Crohn Disease (cont.)
What Is the Treatment for Crohn's Disease and Its Symptoms?
The goals of treatment of Crohn's disease are to reduce the underlying inflammation, which then relieves symptoms, prevents complications, and maintains good nutrition.
Inflammation: Medications used in reducing inflammation in Crohn's disease include anti-inflammatory drugs, corticosteroids, other immunosuppressants, biologics, and antibiotics. The types of medications most widely used in Crohn's disease are the following:
- Aspirin-like anti-inflammatory drugs, for example, mesalamine (Apriso, Asacol, Asacol HD, Lialda, Pentasa) reduce the inflammation. These drugs are used to prevent flares in people with mild Crohn's disease.
- Corticosteroids reduce inflammation and suppress the immune system. They can be used in the short term only. Corticosteroids are indicated in persons with severe systemic symptoms (for example, fever, nausea, weight loss) and in those who do not respond to anti-inflammatory agents.
- Antibiotics reduce inflammation indirectly by reducing infection.
- Immunosuppressants suppress the immune system. Some are more effective than steroids, while others have longer duration of effect.
- Biologic therapy works as an anti TNF blocker, which also helps in reducing inflammation.
If these drugs are not successful in suppressing inflammation, the alternative is surgery to manage the complications of Crohn's disease.
Symptoms often go away when the inflammation is treated. Symptoms may be treated separately if necessary.
- For symptoms such as diarrhea, cramps, and bloating, medication is usually enough. Antidiarrheal agents usually relieve mild to moderately severe symptoms.
- Dietary therapies, such as diets high in fiber, low in fiber, or low in fat, are helpful in some people over the short term, but are rarely helpful over the long term.
- Do not take dietary supplements or vitamins without first discussing it with a health-care professional.
- Many people with Crohn's disease are lactose intolerant and should avoid dairy products if they are intolerant of them.
Most complications resolve when the inflammation is treated. Some, however, require additional treatment. A fistula, for example, usually is treated with antibiotics to get rid of the infection. Other medications may be tried to help heal the fistula, but these work in only about 30% to 40% of cases.
- During this treatment, the patient may have to stop eating and receive nutritious fluids intravenously for several days. A nasogastric (NG) tube placed in the stomach through the nose will remove some of the fluids and gases that collect there. This combination of approaches, called bowel rest, lets the digestive tract stop working temporarily, which promotes healing.
- Fistulas that bypass a large amount of the intestine (thus causing very severe symptoms) or do not improve with medical treatment may need to be repaired surgically.
Medically Reviewed by a Doctor on 9/11/2017
Senthil Nachimuthu, MD, BS
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