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Crohn’s Disease Medication Options

Successful medical treatment accomplishes two important goals: it allows the intestinal tissue to heal and it also relieves the symptoms of fever, diarrhea, and abdominal pain.

Once the symptoms are brought under control (this is known as inducing remission), medical therapy is used to decrease the frequency of disease flares (this is known as maintaining remission, or maintenance).

Several groups of drugs to treat Crohn’s disease today. They are:

Aminosalicylates (5-ASA)

These include medicationsthat contain 5-aminosalicylate acid (5-ASA).Examples are sulfasalazine, mesalamine,olsalazine, and balsalazide.These drugs arenot specially approved by the Food and DrugAdministration (FDA) for use in Crohn’s. However,they can work at the level of the liningof the GI tract to decrease inflammation.They are thought to be effective in treatingmild-to-moderate episodes of Crohn’s diseaseand useful as a maintenance treatmentin preventing relapses of the disease. Theywork best in the colon and are not particularlyeffective if the disease is limited to thesmall intestine.

Corticosteroids

Prednisone and methylprednisolone are available orally and rectally. Corticosteroids nonspecifically suppress the immune system and are used to treat moderate to severely active Crohn’s disease. (By “nonspecifically,” we mean that these drugs do not target specific parts of the immune system that play a role in inflammation, but rather, that they suppress the entire immune response.) These drugs have significant short- and long-term side effects and should not be used as a maintenance medication. If you cannot come off steroids without suffering a relapse of your symptoms, your doctor may need to add some other medications to help manage your disease.

Immunomodulators

This class of medicationsmodulates or suppresses the body’s immunesystem response so it cannot cause ongoinginflammation. Immunomodulators generallyare used in people for whom aminosalicylatesand corticosteroids haven’t been effective orhave been only partially effective. They maybe useful in reducing or eliminating the needfor corticosteroids. They also may be effectivein maintaining remission in people whohaven’t responded to other medicationsgiven for this purpose. Immunomodulatorsmay take several months to begin working.

Antibiotics

Antibiotics may be used wheninfections—such as abscesses—occur inCrohn’s disease. They can also be helpful with fistulas around the anal canal and vagina.Antibiotics used to treat bacterial infection in the GI tract include metronidazole, ampicillin, ciprofloxacin, others.

Biologic Therapies

Also known as anti-TNFagents, these represent the latest class oftherapy used for people suffering from moderate-to-severe Crohn’s disease. Tumornecrosis factor (TNF) is a chemical producedby our bodies to cause inflammation. Antibodiesare proteins produced to attach tothese chemicals and allow the body to destroythe chemical and reduce the inflammation.

 

Source: http://www.ccfa.org

Crohn’s Treatment Options

A combination of treatment options can help you stay in control of your disease andhelp you to leada full and rewarding life. Remember that there is no standard treatment that will work for all patients. Each patient’s situation is different and treatment must be followed for each circumstance.

Treatment for Crohn’s and other IBD varieties can include the use of medication, alterations in diet and nutrition, and sometimes surgical procedures to repair or remove affected portions of your GI tract.

Medication

Medication treating Crohn’s disease is designed to suppress your immune system’s abnormal inflammatory response that is causing your symptoms. Suppressing inflammation not only offers relief from common symptoms like fever, diarrhea, and pain, it also allows your intestinal tissues to heal.

In addition to controlling and suppressing symptoms (inducing remission), medication can also be used to decrease the frequency of symptom flare ups (maintaining remission). With proper treatment over time, periods of remission can be extended and periods of symptom flare ups can be reduced.

Several types of medication are being used to treat Crohn’s disease today. Read more about Crohn’s disease Medication.

Diet & Nutrition

While Crohn’s Disease may not be the result of bad reactions to specific foods, paying special attention to your diet may help reduce symptoms, replace lost nutrients, and promote healing.

For people diagnosed with Crohn’s disease, it is essential to maintain good nutrition because Crohn’s often reduces your appetite while increasing your body’s energy needs. Additionally, common Crohn’s symptoms like diarrhea can reduce your body’s ability to absorb protein, fat, carbohydrates, as well as water, vitamins, and minerals.

Many people who experience Crohn’s disease flare ups find that soft, bland foods cause less discomfort than spicy or high-fiber foods. While your diet can remain flexible and should include a variety of foods from all food groups, your doctor will likely recommend restricting your intake of dairy if you are found to be lactose-intolerant.

Surgery

Even with proper medication and diet, as many as two-thirds to three-quarters of people with Crohn’s disease will require surgery at some point during their lives. While surgery does not cure Crohn’s disease, it can conserve portions of your GI tract and return you to the best possible quality of life.

Surgery becomes necessary when medications can no longer control symptoms, or if you develop a fistula, fissure, or intestinal obstruction. Surgery often involves removal of the diseased segment of bowel (resection), the two ends of healthy bowel are then joined together (anastomosis). While these procedures may cause your symptoms to disappear for many years, Crohn’s frequently recurs later in life.

Key things to know about Surgery:

• About 70% of people with Crohn’s disease eventually require surgery.
• Different types of procedures may be performed depending on the reason, severity of illness, and location of the disease.
• Unlike ulcerative colitis, surgery does not cure Crohn’s disease.
• Approximately 30% of patients who have surgery for Crohn’s disease experience recurrence of their symptoms within three years and up to 60% will have recurrence within ten years.

Source: http://www.ccfa.org

Crohn’s Diagnosis & Testing

Crohn’s disease is characterized by a range of signs and symptoms, so there is no single test that can determine the diagnosis of Crohn’s with certainty.

The symptoms of Crohn’s disease are often similar to other conditions, including bacterial infection. To diagnose you with Crohn’s,doctors need to evaluate a combination of information and begin to exclude other potential causes of your symptoms. This process can take some time. Should you or a loved one experience symptoms, be sure to see your doctor as soon as possible.

Early Tests and Exams

First, your doctor will conduct a standard physical exam of your body and interview you to learn more about your general health, diet, family history, and environment. Bring a record of your symptoms.

Early steps in the diagnostic process can include laboratory tests of blood and stool matter, as well as X-rays of the upper and lower GI tract including the use of Barium, a chemical that helps doctors see more details of your GI tract by increasing contrast of the X-Ray image.

Endoscopy and Biopsy

Your doctor may recommend an endoscopy, which is the use of medical instruments to visually examine the interior of your colon with a small camera mounted to the end of a lighted tube. There are two types of endoscopic examinations: a colonoscopy and an upper endoscopy.

• Colonoscopy involves insertion of a flexible tube through the opening of the anus and allows for the examination of the colon, the lowest part of the large intestine.
• Upper Endoscopy involves the insertion of a flexible tube through the opening of the mouth, down the esophagus, into the stomach, and as far as the duodenum, the first part of the small intestine.

In addition to a visual examination, doctors will often wish to obtain a biopsy of the colon or other affected areas by removing a small piece of tissue. Biopsied tissues are then analyzed in pathology to determine the presence of disease.

While endoscopy and biopsy may sound invasive, modern medical technology and techniques have made these procedures virtually painless and easily accomplished during an outpatient visit.

Source: http://www.ccfa.org/

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