Given the chronic nature of the disease, treatment for Crohn’s disease has three main goals:
- To relieve symptoms, also called achieving remission
- To prevent symptom flare-ups, also called maintaining remission
- To improve quality of life
Because Crohn’s is unpredictable, treatment must be customized to each person. There is no “one way” to treat Crohn’s disease. Treatment often involves a combination of therapies and approaches that may change over time as the disease progresses. How the disease is treated depends on a number of factors:
- Where the disease is found in the GI tract
- What complications you may have
- How severe the disease is
- What past treatments you have received and how you responded to them
There are essentially two phases of treatment for Crohn’s disease. The first is to control inflammation and relieve symptoms. This allows the intestines to heal. Then once symptoms have gone into remission, treatment is aimed at keeping your symptoms from returning.
Medications for Crohn’s Disease
Many of the medications used for Crohn's are used both to ease symptoms and to maintain remission once symptoms are under control, although at different dosages depending on the desired goal. There are five main drug classes used to treat Crohn’s disease.
Antibiotics may be used both to treat symptoms of Crohn’s disease and as a long-term therapy to help treat abscesses and fistulas.
- How given: orally, by mouth, or intravenously (IV).
- How they work: Antibiotics are very effective at killing bacteria that cause infections. Some researchers also believe they may help suppress the immune system. Currently, studies are being done to determine the effectiveness of using antibiotics to help control the disease.
- Possible side effects: Nausea, vomiting, metallic taste, diarrhea, stomach pain, headache, insomnia, discolored urine, and nervousness.
Aminosalicylates (5-ASA medications) are a class of anti-inflammatory drugs used to treat people with mild to moderate Crohn’s disease. They are aspirin-like compounds that contain 5-aminosalicylic acid (5-ASA).
- How given: orally, by mouth, or rectally, as an enema or a suppository
- How they work: These drugs help control inflammation directly at the lining of the GI tract. They also work throughout the body to interfere with the inflammatory process. Aminosalicylates are used both to help control symptoms and to maintain remission of the disease.
- Possible side effects: headaches, rash, nausea, respiratory infection, hair loss, joint or muscle pain, diarrhea, stomach pain, vomiting, and loss of appetite. Men using one type of 5-ASA drug may experience infertility, although this goes away after the drug is stopped.
Corticosteroids are powerful and fast-acting drugs used for short-term treatment of symptom flares in people with moderate to severe Crohn’s disease. People receiving these drugs often see an improvement in symptoms within a few days of taking them. Because of the risk for significant side effects, corticosteroids are not used for maintenance therapy.