Treatment Options

There are a variety of treatments available for Crohn's disease. With the help of your gastroenterologist, you'll need to find the one that is appropriate for you, based on your symptoms and the severity of your disease. Plus, if you've previously tried one or more Crohn's treatments, your gastroenterologist will consider how you've responded to those therapies.

You will also need to discuss the goals of treatment. As a foundation for your future discussions with your gastroenterologist, keep in mind these important treatment goals recommended by the American College of Gastroenterology:

• Induce and maintain remission
• Restore and maintain nutrition
• Maintain quality of life as it relates to Crohn's disease
• Select optimal timing for those requiring surgical intervention

Finding an effective treatment is important. Crohn's can lead to complications such as abscesses, perforations, and fistulas, not to mention fatigue and anemia. What's more, symptoms can interfere with activities, work, and relationships. For Crohn's patients, preserving quality of life remains an important treatment goal.

The proper medication regimen is also important in controlling your Crohn's disease. It is important that you help your doctor determine the best combination for you. However, keep in mind that nearly all medications have side effects. Be sure to check the patient information provided with your prescription and talk to your doctor about the kinds of side effects certain medications may have, and whether they are safe for you to use.

Drug therapy
Alternative therapy

Drug therapy

Aminosalicylates (5-ASA-based drugs)

When someone is first diagnosed with Crohn's, he or she may be treated initially with drugs containing mesalamine, which helps control inflammation. Sulfasalazine is the most commonly used of these drugs. If you do not benefit from sulfasalazine or cannot tolerate it, you may be put on other drugs that contain mesalamine, generally known as 5-ASA agents. These drugs are frequently effective for mild to moderate, but not severe, inflammation.

Antibiotics

Antibiotics are used to treat bacterial overgrowth in the small intestine caused by strictures, fistulas, or prior surgery. They are also used to treat any bacterial infections that are present, including abscesses. Your gastroenterologist may prescribe an antibiotic therapy.

Antidiarrheal medications

Diarrhea and abdominal pain are often relieved when the inflammation subsides, but you may need additional medication. Several antidiarrheal agents may be prescribed by your gastroenterologist, including diphenoxylate, loperamide, and codeine. If you are dehydrated because of diarrhea, you will be treated with fluids and electrolytes.

Biologics

Biologics have been approved for the treatment of Crohn's disease. These drugs specifically target parts of the immune system that lead to inflammation associated with Crohn's disease.

Corticosteroids

Corticosteroids help control inflammation and are very effective for active Crohn's disease, even if severe. If you respond to steroid treatment, your gastroenterologist will usually try to gradually lower the dose of the steroid in order to avoid some of the significant side effects of this class of drugs. Corticosteroids are not recommended for long-term therapy.

Immunomodulators

Drugs that modulate or alter the immune system are also used to treat Crohn's disease. Most commonly prescribed are 6-mercaptopurine (6-MP) and a related drug, azathioprine. Immunomodulators work by blocking the immune reaction that contributes to inflammation. It often takes a few months of treatment for immunomodulators to take effect.

Alternative therapy

Traditional drugs and treatment for people with Crohn's disease usually include drug therapy and surgery. However, these kinds of treatments can sometimes cause unwanted side effects. Alternative medicine, also called holistic medicine, is an approach to healing which looks at the body as a whole. Some alternative therapies that have been used to complement conventional treatment include relaxation training, vitamin therapy, biofeedback, acupuncture, and homeopathy. You should discuss any alternative treatment with your gastroenterologist before you begin.

Relaxation training

You may have already discovered that stress can exacerbate Crohn's symptoms. Relaxation training includes techniques such as progressive muscle relaxation, meditation, and yoga, and can be used to reduce stress and to manage chronic pain.

Vitamin therapy

Research is currently underway looking for a link between vitamin therapy and Crohn's disease. Specifically, researchers are trying to find out if certain nutrients that produce antioxidant enzymes can help neutralize excessive free-radical production, which can be found in people who have Crohn's disease. Always talk to your doctor before taking any herbs, vitamins, or alternative medicines.

Click here to find a listing of support organizations for people living with Crohn's disease.