There is currently no cure for Crohn's disease, and there is no treatment that works for everyone.
The purpose of medical treatment is to reduce the inflammation that triggers your symptoms. It is also to improve the long-term prognosis by limiting complications. In the best case, it can lead not only to relieve symptoms but also long-term remission. The treatment of Crohn's disease usually involves drug therapy or, in some cases, surgery.
Anti-inflammatory
Anti-inflammatory medications are often the first step in the treatment of inflammatory bowel disease. These include:
Sulfasalazine (Azulfidine). Although this drug is not always effective in the treatment of Crohn's disease, may be useful in Crohn's disease, which affects the colon. Has several side effects such as nausea, vomiting, heartburn and headaches. Do not take this medication if you are allergic to drugs.
Mesalamine (Asacol, Rowasa). This drug is less likely to cause side effects of sulfasalazine, but the possible side effects include nausea, vomiting, heartburn, diarrhea and headache. You take in pill form, or use it rectally in the form of enema or suppository, depending on what part of your colon affected. This medication is usually ineffective in disease involving the small intestine.
Corticosteroids. Corticosteroids may help reduce inflammation in your body, but also have many side effects such as swelling of the face, excess facial hair, night sweats, insomnia and hyperactivity. The most serious side effects, high blood pressure, diabetes, osteoporosis, bone fractures, cataracts, glaucoma and increased susceptibility to infections. Prolonged use of corticosteroids in children can lead to stunted growth.
In addition, these drugs do not work for everyone with Crohn's disease. Doctors generally use corticosteroids only if you have moderate to severe inflammatory bowel disease unresponsive to other treatments. A new type of corticosteroid, budesonide (Entocort EC), does not work faster than traditional steroids and appears to produce fewer side effects. Entocort EC is only effective in Crohn's disease, where the small intestine and the first part of the colon.
Corticosteroids are not suitable for long-term use. But they can be used in the short term (3-4 months), improvement in symptoms and lead to remission. Corticosteroids may also be used as a suppressor of the immune system - corticosteroids may lead to remission when the suppressors of the immune system may help maintain remission.
Suppressors of the immune system
These drugs also reduce inflammation, but that attack the immune system rather than directly treating the inflammation. By suppressing the immune response, inflammation is reduced. Sometimes these medications are used in combination. For example, a combination of azathioprine and infliximab has been shown to work better than either drug alone in some people. Immunosuppressants are:
Azathioprine (Imuran) and mercaptopurine (Purinethol). These are the most commonly used immunosuppressants for the treatment of inflammatory bowel disease. If you are taking any of these drugs will have to follow very closely with your doctor and regular blood tests to look for side effects such as lowered resistance to infection. These drugs can also cause nausea and vomiting.
Infliximab (Remicade). This product is intended for adults and children with moderate to severe Crohn's disease. Can be used as soon as possible after diagnosis, especially if the doctor suspects that you are likely to be more severe Crohn's disease, or if you have an ostomy. It 'also used when other medicines have failed. It can be combined with an immunosuppressant in some people, but this practice is somewhat controversial. Infliximab is produced to counteract the immune system proteins known as tumor necrosis factor (TNF). Infliximab finds TNF in the blood and removes it before it causes inflammation in your gut.
Some people with heart failure, people with multiple sclerosis and those with cancer or a history of cancer can not take infliximab or other members of this class (adalimumab and certolizumab pegol). Talk to your doctor about potential risks to infliximab. Tuberculosis and other serious infections have been associated with the use of immunosuppressive drugs. If you have an active infection, do not take these drugs. You must have a TB skin test, chest X-ray and a test for hepatitis B before taking infliximab.
Adalimumab (Humira). Adalimumab works similarly to infliximab in blocking TNF for people with moderate to severe Crohn's disease. It can be used quickly after you are diagnosed, if you have a fistula, or if you have more severe disease Crohn's. It can also be used after other drugs fail to improve your symptoms. Adalimumab can be used instead of infliximab and certolizumab certoluzimab, or it can be used if infliximab and certolizumab certoluzimab stop working. Adalimumab may reduce the signs and symptoms of Crohn's disease and can lead to remission.
However, adalimumab, such as infliximab, is a small risk of infections, including tuberculosis and serious fungal infections. You must have a TB skin test, chest X-ray and a test for hepatitis B before taking infliximab. The most common side effects of adalimumab is a skin irritation and pain at the injection site, respiratory tract infection, nausea, runny nose, and upper.
Certolizumab pegol (Cimzia). Approved by the Food and Drug Administration (FDA) for treatment of Crohn's disease, certolizumab pegol works by inhibiting the TNF. Certolizumab pegol is prescribed for people with moderate to severe disease Crohn's disease. Certolizumab pegol may be used in place of infliximab or adalimumab, or infliximab can be used if you stop working or adalimumab. Common side effects include headache, upper respiratory tract infections, abdominal pain, nausea and reactions at the site. Like other drugs that inhibit TNF, since this drug affects the immune system, which are also at risk of becoming seriously ill with certain infections such as tuberculosis. You must have a tuberculin test, chest X-ray and a test for hepatitis B before starting certolizumab pegol.
Methotrexate (Rheumatrex). This drug used to treat cancer, psoriasis and rheumatoid arthritis are sometimes used for people with Crohn's disease who do not respond well to other medicines. Short-term side effects include nausea, fatigue and diarrhea, and rarely can cause potentially fatal pneumonia. Prolonged use can lead to cirrhosis and sometimes cancer. Avoid becoming pregnant while taking methotrexate. If you are taking this medication, carefully follow up with your doctor and regular blood tests to look for side effects.
Cyclosporine (Gengraf, Neoral, Sandimmune). It is a powerful drug often used to improve related Crohn's fistulas, is normally reserved for those who have not occurred in any other medicine. Cyclosporine causes serious side effects such as damage to the kidneys and liver, seizures, and fatal infections. This drug is not a long-term use.
Natalizumab (Tysabri). This drug works by blocking certain immune system cells, molecules - integrins - binding to other cells of the intestinal mucosa. Blocking these molecules is thought to reduce the chronic inflammation that occurs when they engage their intestinal cells. Natalizumab was approved for people with moderate to severe Crohn's disease with evidence of inflammation, and that do not match well with other conventional treatments for Crohn's disease, including anti-TNF agents and immunomodulators. Because the drug linked to rare but severe multifocal leukoencephalopathy - a brain infection that usually leads to death or severe disability - you must be enrolled in a special restricted distribution program to use it.
Drugs and cancer risk
Suppressor of the immune system are also associated with a lower risk of developing cancers such as lymphoma. These include azathioprine, mercaptopurine, methotrexate, infliximab, adalimumab, certolizumab pegol, and others. The risk may be due to the suppression of the immune system, these drugs cause. Although these drugs do not increase the risk, they may be needed for people with Crohn's disease to improve the quality of life and avoid surgery or hospitalization. Work with your doctor to determine which medications are right for you.
Antibiotics
Antibiotics can reduce the drying process and, sometimes, to heal fistulas and abscesses in people with Crohn's disease. The researchers also believe antibiotics help reduce harmful intestinal bacteria and to suppress the intestinal immune system, which can trigger symptoms. However, there is strong evidence that antibiotics are effective in Crohn's disease. Antibiotics are frequently prescribed:
Metronidazole (Flagyl). Once the most commonly used antibiotics for Crohn's disease, metronidazole can cause serious side effects include numbness and tingling in hands and feet and sometimes pain or weakness. If these effects occur, stop the medication and call your doctor.
Ciprofloxacin (Cipro). This substance, which improves symptoms in some people with Crohn's disease is now generally preferred to metronidazole. A rare side effect of this drug is a tendon rupture.
Other drugs
In addition to controlling inflammation, some medications may help relieve your signs and symptoms. Depending on the severity of Crohn's disease, your doctor may recommend one or more of the following:
Diarrhea. A fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel) can help relieve mild to moderate diarrhea by adding bulk to the stool. For more severe diarrhea, loperamide (Imodium) can be effective. Use of antidiarrheals with caution and only after consulting your doctor.
Laxatives. In some cases, get the swelling to shrink your gut, leading to constipation. Talk to your doctor before taking any laxatives, because even those sold without a prescription may be too harsh for your system.
Analgesics. For mild pain, your doctor may recommend acetaminophen (Tylenol, others). Avoid aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve). These are likely to worsen the symptoms.
Iron supplements. If you have chronic intestinal bleeding, you may develop iron deficiency anemia. Taking iron supplements can help restore your iron levels to normal and reduce this type of anemia once your bleeding has stopped or reduced.
Nutrition. Your doctor may recommend a special diet given through a feeding tube (enteral nutrition) or nutrients into a vein (parenteral) in the treatment of Crohn's disease. This can improve the overall nutrition and provide bowel rest. Bowel rest can reduce inflammation in the short term. However, when regular feeding is resumed, the symptoms may return. The medical nutrition therapy can be short term, and combine it with other drugs, such as immune system suppressants. Parenteral and enteral nutrition is generally used to make people healthy, surgery, or when other medications have no symptoms. The doctor may also recommend low-residue diet low in fiber or if you have a small bowel (stricture) to try to reduce the risk of thrombosis. Low-residue diet is one that is designed to reduce the size and number of stools.
Vitamin B12 shots. Vitamin B12 helps prevent anemia, promotes normal growth and development, and it is important for proper nerve function. And 'absorbed the terminal ileum, which is part of the small intestine is often affected by Crohn's disease. If the inflammation of the ileum phone interferes with the ability to absorb this vitamin, you may need monthly B-12 shots for life. You will also need lifelong B-12 injections if the ileum phone was removed during surgery.
Calcium and vitamin D. You may need to take a calcium supplement with vitamin D. As added Crohn's disease and steroids to treat may increase your risk of osteoporosis. Ask your doctor if a calcium supplement is right for you.
Future drugs
New drugs are in development and in clinical trials. If your Crohn's disease is not well controlled with current medications, ask your doctor if there are clinical trials available to you.
Surgery
If changes in diet and lifestyle, medications or other treatments do not relieve the signs and symptoms, your doctor may recommend surgery.
During surgery, the surgeon removes a damaged portion of your digestive tract and restores the healthy sections. In addition, surgery can also be used to close fistulas and abscess drainage. A common procedure for Crohn's disease is strictureplasty, which expands a segment of bowel that has become too narrow.
The benefits of surgery for Crohn's disease is usually temporary. The disease often returns, often near the reconnected tissue or elsewhere in the digestive tract. Up to 3 to 4 people with Crohn's disease eventually need some form of surgery. Many will also have a second procedure or more. The best approach is to follow surgery with medication to minimize the risk of recurrence.
Cancer control
Screening for colon cancer may be more frequent, because people who have Crohn's disease, which affects the colon are at increased risk of colon cancer. General guidelines for screening colorectal cancer call for a colonoscopy every 10 years from 50 years. Ask your doctor whether you should have this test done before and with greater frequency.
The purpose of medical treatment is to reduce the inflammation that triggers your symptoms. It is also to improve the long-term prognosis by limiting complications. In the best case, it can lead not only to relieve symptoms but also long-term remission. The treatment of Crohn's disease usually involves drug therapy or, in some cases, surgery.
Anti-inflammatory
Anti-inflammatory medications are often the first step in the treatment of inflammatory bowel disease. These include:
Sulfasalazine (Azulfidine). Although this drug is not always effective in the treatment of Crohn's disease, may be useful in Crohn's disease, which affects the colon. Has several side effects such as nausea, vomiting, heartburn and headaches. Do not take this medication if you are allergic to drugs.
Mesalamine (Asacol, Rowasa). This drug is less likely to cause side effects of sulfasalazine, but the possible side effects include nausea, vomiting, heartburn, diarrhea and headache. You take in pill form, or use it rectally in the form of enema or suppository, depending on what part of your colon affected. This medication is usually ineffective in disease involving the small intestine.
Corticosteroids. Corticosteroids may help reduce inflammation in your body, but also have many side effects such as swelling of the face, excess facial hair, night sweats, insomnia and hyperactivity. The most serious side effects, high blood pressure, diabetes, osteoporosis, bone fractures, cataracts, glaucoma and increased susceptibility to infections. Prolonged use of corticosteroids in children can lead to stunted growth.
In addition, these drugs do not work for everyone with Crohn's disease. Doctors generally use corticosteroids only if you have moderate to severe inflammatory bowel disease unresponsive to other treatments. A new type of corticosteroid, budesonide (Entocort EC), does not work faster than traditional steroids and appears to produce fewer side effects. Entocort EC is only effective in Crohn's disease, where the small intestine and the first part of the colon.
Corticosteroids are not suitable for long-term use. But they can be used in the short term (3-4 months), improvement in symptoms and lead to remission. Corticosteroids may also be used as a suppressor of the immune system - corticosteroids may lead to remission when the suppressors of the immune system may help maintain remission.
Suppressors of the immune system
These drugs also reduce inflammation, but that attack the immune system rather than directly treating the inflammation. By suppressing the immune response, inflammation is reduced. Sometimes these medications are used in combination. For example, a combination of azathioprine and infliximab has been shown to work better than either drug alone in some people. Immunosuppressants are:
Azathioprine (Imuran) and mercaptopurine (Purinethol). These are the most commonly used immunosuppressants for the treatment of inflammatory bowel disease. If you are taking any of these drugs will have to follow very closely with your doctor and regular blood tests to look for side effects such as lowered resistance to infection. These drugs can also cause nausea and vomiting.
Infliximab (Remicade). This product is intended for adults and children with moderate to severe Crohn's disease. Can be used as soon as possible after diagnosis, especially if the doctor suspects that you are likely to be more severe Crohn's disease, or if you have an ostomy. It 'also used when other medicines have failed. It can be combined with an immunosuppressant in some people, but this practice is somewhat controversial. Infliximab is produced to counteract the immune system proteins known as tumor necrosis factor (TNF). Infliximab finds TNF in the blood and removes it before it causes inflammation in your gut.
Some people with heart failure, people with multiple sclerosis and those with cancer or a history of cancer can not take infliximab or other members of this class (adalimumab and certolizumab pegol). Talk to your doctor about potential risks to infliximab. Tuberculosis and other serious infections have been associated with the use of immunosuppressive drugs. If you have an active infection, do not take these drugs. You must have a TB skin test, chest X-ray and a test for hepatitis B before taking infliximab.
Adalimumab (Humira). Adalimumab works similarly to infliximab in blocking TNF for people with moderate to severe Crohn's disease. It can be used quickly after you are diagnosed, if you have a fistula, or if you have more severe disease Crohn's. It can also be used after other drugs fail to improve your symptoms. Adalimumab can be used instead of infliximab and certolizumab certoluzimab, or it can be used if infliximab and certolizumab certoluzimab stop working. Adalimumab may reduce the signs and symptoms of Crohn's disease and can lead to remission.
However, adalimumab, such as infliximab, is a small risk of infections, including tuberculosis and serious fungal infections. You must have a TB skin test, chest X-ray and a test for hepatitis B before taking infliximab. The most common side effects of adalimumab is a skin irritation and pain at the injection site, respiratory tract infection, nausea, runny nose, and upper.
Certolizumab pegol (Cimzia). Approved by the Food and Drug Administration (FDA) for treatment of Crohn's disease, certolizumab pegol works by inhibiting the TNF. Certolizumab pegol is prescribed for people with moderate to severe disease Crohn's disease. Certolizumab pegol may be used in place of infliximab or adalimumab, or infliximab can be used if you stop working or adalimumab. Common side effects include headache, upper respiratory tract infections, abdominal pain, nausea and reactions at the site. Like other drugs that inhibit TNF, since this drug affects the immune system, which are also at risk of becoming seriously ill with certain infections such as tuberculosis. You must have a tuberculin test, chest X-ray and a test for hepatitis B before starting certolizumab pegol.
Methotrexate (Rheumatrex). This drug used to treat cancer, psoriasis and rheumatoid arthritis are sometimes used for people with Crohn's disease who do not respond well to other medicines. Short-term side effects include nausea, fatigue and diarrhea, and rarely can cause potentially fatal pneumonia. Prolonged use can lead to cirrhosis and sometimes cancer. Avoid becoming pregnant while taking methotrexate. If you are taking this medication, carefully follow up with your doctor and regular blood tests to look for side effects.
Cyclosporine (Gengraf, Neoral, Sandimmune). It is a powerful drug often used to improve related Crohn's fistulas, is normally reserved for those who have not occurred in any other medicine. Cyclosporine causes serious side effects such as damage to the kidneys and liver, seizures, and fatal infections. This drug is not a long-term use.
Natalizumab (Tysabri). This drug works by blocking certain immune system cells, molecules - integrins - binding to other cells of the intestinal mucosa. Blocking these molecules is thought to reduce the chronic inflammation that occurs when they engage their intestinal cells. Natalizumab was approved for people with moderate to severe Crohn's disease with evidence of inflammation, and that do not match well with other conventional treatments for Crohn's disease, including anti-TNF agents and immunomodulators. Because the drug linked to rare but severe multifocal leukoencephalopathy - a brain infection that usually leads to death or severe disability - you must be enrolled in a special restricted distribution program to use it.
Drugs and cancer risk
Suppressor of the immune system are also associated with a lower risk of developing cancers such as lymphoma. These include azathioprine, mercaptopurine, methotrexate, infliximab, adalimumab, certolizumab pegol, and others. The risk may be due to the suppression of the immune system, these drugs cause. Although these drugs do not increase the risk, they may be needed for people with Crohn's disease to improve the quality of life and avoid surgery or hospitalization. Work with your doctor to determine which medications are right for you.
Antibiotics
Antibiotics can reduce the drying process and, sometimes, to heal fistulas and abscesses in people with Crohn's disease. The researchers also believe antibiotics help reduce harmful intestinal bacteria and to suppress the intestinal immune system, which can trigger symptoms. However, there is strong evidence that antibiotics are effective in Crohn's disease. Antibiotics are frequently prescribed:
Metronidazole (Flagyl). Once the most commonly used antibiotics for Crohn's disease, metronidazole can cause serious side effects include numbness and tingling in hands and feet and sometimes pain or weakness. If these effects occur, stop the medication and call your doctor.
Ciprofloxacin (Cipro). This substance, which improves symptoms in some people with Crohn's disease is now generally preferred to metronidazole. A rare side effect of this drug is a tendon rupture.
Other drugs
In addition to controlling inflammation, some medications may help relieve your signs and symptoms. Depending on the severity of Crohn's disease, your doctor may recommend one or more of the following:
Diarrhea. A fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel) can help relieve mild to moderate diarrhea by adding bulk to the stool. For more severe diarrhea, loperamide (Imodium) can be effective. Use of antidiarrheals with caution and only after consulting your doctor.
Laxatives. In some cases, get the swelling to shrink your gut, leading to constipation. Talk to your doctor before taking any laxatives, because even those sold without a prescription may be too harsh for your system.
Analgesics. For mild pain, your doctor may recommend acetaminophen (Tylenol, others). Avoid aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve). These are likely to worsen the symptoms.
Iron supplements. If you have chronic intestinal bleeding, you may develop iron deficiency anemia. Taking iron supplements can help restore your iron levels to normal and reduce this type of anemia once your bleeding has stopped or reduced.
Nutrition. Your doctor may recommend a special diet given through a feeding tube (enteral nutrition) or nutrients into a vein (parenteral) in the treatment of Crohn's disease. This can improve the overall nutrition and provide bowel rest. Bowel rest can reduce inflammation in the short term. However, when regular feeding is resumed, the symptoms may return. The medical nutrition therapy can be short term, and combine it with other drugs, such as immune system suppressants. Parenteral and enteral nutrition is generally used to make people healthy, surgery, or when other medications have no symptoms. The doctor may also recommend low-residue diet low in fiber or if you have a small bowel (stricture) to try to reduce the risk of thrombosis. Low-residue diet is one that is designed to reduce the size and number of stools.
Vitamin B12 shots. Vitamin B12 helps prevent anemia, promotes normal growth and development, and it is important for proper nerve function. And 'absorbed the terminal ileum, which is part of the small intestine is often affected by Crohn's disease. If the inflammation of the ileum phone interferes with the ability to absorb this vitamin, you may need monthly B-12 shots for life. You will also need lifelong B-12 injections if the ileum phone was removed during surgery.
Calcium and vitamin D. You may need to take a calcium supplement with vitamin D. As added Crohn's disease and steroids to treat may increase your risk of osteoporosis. Ask your doctor if a calcium supplement is right for you.
Future drugs
New drugs are in development and in clinical trials. If your Crohn's disease is not well controlled with current medications, ask your doctor if there are clinical trials available to you.
Surgery
If changes in diet and lifestyle, medications or other treatments do not relieve the signs and symptoms, your doctor may recommend surgery.
During surgery, the surgeon removes a damaged portion of your digestive tract and restores the healthy sections. In addition, surgery can also be used to close fistulas and abscess drainage. A common procedure for Crohn's disease is strictureplasty, which expands a segment of bowel that has become too narrow.
The benefits of surgery for Crohn's disease is usually temporary. The disease often returns, often near the reconnected tissue or elsewhere in the digestive tract. Up to 3 to 4 people with Crohn's disease eventually need some form of surgery. Many will also have a second procedure or more. The best approach is to follow surgery with medication to minimize the risk of recurrence.
Cancer control
Screening for colon cancer may be more frequent, because people who have Crohn's disease, which affects the colon are at increased risk of colon cancer. General guidelines for screening colorectal cancer call for a colonoscopy every 10 years from 50 years. Ask your doctor whether you should have this test done before and with greater frequency.
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