Living with Crohn's disease today means having more options to treat it than ever before. Your doctor will tailor your treatment just for you.
Your treatment plan will depend partly on where and how severe your Crohn's is and whether it is causing other health problems. It may involve more than one approach and may change over time as your needs do.
"A patient and physician have to weigh the risks and benefits of each treatment together, based on the patient's comfort level and the doctor's expertise and experience," says Edward Loftus, MD, professor of medicine at the Mayo Clinic in Rochester, MN. The more you learn about your options, the better you and your doctor can pick what is right for you.
Drugs for Crohn's
There are two phases of treatment for Crohn's. The goals of the first are to stop your gut from being inflamed and to relieve symptoms. The goal of the second is to keep symptoms from coming back.Many Crohn's drugs are used for both.
There are five main drug classes used to treat Crohn's disease.
Aminosalicylates (5-ASA drugs). These treat mild to moderate Crohn's disease. They help control inflammation in the lining of the gastrointestinal (GI) tract.
Antibiotics. These treat symptoms and help heal infections.
Corticosteroids. These strong and fast-acting drugs can often relieve flares in moderate to severe Crohn's within a few days. You usually take them in small doses for a short time because they can cause serious side effects.
Immunomodulators. If you have moderate to severe Crohn's, and you have not had luck with aminosalicylates or corticosteroids or have side effects from them, your doctor may suggest one of these. They can help your body respond better to corticosteroids during a flare and help you stay flare-free longer. They may take 3 months or more to work.
Biologics. These drugs treat people with moderate to severe disease, often if other drugs have not worked well. They don't affect your whole immune system, so they tend to cause fewer side effects, although some side effects can be serious.
If drugs stop easing your symptoms or if your Crohn's causes other health problems, your doctor may advise surgery. It can be the best option to relieve your symptoms long-term.
"Sixty to 80% of people with Crohn's will need at least one surgery," Loftus says. "Half of those people will need a second surgery."
Surgery may be used to remove part of your intestine, rectum, or colon or to treat other problems. Your doctor will aim to relieve your symptoms and still preserve as much of your intestine as he can.
Surgery does not cure Crohn's. About half the people who have surgery do have Crohn’s symptoms again in about 5 years. But for others, surgery can relieve symptoms for much longer. Taking some Crohn's drugs after surgery can lower the chance that it will return. And if it does, drugs can often treat it.