One of the most common forms of crohn’s disease treatment is medication therapy. There are several classes of drugs that can help induce and maintain remission of symptoms.
Aminosalicylates: Drugs like mesalamine (Asacol, Pentasa) and sulfasalazine (Azulfidine) are classified as aminosalicylates. They help reduce inflammation in the digestive tract and are often used as a first-line treatment for mild to moderate Crohn’s disease. These medications are taken orally and can induce remission in 30-40% of patients. Common side effects include nausea, diarrhea, and headache.
Corticosteroids: For moderate to severe active Crohn’s disease, corticosteroids like prednisone are frequently prescribed. They work to rapidly reduce inflammation. Short-term use has been shown to induce remission. However, long-term steroid treatment is not recommended due to potential side effects involving metabolic changes, weight gain, and osteoporosis.
Immunomodulators: Drugs in the immunomodulatory class help regulate the body’s immune system response. Common options include azathioprine (Imuran), 6-mercaptopurine (Purinethol), and methotrexate (Rheumatrex, Trexall). These medications take 4-8 weeks to achieve the desired effects and help maintain remission over the long run. Side effects can include nausea, pancreatitis, and potential increased infection risk.
Biologics: For patients who do not respond well to or cannot tolerate other therapies, biologic agents may be prescribed. Biologics target specific components of the immune system that are believed to play a role in Crohn’s Disease Treatment. Some common biologic options are infliximab (Remicade), adalimumab (Humira), vedolizumab (Entyvio), and ustekinumab (Stelara). While highly effective at inducing and maintaining remission, biologics carry some risks like headache, respiratory infections, and increased susceptibility to certain cancers with long-term use. Close monitoring is required.
Nutritional Therapy
For some patients, dietary and nutritional changes are an important part of managing crohn’s disease treatment symptoms and promoting healing. Some options to discuss with your healthcare provider include:
Exclusive Enteral Nutrition (EEN): During an active flare, consuming liquid feedings that provide full nutritional requirements through a feeding tube or orally for 6-8 weeks can help induce remission. This “nutritional therapy” excludes all normal foods.
Low-Residue Diet: During an active flare, eating soft, easily digestible foods that are low in fiber may help allow the digestive tract to rest and reduce inflammation. Foods to focus on include white rice, applesauce, bananas, boiled potatoes without skin, lean meats, mild cheeses and yogurts.
Anti-Inflammatory Diet: Even when not flaring, following an overall anti-inflammatory dietary pattern focused on whole foods like fruits and vegetables, soluble fiber-rich foods like oats, omega-3 fatty acids from fish, and antioxidant-rich spices may promote gut healing over the long run. Processed and red meats, sugar, alcohol and caffeine are best limited.
Vitamin/Mineral Supplementation: Due to potential for malabsorption during active inflammation, your doctor may recommend supplements including a multivitamin, calcium + vitamin D, and sometimes zinc. Ensuring adequate nutrition is important for health and treatment response.
Surgery
For some Crohn’s disease patients who do not respond well to medications or nutritional therapy alone, surgery may eventually be necessary to remove diseased segments of the bowel or treat complications like strictures or fistulas. Some common procedures include:
Strictureplasty: For narrowing of the bowel (strictures) that cause blockages, this procedure enlarges the narrowed area to restore normal flow.
Resection: Diseased or damaged sections of the small intestine or colon are surgically removed (resected). This offers relief from inflammation in that area but may later require additional resection if the disease progresses or returns.
Ileostomy or Colostomy: If a large section of bowel is removed, it may be necessary to create an opening (stoma) for feces to exit the body via a bag attached to the abdominal wall. This divers the stool away from areas of inflammation.
Additional Therapies
Some other treatment approaches that may provide supplemental benefit for crohn’s disease treatment include:
– Probiotics: Consuming certain beneficial bacteria through supplements or fermented foods could potentially help balance gut microbiome and reduce risk of flare development.
– Stress Management: Reducing stress through relaxation techniques, yoga, meditation, counseling, etc. may assist in coping with a chronic illness and its symptoms.
– Exercise: Regular physical activity, in moderation for those with active symptoms, could aid in weight maintenance, core muscle strengthening and overall quality of life improvements.
Get more insights on Crohn’s Disease Treatment