Crohns disease treatment
Treatment for Crohn's disease depends on the location and severity of disease, complications, and the person's response to previous medical treatments when treated for re-occurring symptoms. Treatment can help control the disease by decreasing recurrence of GI tract inflammation, but there is currently no cure for this chronic illness. In general, goals of treatment are to:
Help reduce inflammation in the digestive system
Help relieve symptoms such as abdominal pain, diarrhea, and rectal bleeding
A person diagnosed with Crohn's disease may need medical care for a long time, with regular doctor visits to monitor the condition. Some people experience long periods of remission, sometimes years, when they are free of symptoms. However, Crohn's disease usually recurs at various times over a lifetime. The changing pattern of the disease makes it difficult to assess which treatments have helped, or not. Treatment options for Crohn's may include drugs, nutrition supplements, surgery, or a combination of these options.
It is very important that people diagnosed with Crohn's disease follow a nutritious diet and avoid any foods that seem to worsen symptoms. Although no foods are known to cause injury or inflammation to the bowel, hot spices, alcohol, greasy foods, and dairy products can make diarrhea and abdominal pain worse.
People with Crohn's disease often experience a decrease in appetite, which can affect their ability to receive the daily nutrition needed for good health and healing. This is why your doctor may start you on a special diet so you get extra nutrients and to correct nutritional problems. Your doctor might recommend iron supplements or Vitamin B-12 shots, for example.
High-calorie liquid supplements may be prescribed to give you extra calories and right amount of vitamins and minerals to keep you healthy. A small number of people may need to be fed intravenously for a brief time through an IV infusion. This procedure can help patients who need extra nutrition temporarily, those whose intestines need to rest, or those whose intestines cannot absorb enough nutrition from food.
The goal for using pharmaceutical drugs is to avoid long-term steroid use, to get you better, and keep you better. The following list outlines the general classes of medicines that doctors use to treat Crohn's Disease.
Antibiotics - Antibiotics treat bacterial overgrowth in the small intestine caused by stricture, fistulas, or prior surgery. Your doctor may prescribe one or more of the following antibiotics (if you are not allergic to them):
Anti-diarrheal drugs. Diarrhea and abdominal pain are often relieved when the inflammation subsides, but additional medication may also be necessary. Several anti-diarrhea agents may be prescribed, including fluid replacements. Patients who are dehydrated because of diarrhea will be treated with fluids and electrolytes (oral rehydration solutions).
Anti-inflammatory drugs - The doctor may first treat your Crohn's disease with anti-inflammatory drugs. These drugs help stop inflammation and help relieve the pain and diarrhea. Sometimes these drugs cause side effects, so you should talk with your doctor about what to expect. Your doctor may also prescribe very strong drugs that need to be given by an injection in the vein which can include:
- Adalimumab (Humira)
- Infliximab (Remicade)
Immune modifiers - This type of drugs, sometimes called immunomodulators, are used to help decrease corticosteroid dosage and also to help heal fistulas. In addition, immune modifiers can help maintain disease remission.
Immune system suppressors - Immune system suppressors work by keeping your body from attacking itself. Side effects to these types of drugs exist, so ask your doctor for more information.
Laxatives - If swelling causes the intestines to narrow, you might become constipated. Talk to your doctor before taking any laxatives, because even those sold over-the-counter may be too harsh for your GI system.
Pain relievers - For mild pain, your doctor may recommend acetaminophen or paracetamol (Tylenol, others). Don't use nonsteroidal anti-inflammatory drugs (NSAIDs), such as acetylsalicylic acid (Aspirin, others), ibuprofen (Advil, Motrin, others) or naproxen (Aleve). These types of drugs can make symptoms worse and provoke GI bleeding.
Steroids - Your doctor may also treat you with corticosteroids made from natural chemicals in the body. Steroids such as cortisone are used only for a short time because long-term exposure is not good for a person.
Some people with Crohn's disease may need surgery to treat blockage, fistulas, infection, and bleeding, when medicines no longer work. Surgery usually does not make a person disease-free forever. Sometimes people require several surgeries to treat recurring inflammation and symptoms. Know what to expect from surgery and work with your doctor to decide which medications might work best afterwards, to try to prevent disease recurrence.
Colectomy - People who have Crohn's disease involving all or part of the large intestine may need to have their entire colon removed in an operation called a colectomy.
Intestine removal - The most common surgery for Crohn's disease is removing only the diseased section of intestine. In this operation, after the diseased piece of the intestine is cut out, both healthy ends of the intestine are sewn back together during a procedure called anastomosis.
Stoma - On rare occasions, a surgeon creates an outlet on the skin, when intestinal sections cannot be bound together. To create a stoma, an end of the bowel is brought out through a small opening made on the lower abdominal wall. The stoma is about the size of a quarter and can be either temporary or permanent. A small bag is worn over the opening, to collect waste, and the person empties the bag as needed.
People with Crohn's disease may feel well and be symptom-free for a long time. They may need to take drugs for long periods of time, but most are able to hold jobs, raise families, and live fulfilling lives.