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Crohn’s Disease Treatment: Common Medications for Treating Crohn’s

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How is Crohn's disease treated?

There is no cure for Crohn's disease. The goals for treatment are:

  • to reduce inflammation
  • to relieve symptoms of pain, diarrhea, and bleeding
  • to eliminate nutritional deficiencies

Treatment might involve drugs, nutritional supplements, surgery, or a combination of these therapies. Treatment choices depend upon where the disease is located and how severe it is. They also depend on the complications associated with the disease and the way the person has responded in the past to treatment when symptoms recurred.

What kinds of drugs are used to treat Crohn's disease?

There are several types of drugs used to treat Crohn's disease. The first step usually involves reducing inflammation. Many people are first treated with sulfasalazine (Azulfidine). This drug is the most common of those that contain mesalamine. Mesalamine is also known as 5-aminosalicylic acid, or 5-ASA. Possible side effects of sulfasalazine and other mesalamine-containing drugs may include:

  • nausea
  • vomiting
  • diarrhea
  • heartburn
  • headache

If a person does not respond to sulfasalazine, the doctor may prescribe other types of drugs that contain 5-ASA. These other products include:

Corticosteroids such as prednisone are another class of drugs that reduce inflammation. A doctor is likely to prescribe an initial large dose of prednisone when the disease is very active. The dose is then tapered off. A problem with corticosteroids is the large number of possible side effects -- some of them serious -- such as a higher susceptibility to infection and stomach ulcers.

Crohn's disease may also be treated with drugs that stop the immune system from causing inflammation. Immunomodulators change the way the immune system behaves. Immunosuppressants decrease the activity of the immune system. Immunostimulators increase the activity. Immunosuppressants prescribed for Crohn's disease include:

Side effects of immunosuppressants may include:

  • diarrhea
  • higher susceptibility to infection
  • nausea
  • vomiting

A biologic drug, infliximab (Remicade), is often prescribed when a person with Crohn's disease does not respond to the standard treatments of mesalamine-containing drugs, corticosteroids, and immunosuppressants. Infliximab is an antibody that attaches itself to the inflammation-promoting protein, tumor-necrosis factor-alpha (TNF-alpha). Another anti-TNF medication is adalimumab (Humira). This is a drug that has been used to treat other immune system disorders such as rheumatoid arthritis. Certolizumab (Cimzia) is another anti-TNF blocker approved recently for Crohn's disease.

Other substances that may be prescribed to treat Crohn's include:

  • Antibiotics to treat bacterial infections and overgrowth of bacteria in the small intestine; types of antibiotics commonly prescribed include:
    • ampicillin (Omnipen)
    • sulfonamides
    • cephalosporins
    • tetracycline
    • metronidazole (Flagyl)
  • Antidiarrheal agents to stop diarrhea
  • Fluid replacements to counteract dehydration
  • Nutritional supplements to provide the nutrients that may not be absorbing properly

 

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WebMD Medical Reference

Reviewed by David T. Derrer, MD on August 29, 2013

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