Drugs That Calm Crohn's Inflammation

When you have Crohn's disease, you want to prevent flare-ups and keep them away for good.

Inflammation in your intestines causes symptoms like belly pain and diarrhea. Anti-inflammatory drugs ease them and may even keep them away for years. Although they aren't a cure, they can help you feel much better. Your doctor will help you decide which one is best for you.

Steroids

These are one of the oldest treatments for Crohn's disease. Your doctor may suggest one:

  • If your case is mild to moderate
  • If other drugs aren't helping
  • If your symptoms are severe right away

Your doctor may call them corticosteroids, but most people just call them steroids. They're not the same as the drugs you take to build your muscles. 

Most of them will cut inflammation all over your body, not just in your intestines. They work quickly during flare-ups and can ease symptoms for days after you take them.

There are a few different types. Some you take by mouth, and others you get through an IV.

Steroid drugs you take by mouth include:

  • Budesonide (Entocort EC)
  • Prednisone (Prednisone Intensol, Rayos)

Budesonide lowers inflammation only in the intestine when you take it as a capsule. Because it's designed to dissolve in the small intestine, it may cause fewer side effects than other steroids.

If your Crohn's disease is severe, or it's in many parts of your intestines, you may need a higher dose through an IV.

Because they can cause serious side effects, your doctor will keep you on these steroids only as long as it takes to ease your symptoms. You may start on a large dose and then get smaller doses as you feel better.

When you take steroids, you might notice one or more of these side effects:

  • Acne
  • Hair growth on your face
  • Night sweats
  • Swelling of the face (called "moon face")
  • Trouble sleeping
  • Weight gain

More serious side effects include:

  • Cataracts
  • Diabetes
  • Glaucoma
  • High blood pressure
  • Weakened bones and fractures

Because steroids weaken your immune system, they can make you more likely to get an infection. Children who take them for a long time may grow more slowly than normal.

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5-ASA Drugs

There's some question about how effective these drugs are for Crohn's. Your doctor may suggest these if you have mild Crohn's disease in your large intestine (also called the colon). Once your symptoms get better, you may continue to take them to prevent flare-ups.

There are two main 5-ASA drugs used in Crohn’s:

  • Mesalamine (Apriso, Asacol, Delzicol, Lialda, Pentasa)
  • Sulfasalazine (Azulfidine)

The main side effects are:

  • Diarrhea
  • Nausea
  • Stomachache
  • Headache
  • Skin rash

Sulfasalazine can cut sperm counts in men, and it may lower your supply of infection-fighting white blood cells. If you're allergic to sulfa drugs, you may have a reaction to sulfasalazine and shouldn't take it.

If your Crohn's affects the top part of your intestinal tract, you'll probably take these medicines by mouth. If it’s in the lower part, you can take them through your rectum as an enema (when you put liquid into your rectum to help start a bowel movement) or a suppository, a small, round or cone-shaped object you put into your bottom to deliver medicine.

You Have Treatment Options

Crohn's disease drugs aren't one-size-fits-all. If the treatment you're on isn't working, talk to your doctor about other options.

WebMD Medical Reference Reviewed by Neha Pathak, MD on October 08, 2019

Sources

SOURCES:

Crohn's and Colitis Foundation of America: "Crohn's Disease," "Types of Medications," "Crohn's Disease Medication Options," "Corticosteroids," "Aminosalicylates."

UpToDate: "Patient information: Sulfasalazine and the 5-aminosalicylates."

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