Crohn's Disease (cont.)
IN THIS ARTICLE
The main treatment for Crohn's disease is medicine to stop the inflammation in the intestine and medicine to prevent flare-ups and keep you in remission. A few people have severe, persistent symptoms or complications that may require a stronger medicine, a combination of medicines, or surgery. The type of symptoms you have and how bad they are will determine the treatment you need.
Your doctor will most likely start with the traditional first-line treatment for Crohn's disease. He or she will then add or change medicines if you are not getting better.
For mild to moderate symptoms, your doctor will probably have you take:
Severe symptoms may be treated with corticosteroids given through a vein (intravenous, IV) or biologics. With severe symptoms, the first step is to control the disease. When your symptoms are gone, your doctor will probably have you start taking one of the medicines listed above to keep you symptom-free (in remission).
Ongoing treatment is designed to find a medicine or combination of medicines that keeps Crohn's disease in remission.
If aminosalicylates or immune system suppressors keep your disease in remission, you will continue taking the medicines. Your doctor will want to see you about every 6 months if your condition is stable or more frequently if you have flare-ups. You may have lab tests every 2 to 3 months.
Corticosteroids may be given to stop inflammation if you have flare-ups of symptoms. If you need to take corticosteroids for an extended time, you also may receive calcium, vitamin D, and prescription medicine to prevent osteoporosis.
Biologics are also used as maintenance medicines.
Treatment if the condition gets worse
If you have a very bad flare-up of Crohn's disease, you will most likely need IV corticosteroids (like hydrocortisone) to get the disease under control.
Some severe cases of Crohn's disease need to be treated in the hospital where you would receive supplemental nutrition through a tube placed in your nose and down into the stomach (enteral nutrition). In other cases, the bowel may need to rest, and you will be fed liquid nutrients in a vein (total parenteral nutrition, TPN). Supplemental nutrition may be needed if you are malnourished because of severe Crohn's disease in the small intestine. Nutritional support is especially important for children who are not growing normally because of severe disease.
Surgery may be needed if no medicine is effective, if you have serious side effects from medicine, if your symptoms can be controlled only with long-term use of corticosteroids, or if you develop complications such as fistulas, abscesses, or bowel obstructions. Surgery involves removing the affected portion of the intestines, preserving as much of the intestines as possible to maintain normal function. Crohn's disease tends to return to other areas of the intestines after surgery.
eMedicineHealth Medical Reference from Healthwise
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