. If you suspect you have an IBD, a doctor can help you identify the exact condition.

5. Crohn's disease can also affect the joints, eyes, and skin.

Crohn’s disease is known as a gastrointestinal disease, but the symptoms can extend beyond the digestive tract. People experiencing inflammation in the colon can also have inflammation in the joints. Up to 25 percent of patients with Crohn’s or UC also suffer from arthritis. Other complications include inflammation of the skin and eyes. Because eye tissue is so sensitive, ocular symptoms like redness and itchiness often appear before the first gastrointestinal signs.

6. A fecal occult blood test is one way to diagnose Crohn's disease.

There’s no one test for Crohn’s disease. Instead, doctors diagnose the condition by performing a series of tests to rule out other possible ailments. Testing poop samples with a fecal occult blood test can reveal hidden (or occult) blood in a patient’s stool, and testing antibodies can indicate whether symptoms are caused by Crohn’s or UC. Imaging tests—such as an ultrasound, MRI, X-ray, CT scan, or colonoscopy—gives doctors visual clues to the extent of a patient’s condition.

7. Incidence of Crohn's disease is increasing.

Crohn’s affects people of all ages, but symptoms usually appear in younger patients: People in the 15-to-35 age group are most likely to be diagnosed with the condition. Childhood cases of Crohn’s disease can lead to complications like delayed growth. Some studies have shown that the disease is becoming more prevalent, especially in Western countries and in children. Researchers think the "Westernized lifestyle" of poor-quality diet and lack of exercise are contributing factors to the increase.

8. Crohn's disease complications can be deadly.

If left untreated, Crohn’s disease can lead to some life-threatening complications. Inflammation can permanently damage the intestines, scarring parts the GI tract and causing tissue to thicken. In some cases, the damage is so severe that the bowel becomes blocked and surgery is required to remove the obstruction. Another possible complication is a fistula: an ulcer that has penetrated the intestinal wall and connected into a different part of the body, such as another organ or skin. An infected fistula is potentially fatal if ignored. Crohn's disease also increases a patient's risk of developing colorectal cancer. Inflammatory bowel disease is the third highest risk factor for colorectal cancer cases, though IBD-related cancer incidence is decreasing in some countries.

9. Surgery is a last resort for Crohn's disease.

Though Crohn’s disease can’t be cured, it can be managed. Most patients are initially put on anti-inflammatory medications. Other drugs, like pain relievers, nutritional supplements, and anti-diarrheal medications, are prescribed to treat the symptoms of the disease. If the condition doesn't improve, patients may require surgery to remove damaged portions of the bowel, close fistulas, and drain abscesses. Doctors may also recommend specific dietary changes to avoid flare-ups.

10. Crohn's disease was identified in the 1930s.

In 1932, gastroenterologist Burrill B. Crohn and his colleagues Leon Ginzburg and Gordon D. Oppenheimer identified the condition now known as Crohn’s disease, which Crohn called ileitis (meaning inflammation of the ileum). Prior to the report, the condition was thought to be type of a tuberculosis and not an inflammatory bowel disease. In addition to helping define the disease that bears his name, Crohn was one of the first medical professionals to link gastrointestinal distress to anxiety. He also published a book with the charming title Affections of the Stomach in 1927 and commented in media reports when President Dwight D. Eisenhower came down with ileitis symptoms in 1956.

12 Creative Ways to Spend Your FSA Money Before the Deadline

stockfour/iStock via Getty Images
stockfour/iStock via Getty Images

If you have a Flexible Spending Account (FSA), chances are, time is running out for you to use that cash. Depending on your employer’s rules, if you don’t spend your FSA money by the end of the grace period, you potentially lose some of it. Lost cash is never a good thing.

For those unfamiliar, an FSA is an employer-sponsored spending account. You deposit pre-tax dollars into the account, and you can spend that money on a number of health care expenses. It’s kind of like a Health Savings Account (HSA), but with a few big differences—namely, your HSA funds roll over from year to year, so there’s no deadline to spend it all. With an FSA, though, most of your funds expire at the end of the year. Bummer.

The good news is: The law allows employers to roll $500 over into the new year and also offer a grace period of up to two and a half months to use that cash (March 15). Depending on your employer, you might not even have that long, though. The deadline is fast approaching for many account holders, so if you have to use your FSA money soon, here are a handful of creative ways to spend it.

1. Buy some new shades.

Head to the optometrist, get an eye prescription, then use your FSA funds to buy some new specs or shades. Contact lenses and solution are also covered.

You can also buy reading glasses with your FSA money, and you don’t even need a prescription.

2. Try acupuncture.

Scientists are divided on the efficacy of acupuncture, but some studies show it’s useful for treating chronic pain, arthritis, and even depression. If you’ve been curious about the treatment, now's a good time to try it: Your FSA money will cover acupuncture sessions in some cases. You can even buy an acupressure mat without a prescription.

If you’d rather go to a chiropractor, your FSA funds cover those visits, too.

3. Stock up on staples.

If you’re running low on standard over-the-counter meds, good news: Most of them are FSA-eligible. This includes headache medicine, pain relievers, antacids, heartburn meds, and anything else your heart (or other parts of your body) desires.

There’s one big caveat, though: Most of these require a prescription in order to be eligible, so you may have to make an appointment with your doctor first. The FSA store tells you which over-the-counter items require a prescription.

4. Treat your feet.

Give your feet a break with a pair of massaging gel shoe inserts. They’re FSA-eligible, along with a few other foot care products, including arch braces, toe cushions, and callus trimmers.

In some cases, foot massagers or circulators may be covered, too. For example, here’s one that’s available via the FSA store, no prescription necessary.

5. Get clear skin.

Yep—acne treatments, toner, and other skin care products are all eligible for FSA spending. Again, most of these require a prescription for reimbursement, but don’t let that deter you. Your doctor is familiar with the rules and you shouldn’t have trouble getting a prescription. And, as WageWorks points out, your prescription also lasts for a year. Check the rules of your FSA plan to see if you need a separate prescription for each item, or if you can include multiple products or drug categories on a single prescription.

While we’re on the topic of faces, lip balm is another great way to spend your FSA funds—and you don’t need a prescription for that. There’s also no prescription necessary for this vibrating face massager.

6. Fill your medicine cabinet.

If your medicine cabinet is getting bare, or you don’t have one to begin with, stock it with a handful of FSA-eligible items. Here are some items that don’t require a prescription:

You can also stock up on first aid kits. You don’t need a prescription to buy those, and many of them come with pain relievers and other medicine.

7. Make sure you’re covered in the bedroom.

Condoms are FSA-eligible, and so are pregnancy tests, monitors, and fertility kits. Female contraceptives are also covered when you have a prescription.

8. Prepare for your upcoming vacation.

If you have a vacation planned this year, use your FSA money to stock up on trip essentials. For example:

9. Get a better night’s sleep.

If you have trouble sleeping, sleep aids are eligible, though you’ll need a prescription. If you want to try a sleep mask, many of them are eligible without a prescription. For example, there’s this relaxing sleep mask and this thermal eye mask.

For those nights you’re sleeping off a cold or flu, a vaporizer can make a big difference, and those are eligible, too (no prescription required). Bed warmers like this one are often covered, too.

Your FSA funds likely cover more than you realize, so if you have to use them up by the deadline, get creative. This list should help you get started, and many drugstores will tell you which items are FSA-eligible when you shop online.

10. Go to the dentist.

While basics like toothpaste and cosmetic procedures like whitening treatments aren’t FSA eligible, most of the expenses you incur at your dentist’s office are. That includes co-pays and deductibles as well as fees for cleanings, x-rays, fillings, and even the cost of braces. There are also some products you can buy over-the-counter without ever visiting the dentist. Some mouthguards that prevent you from grinding your teeth at night are eligible, as are cleaning solutions for retainers and dentures.

11. Try some new gadgets.

If you still have some extra cash to burn, it’s a great time to try some expensive high-tech devices that you’ve been curious about but might not otherwise want to splurge on. The list includes light therapy treatments for acne, vibrating nausea relief bands, electrical stimulation devices for chronic pain, cloud-connected stethoscopes, and smart thermometers.

12. Head to Amazon.

There are plenty of FSA-eligible items available on Amazon, including items for foot health, cold and allergy medication, eye care, and first-aid kits. Find out more details on how to spend your FSA money on Amazon here.

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The 40 Best Christmas Television Episodes

Dan Stevens and Michelle Dockery in Downton Abbey.
Dan Stevens and Michelle Dockery in Downton Abbey.
Masterpiece on PBS

If the gifts, cookies, PTO, full-fledged trees indoors, license to wear ugly sweaters, and general sense of cheerfulness aren't enough to make you look forward to Christmastime more than any other time of year, there's one last selling point that just might make you change your tune to "Jingle Bells": the possibility of your favorite TV show airing a Christmas episode.

Watching characters you've come to know so well in other contexts navigate an emotionally-charged holiday atmosphere is not only extremely entertaining, it can also deepen your understanding of what the holiday is about—or at least give you a break from your own eccentric extended family to laugh at someone else's.

Settle in with a gallon of eggnog and gear up for this year's yuletide festivities by revisiting our top 40 Christmas television episodes of all time (listed in alphabetical order by series titles).

1. 30 Rock // "Ludachristmas"

With Christmas in New York City, family dysfunction, and unabashed partying, "Ludachristmas" is a 30-minute encapsulation of what the holidays are all about—the only thing missing from this 30 Rock episode is Ludacris himself. From Jack’s hilariously malevolent mother to Kenneth's painfully boring (but essential and meaningful) portrayal of Christmas to Liz's not-so-happy-after-all family, just about every audience member can relate to this. Christmas is the best time of the year! Just ask Tracy, who couldn't help but wildly celebrate and disobey his 30-day alcohol probation mandated by a judge. —Thomas Carannante

2. Alfred Hitchcock Presents // "Back for Christmas"

Alfred Hitchcock might not be known for holiday cheer, but the Master of Suspense did put his distinctively dour stamp on this yuletide installment of his long-running anthology series, and it's one of the few episodes he directed himself. In “Back for Christmas,” John Williams (not the composer) portrays Herbert Carpenter, a man who offs his wife Hermione (Isobel Elsom) in England and believes he can conceal her body in the foundation of their home. While relaxing in America during a holiday break, he receives distressing news from across the pond. His late wife’s Christmas gift to him was a wine cellar—one that will require excavating his basement floor. And now you understand why Hitchcock, despite his Santa-esque proportions, was considered less than jolly. —Jake Rossen

3. Arrested Development // "Afternoon Delight"

Don't disrespect President Gob in his $5000 suit or else you'll face the consequences, which the entire Bluth Company does at the annual holiday party when Gob mistakes some forced compliments from an employee as a roast. The only thing worse (and more hilarious) than that is Michael singing "Afternoon Delight" with his niece, Maeby, before realizing the lyrics are inappropriate for such a duet. Lucille is even more neurotic during the holidays; Buster enjoys his Christmas detour from Army at the arcade; Tobias's ruptured eardrum (thanks to Lucille's poking and blowing) forces him to miss a life-changing call from the Blue Man Group; and the locals continue their Christmas tradition of destroying the famed banana stand—COME ON! —TC

4. Black Mirror // "White Christmas"

No amount of seasonal cheer can alter the bleak outlook of Black Mirror, and its holiday special is no exception. Trapped together in a cabin with snow piling up outside, Matt (Jon Hamm) and Joe (Rafe Spall) discuss the circumstances that have brought them together. Matt was an expert in artificial intelligence and ruthlessly captured the consciousness of people to become part of a sentient personal assistant device; Joe admits he killed his fiancée’s father with a snow globe after an argument. The cabin seems like a prison, and both of their fates are intertwined. By the time Matt is wandering the streets, rendered unseen and essentially invisible to the outside world, and Joe is trapped in a purgatory of his own making, you’ll be wishing for the Grinch to help cheer you up. —JR

5. Cheers // "Christmas Cheers"

As is par for the course with Cheers, nothing about season 6's Christmas episode is remotely subtle—which, of course, is why we love it. From It’s a Wonderful Life playing on the bar’s television to Norm’s Santa suit (and Santa-suited friends), the whole episode makes you wonder if maybe you’d rather skip the big family shebang this year and spend the holidays in a cozy bar with a frothy pint instead. —Ellen Gutoskey

6. Community // "Comparative Religion"

“Comparative Religion” is hardly a canonical episode of Community. This is, after all, the show best known for its high-concept, over-budget homages. “Comparative Religion” has none of that, though it does feature an exceptional guest spot from Anthony Michael Hall. Instead, the episode focuses on building the characters of the study group, dealing out simple but hilarious jokes (“We're trying to get Jeff ready for the fiiiiiiiiiiiiiight,”), and giving the world the gift of Christmas Troy. —Noam Radcliffe

7. Community // "Abed’s Uncontrollable Christmas"

Born of a vague, technical approval from an executive and a “screw-it” attitude, "Abed's Uncontrollable Christmas" is peak Community. With its striking stop-motion aesthetic, it earned the show its sole Emmy—for Individual Achievement in Animation—and sent director Duke Johnson on the path to 2015’s Anomalisa, but its real legacy lives in the simple fact of its existence. “Abed’s Uncontrollable Christmas” does what only Community could, balancing studied homage, formal wanderlust, and unbelievable heart in an all-too-brief 23-minute package. —NR

8. Curb Your Enthusiasm // "Mary, Joseph and Larry"

Larry David’s holiday spirit is on full and awkward display in this seasonal episode that sees the comedian ruining Christmas for his wife Cheryl (Cheryl Hines) by accidentally eating cookies intended for a family nativity scene. Finding that the true meaning of Christmas involves not upsetting his in-laws, Larry goes in search of a solution and finds a live nativity that might be able to save the day. On Curb Your Enthusiasm, you can expect he’s likely to just make everything delightfully worse. —JR

9. Doctor Who // "A Christmas Carol"

Christmas specials are just as much a part of Doctor Who canon as regeneration or Daleks, which means there are several holiday-themed episodes from which to choose. But the 2010 edition, featuring Matt Smith’s Eleventh Doctor, was a clever retelling of Charles Dickens’s A Christmas Carol—which, when you think about it, is sort of about time travel anyway. Which fits perfectly into the series’ legendary sci-fi pedigree. —Jennifer M. Wood

10. Downton Abbey // "Christmas at Downton Abbey"

After two dramatic seasons of will-they-or-won’t-they-get-together storylines—plus one scandalous post-coital death, a miraculous recovery from paralysis, and a convenient case of Spanish flu that killed off a romantic rival—(distant) cousins Matthew and Mary Crawley finally seal the deal. Which, in this case means: Matthew proposes, Mary tells him he better do it properly (she likes things done properly), she says yes, the ASMR-inducing music swells, and they spin around in the snow to celebrate their newly betrothed bliss. Don’t knock it ‘til you watch it. —JMW

11. Friends // "The One With the Holiday Armadillo"

Whatever your feelings may be about Ross Geller’s questionable behavior as a parent, boyfriend, professor, doctor (of paleontology), or person in general, you must admit his histrionics as the holiday armadillo have earned him a place in the Christmas television hall of fame. In the absence of any available Santa Claus costumes, Ross dons a terrifying armadillo suit to teach his half-Jewish son about Hanukkah—but when Chandler appears dressed as Santa Claus, and Joey bursts in dressed as Superman, it turns into the weirdest Christmas pageant of all time. —EG

12. Futurama // "Xmas Story"

Futurama’s ability to be heartfelt and charming seconds after a sophomoric gag is a great strength, and this first Xmas episode strikes that strange balance. John Goodman as murderous Robot Santa is a treat, but Fry and Leela’s bond growing deeper over their shared loneliness—he as an unfrozen future man, she as an alien of unknown parentage—is a building block for what’s to come. Oh, and Zoidberg saves the day! Now, let us all sing "Santa Claus is Gunning You Down.” —Sam Dunn

13. Gilmore Girls // "Forgiveness and Stuff"

Gilmore Girls is rife with enchanting snowfalls, steaming mugs of coffee, and a general sense of coziness throughout, so a solid series binge come December is totally justified. If you only have about 45 minutes of free time, however, this episode from season 1 is worth a rewatch. Familial tensions run high when Richard suffers a heart attack, and we get to see all the characters (Lorelai and Emily in particular) at their worst, then best, then worst again, then best again, and so on. It’s not only classic Gilmore Girls, it’s classic “any family during the holidays.” Messy, relatable, and ultimately impossible not to love. —EG

14. Hey Arnold // "Arnold’s Christmas"

One of the first iconic tear-jerkers in this young adult series, Arnold gets lonely Vietnamese boarder Mr. Hyunh (long before he became a country star) in their household's Secret Santa drawing. His grandiose Christmas plan is to reunite the recent immigrant with his daughter Mai, whom he had allowed to escape on a helicopter 20 years prior. After many fruitless attempts, Arnold surrenders hope, only to watch Mai arrive on his doorstep anyway, thanks to his guardian angel, the head-over-heels Helga. We're not sure why one cartoon was legally allowed to make us cry so deeply and for so long. —Adam Weinrib

15. The Honeymooners // "'Twas the Night Before Christmas"

First aired on actual Christmas Eve 1955 (television used to be a smidge more magical back then), Ralph Kramden learns a lesson in generosity, courtesy of the Ghost of O. Henry (figuratively, not literally). After blowing his Christmas money on a bowling ball for himself, he then regrets it and sells the ball to buy his wife a real present. She then gifts him … a now-unusable bowling ball bag, leading to a tender moment and oft-remembered Kramden monologue about the real joy of the holiday. —AW

16. It’s Always Sunny in Philadelphia // "A Very Sunny Christmas"

What does the Gang want for Christmas? For Dennis (Glenn Howerton) and Dee (Kaitlin Olson), it’s the respect of their father Frank (Danny DeVito), a selfish ogre who buys their most desired gifts then keeps them for himself. They attempt to course-correct by stuffing him into a couch so he can hear his old co-workers discuss what a terrible person he is. For Mac (Rob McElhenney) and Charlie (Charlie Day), it’s rediscovering the joy of the holiday after finding out Mac’s parents broke into homes to steal presents and that Charlie’s mom apparently traded sexual favors with Santa for gifts. That this all involves Charlie assaulting a mall Santa and Frank running around naked and gasping for air is par for the course on Sunny. In attempting to find the true meaning of Christmas, the Gang is that rare television holiday special oddity: They learn absolutely nothing. —JR

17. Lizzie McGuire // "Aaron Carter’s Coming to Town"

Basically, Lizzie, Gordo, and Miranda learn that teen pop star Aaron Carter will be filming a music video nearby and immediately start scheming ways to meet him. Using the classic Disney blueprint of sneaking into anywhere—head-stacks peeking around corners, really weak disguises, etc.—they finally find themselves in Aaron’s dressing room. Lizzie convinces Aaron’s less-than-pleased manager to let one of them meet the singer (because ’tis the season, am I right?). Next, Lizzie pulls the ultimate Christmas move by suggesting Miranda use this opportunity to further her music career. Cute.

But the true Christmas miracle happens when Lizzie “realizes” she “forgot” her tape recorder in Aaron’s room. She knocks on his door and that’s when it happens—that’s when Aaron Carter opens the door, asks “Is this yours?,” Lizzie goes “Yeah.” Then comes Aaron's iconic line: “Merry Christmas, Lizzie McGuire” (totally having had peeped her name on the tape recorder). Oh, and would you look at that? Lo and behold, Aaron Carter has mistletoe over his door, so he kisses Lizzie. If you, like 11-year-old me did at the time, are wondering how kissing a famous celebrity would change the plot of the remaining seasons? Don’t, because none of this is ever mentioned again. The episode ends with the gang joining Aaron Carter on stage to sing everyone’s favorite Christmas song: “I Want Candy.” A true Christmas classic. —Angela Trotti

18. Mad Men // "Christmas Comes But Once a Year"

It’s jarring even nine years later watching cowboyish Lee Garner Jr. emasculate Roger Sterling, he of the equal and opposite swagger, by forcing him to wear that Santa suit. Notably, this episode saw Megan begin to emerge; she’s almost Zen-like in her competence compared to the smoldering emotional wreck anyone too closely connected to Don Draper becomes. Dr. Faye gets hard-done here by that drunken black hole of sexy amorality, too, and we’ll never forgive holy-hell-what-a-lil’-creep Glen Bishop for doing weird things in Sally’s room. —SD

19. Mad Men // "Christmas Waltz"

In its fifth season, Mad Men gave us the best Christmas present money couldn’t buy: Don Draper and Joan Harris just hanging out and drinking. Sure, plenty of other stuff goes down in “Christmas Waltz”—Lane Pryce seals his fate by forging Don’s signature, Harry Crane gets it on with a Hare Krishna acolyte in his office, everyone ignores Pete Campbell getting a shot at Jaguar—but sometimes it’s the little things that feel the best. Don and Joan commiserating in a Midtown bar like the old friends they now are is a particularly heady Christmas magic. —NR

20. Mr. Bean // "Merry Christmas, Mr. Bean"

Rowan Atkinson is often referred to as "The Man With the Rubber Face," and much of that is due to his run as the largely silent but painfully expressive Mr. Bean. But he earned a new distinction with this Christmas episode: The Man With the Turkey on His Head (skip ahead to the 19:35 mark above). Yes, long before Friends made it a thing, Mr. Bean—who was always ahead of his time—was doing it. —JMW

21. Mystery Science Theater 3000 // "Santa Claus Conquers the Martians"

The best way to appreciate 1964’s low-budget bomb Santa Claus Conquers the Martians is through the lens of Mystery Science Theater 3000, which riffed on the movie in 1991. In the movie, Santa is kidnapped by aliens so he can dispense gifts to their children. In the margin of the screen sits Joel (Joel Hodgson), Crow (Trace Beaulieu), and Tom Servo (Kevin Murphy), who attempt to make sense of this misfire. By the time the gang is singing “A Patrick Swayze Christmas,” you, too, will believe in Santa and his ability to breathe unassisted in a Martian atmosphere. —JR

22. The O.C. // "The Best Chrismukkah Ever"

In this episode, Seth uses the Christmas-Hanukkah hybrid holiday he calls Chrismukkah to justify not having to choose between the two girls he’s dating simultaneously, and the pressure of the holidays drives Marissa to both shoplift and drink herself into oblivion. Did the showrunners turn down the dial on the melodrama in the spirit of warm and fuzzy Christmas feelings? No. Did we expect them to? Absolutely not. The endlessly soapy, can’t-stop-watching quality that makes The O.C. such an angsty teen classic is on full display here and, as it turns out, it’s even more fun with Christmas decorations in the background. —EG

23. The Office (NBC) // "Christmas Party"

Considering that the Dunder Mifflin employees all purchased gifts with specific recipients in mind, Michael’s decision to turn the Secret Santa into a Yankee Swap is equal parts disastrous and hilarious: Everyone vies for the iPod that Michael bought for Ryan, and Jim’s trinket-filled teapot for Pam almost ends up as Dwight’s nasal cleanser. Alcohol flows freely, emotions run high all around, and one unlucky regional manager ends up getting flashed by an employee. Does this sound like your office’s Christmas party? In the name of all that is holy, we hope not. —EG

24. The Office (NBC) // "A Benihana Christmas"

Though "Dinner Party" may be widely regarded as the best-ever episode of The Office, then “A Benihana Christmas” deserves honorable mention at the very least. In this hour-long Christmas special, Michael Scott cancels Christmas (and threatens to take New Year’s away) but ultimately ends up taking Dwight, Jim, and Andy to Benihana to get drunk before they return to the office for not one, but two dueling Christmas parties (one that starts at 3 p.m., and a “way more fun party” that starts at 2:45 p.m.) The episode’s soundtrack alone is worthy of a Grammy, featuring covers of classic hit songs like Alanis Morissette’s “You Oughta Know” by Kevin Malone and a 30-second preview of James Blunt's “Goodbye My Lover,” which Michael plays on a loop to mourn his breakup with his realtor Carol (played by Nancy Carell, Steve Carell’s real-life wife). “A Benihana Christmas” answers a lot of questions—for example, how does one correctly butcher a goose?—but also keeps viewers wondering … does Michael know how to ride a bike? —AT

25. The Office (UK) // "The Office Christmas Special"

More than a year after "Interview," The Office's season 2 finale, which initially felt like the series finale, Ricky Gervais and Stephen Merchant returned to co-write and co-direct this two-part Christmas special that revisited the Wernham Hogg gang—past and present—and answered some truly burning questions, including: Why was there a documentary crew filming this office at all? What happened after the documentary series aired? How many copies of David Brent's cover of "If You Don't Know Me By Now" did Juxtaposition Records actually sell? How is Tim faring with Gareth as the new office manager? Did Dawn and Lee ever get married? And who does your tampons? Just like its two official seasons, The Office Christmas special mixes brutally uncomfortable humor with moments of true sentimentality—none more so than when Tim finally gets the girl. —JMW

26. Rugrats // "Chanukah"

Rugrats was one of the only depictions of a Jewish family on TV when it aired on Nickelodeon in the 1990s. The show made cartoon history when Tommy, Chuckie, and Angelica reenacted the story of Passover in 1995, and a year later, the Rugrats celebrated another Jewish holiday. "Chanukah" follows the same format as the Passover episode, with the babies playing characters in a retelling of the miracle. Grandpa Boris fighting with his rival Shlomo over who will play the lead in the synagogue's Chanukah play also makes for an entertaining B-plot. —Michele Debczak

27. Saturday Night Live // "Justin Timberlake/Justin Timberlake, 2006"

Though SNL always boasts underrated holiday vibes (even the set dressing always feels warm and highly wreathed), this episode features the most Bulk Christmas, in terms of modern classics. It opens with Amy Poehler, Kristen Wiig, and Maya Rudolph crooning "Santa's My Boyfriend," and prominently features the Emmy-winning, 16-bleep Timberlake-Samberg digital short that NBC execs called "Special Christmas Box" during their publicity push (the box, of course, contains a d***). Also noteworthy? Bill Hader and Timberlake singing the Alvin and the Chipmunks classic "Christmas, Don't Be Late" in the monologue. Don't forget. —AW

28. Scrubs // "My Own Personal Jesus"

The hospital on Scrubs always has a way of shaking the faith of at least one main character every episode, and when it finally happens to Turk—Donald Faison, the show's beacon of positivity—after a Christmas Eve shift beset by tragedy, it just hits a little harder. But Scrubs’s humor just wouldn’t be the same without some heartbreak to go along with it, and Turk’s despair is eventually rewarded with a Christmas miracle that restores his faith and gives us one of the best uses of Nina Simone’s “Sinnerman” you’ll ever see on TV. —Jay Serafino

29. Seinfeld // "The Strike"

Going home for the holidays can get a little dull by December 26, but at least our holidays all end. But n the Costanza household, no celebration—no matter how languid—is ever finished until George can pin his father to the ground, a process that could take days. It's all part of Festivus, the Costanza-specific holiday first explored in this late-season episode. This isn't even to mention that we're dealing with a rare Seinfeld episode where Kramer has a job; he returns to H&H Bagels after a decade-long strike for the holiday season, and swiftly uncorks a steam valve. —AW

30. Sherlock // "A Scandal in Belgravia"

Watching a nearly naked (and surprisingly strapping) Sherlock Holmes display all of his cheeky arrogance in Buckingham Palace is Christmas-themed in that it is the best gift many viewers have ever gotten. That aside, this episode also features an awkward yet heartwarming holiday party, during which Benedict Cumberbatch's Sherlock exhibits some mind-blowingly uncharacteristic behavior in the spirit of Christmas: After pelting Molly with a barrage of verbal abuse, he apologizes, wishes her a merry Christmas, then kisses her on the cheek. If that isn’t Christmas-y enough to qualify its inclusion on this list, I’ll eat my deerstalker hat. —EG

31. The Simpsons // "Simpsons Roasting on an Open Fire"

Marge loses the holiday spending budget when Bart’s tattoo requires removal and Homer’s work bonus doesn’t come through. An attempt to win it all back at the dog track flops, but they don’t come home empty-handed: Santa’s Little Helper is in tow. Watching this very first episode of The Simpsons can be jarring. The character designs aren’t dialed in, and their movement is gelatinous. But the core conceit of a family that loves one another despite their flaws is present. Homer’s brain may not be in the right place, but his heart is. —JR

32. The Simpsons // "Marge Be Not Proud"

In just 22 minutes of television, “Marge Be Not Proud” serves as a crash course in everything that made The Simpsons the premier comic institution during its golden years. First, you’ve got classic gags, like the deadpan brilliance of Lee Carvallo's Putting Challenge, Homer getting hoodwinked by an Allan Sherman record, and the introduction of “Thrillhouse”—or, more fittingly, “Thrillho.” But all of these sight gags and quotable moments wouldn’t still be remembered nearly a quarter-century later if not for the emotional sincerity of the story, which sees Marge and Bart rebuild their strained relationship after Bart gets caught shoplifting a video game at the local department store right before Christmas. If the show’s seventh season is remembered as its peak, then this is the absolute pinnacle. —JS

33. Six Feet Under // "It’s the Most Wonderful Time of the Year"

On the first anniversary of their patriarch's death, the Fisher family reflects on their first Christmas without Nathaniel, as David stresses about bringing his new boyfriend home for the first time. This episode isn't all Christmas dinner and funereal tears, though; it opens with a Santa on a motorcycle getting hit by a car. Ta-da! —AR

34. South Park // "Red Sleigh Down"

“My children, you should know something ... I'm packing.” Thus spake Jesus, our half-Rambo, half-Blade dispenser of righteous violence, as he annihilated a legion of extremist militants. Bringing Christmas to Iraq—Cartman’s grand plan to get off Santa’s Naughty List—is harder than it looks, and the Messiah ultimately pays with his life, sacrificing himself to save Santa Claus and our boys in an outrageous mishmash of 2001’s Black Hawk Down and 1999’s Three Kings. But the topper? Kenny just kind of showing up after being dead for a calendar year. It's a Christmas miracle! —SD

35. Tales From the Crypt // "And All Through the House"

Based on the 1950s pulp comics of the same name, Tales from the Crypt was often more campy than scary, but for its Christmas episode, the HBO series went full horror. "All Through the House" follows a woman being terrorized by an escaped asylum patient dressed as Santa Claus on Christmas Eve. The terrifying tale is the perfect antidote to all the feel-good content clogging the airwaves this time of year. —MD

36. Veep // "Camp David"

As is often the case for Selina Meyer, things go horrifically awry in this particular holiday gift exchange. The always-callous Veep regifts the antique pen her daughter gave her during their family Camp David retreat to Chinese President Lu, then accidentally hands the robe she received to her daughter's partner, Marjorie, eventually leading to the terms of an illicit deal being very much scrapped. Don't you hate when Christmas regifting causes an international incident? —AW

37. Victoria // "Comfort and Joy"

It's 1843 and Christmastime has arrived at Buckingham Palace, where a pregnant (again) Queen Victoria is facing her first holiday without her beloved governess-turned-confidante Baroness Lehzen. So Prince Albert is determined to make it Victoria's best Christmas ever and goes about transforming the palace into a yuletide wonderland full of dangling Christmas trees, gifts galore (including an orphaned princess), and family members that no one really wants to deal with. Though Albert (incorrectly) gets a lot of credit for bringing a variety of German Christmas traditions to England, we'll let accuracy slide in this case because what the show recreates is a thing of beauty—and a reminder that donning a crown doesn't mean that you don't also have to deal with overbearing parents, dysfunctional siblings, and/or frustrating in-laws. —JMW

38. The West Wing // "In Excelsis Deo"

Every episode of The West Wing is actually a Christmas episode if you believe, as I do, that President Bartlet is just a very tan Santa Claus with southern-gentleman vibes (he’s from New Hampshire, which is technically south when compared to the North Pole). This one, however, has many other added elements of holiday cheer, including a scene where the President sneaks into a bookshop for some last-minute Christmas shopping—which he forbids anyone from telling the press about—a scene where Josh gives Donna a book with a heartfelt note inside (They hug! It’s important!), and a subplot where Toby organizes a military funeral for a homeless veteran who died wearing his coat. —EG

39. The Wonder Years // "Christmas"

Kevin doesn’t end up getting the color television he so badly wants in this episode, though he does learn that Christmas isn’t about the “tinsel and wrapping paper,” but about memory. Oh, sweet Kevin, it was never about the tinsel or wrapping paper—it’s about what’s wrapped in it. Anyway, given that the holidays are a time to gorge on the sappy, saccharine feelings that you try to bury for the other 11 months of the year so you can get some dang work done, this episode is definitely worth indulging in. —EG

40. The X-Files // "How the Ghosts Stole Christmas"

The ghosts that steal Christmas in this episode are a pair of lovers played by Ed Asner and Lily Tomlin who, after dying in a murder-suicide pact so they could spend eternity together, terrorize Mulder and Scully to the point where they practically can’t tell up from down. It’s trippy, it’s spooky, it’s tons of fun, and it’s all ultimately irrelevant when compared to the final scene of this episode, during which “Have Yourself a Merry Little Christmas” plays in the background while we watch—through a frosted windowpane, no less—the will-they-or-won’t-they partners exchange Christmas gifts even though they had decided not to. —EG