Crohn’s disease is an inflammatory bowel disease. There is no cure. However, there are many Crohn’s disease treatment options. Patients can pursue these options singly or in combination. And many patients achieve long-term relief and even remission.
What is Crohn’s Disease?
Crohn’s disease causes inflammation of the digestive tract. This can lead to abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition. In some cases, Crohn’s disease centers in the small intestine. In others, the focus is the colon. Sometimes, the inflammation affects the entire digestive tract.
Crohn’s Disease Diagnosis
There is no single Crohn’s disease test. After listening to a patient’s symptoms, a doctor may order further tests. The results of these tests may be used to form a Crohn’s disease diagnosis. First, doctors may perform a colonoscopy to look for inflammation. Next, they may take a biopsy during the colonoscopy. That is, they may remove tiny pieces from your bowel to examine them. They may also perform an MRI (magnetic resonance imaging) or CT (computerized tomography) scan of your bowel.
Crohn’s Disease Treatment
There is no cure for Crohn’s disease, according to the Mayo Clinic. However, different treatments can lessen symptoms for some, even bringing about remission. When it comes to treatment, the goal is the reduction of the inflammation that causes your symptoms. There are three categories of treatment for Crohn’s disease: Crohn’s medications, nutritional therapy, and surgery.
Several different classes of medications are used in Crohn’s disease treatment. There are many sources out there for information on them. We have chosen to draw on the expertise of the world-renowned Mayo Clinic.
Because Crohn’s disease is a disease of inflammation, anti-inflammatory drugs are often the first line of defense. According to the Mayo Clinic, some of the anti-inflammatories that doctors commonly prescribe for Crohn’s disease treatment options include:
Corticosteroids. Corticosteroids are generally for short-term symptom improvement and to induce remission. A doctor may also prescribe corticosteroids in combination with an immune system suppressor. Some corticosteroids include prednisone and (Entocort EC).
Oral 5-aminosalicylates. These drugs include sulfasalazine (Azulfidine) and mesalamine (Asacol HD, Delzicol).
Antibiotics can reduce drainage in people with Crohn’s disease. In addition, they can sometimes heal fistulas and abscesses. Some scientists also believe that antibiotics can help to reduce harmful intestinal bacteria that may lead to inflammation. Some antibiotics that doctors commonly prescribe for Crohn’s disease include ciprofloxacin (Cipro) and metronidazole (Flagyl).
Immune suppressant drugs
The immune system produces substances that cause inflammation. Immunosuppressant drugs target the immune system in order to reduce inflammation. Doctors may prescribe these drugs alone, with other drugs of this class, or with other kinds of Crohn’s medication. Some frequently prescribed immune suppressant drugs for Crohn’s disease treatment options include:
Azathioprine (Azasan, Imuran) and mercaptopurine (Purinethol, Purixan). These are the most widely used immunosuppressants for treatment of inflammatory bowel diseases. Side effects can include lower resistance to infection, liver inflammation, nausea, and vomiting.
Infliximab (Remicade), adalimumab (Humira) and certolizumab pegol (Cimzia). These drugs are TNF inhibitors. They work by neutralizing an immune system protein called Tumor Necrosis Factor (TNF).
Methotrexate (Trexall). Doctors may prescribe Methotrexate for patients who don’t respond well to other medications. Some side effects include digestive symptoms, swelling of the feet or legs, and other symptoms.
Natalizumab (Tysabri) and vedolizumab (Entyvio). These medications work by stopping integrins, a kind of immune cell molecule, from binding to other cells in the intestinal lining. Because of a rare but risk of a fatal brain disease, use of this drug is restricted. Recently, a similar drug, Vedolizumab, received approval for Crohn’s disease. It works in a similar way but appears not to carry a risk of brain disease.
Ustekinumab (Stelara). Stelara is a drug used to treat psoriasis. However, studies have shown that it’s useful in treating Crohn’s disease as well. Doctors may prescribe Stelara when other Crohn’s disease treatments have failed. Stelara side effects may include upper respiratory tract infections, headache, dizziness, fatigue, digestive symptoms, back pain, depression, and more.
Doctors may also recommend one or more of the following over-the-counter remedies.
Fiber Supplements. A fiber supplement, such as psyllium powder (Metamucil) or methylcellulose (Citrucel), can help relieve mild to moderate diarrhea by adding bulk to a patient’s stool.
Anti-diarrheal medication. More severe diarrhea may respond to an anti-diarrheal medication like loperamide (Imodium A-D).
Pain relievers. For mild pain, your doctor may recommend acetaminophen (Tylenol). Other pain relievers, like ibuprofen (Motrin) and naproxen sodium (Aleve) may make your symptoms, and your disease, worse, however.
Iron supplements. Some Crohn’s patients develop iron deficiency anemia due to chronic intestinal bleeding. Iron supplements can help.
Vitamin B-12 shots. Crohn’s disease can also cause vitamin B-12 deficiency. Vitamin B-12 helps prevent anemia and other symptoms.
Calcium and vitamin D supplements. The steroids sometimes used to treat Crohn’s disease can increase a patient’s risk of osteoporosis. Therefore, a doctor might recommend a calcium supplement with vitamin D.
There is no dietary cure for Crohn’s disease. However, the Academy of Nutrition and Dietetics has some recommendations that may help your symptoms. They recommend eating small meals or snacks three to four times per day. In addition, stay hydrated. During symptom-free periods, include whole grains and fruits and vegetables in your diet in small amounts. With that in mind, during flare-ups, avoid high fiber foods, raw and gas-producing vegetables, most raw fruits, and drinks with caffeine. Also, If your doctor or nutritionist gives you a recommended foods list, be sure to follow it. Additionally, Healthline has a guide to Crohn’s friendly foods, as well as foods you may wish to avoid.
About 70 percent of people who receive a Crohn’s disease diagnosis will have surgery within 10 years of that diagnosis. There are different kinds of Crohn’s surgeries. The most common one, however, is to remove a section of bowel that has become too inflamed or too narrow. Many patients have multiple surgeries. Surgery is just one of the Crohn’s disease treatment options, but for many, it becomes necessary.
Crohn’s Disease Life Expectancy and Prognosis
The bad news is, Crohn’s disease is a chronic, lifelong condition. The good news is, Crohn’s disease does not affect a person’s life expectancy. It is not a fatal condition. In addition, many patients are able to control their symptoms with one or more of the therapies mentioned above.
It’s important to note, the word prognosis means the way a condition may change over time. The course of the disease may vary tremendously from person to person. As a result, the prognosis for Crohn’s disease is variable. It will be different based on how the disease changes over time and how it responds to the Crohn’s disease treatment options, whether medications or surgery. In addition, the severity of the disease will vary from person to person. And it may vary over time, becoming worse, especially if it isn’t treated adequately. Many Crohn’s sufferers will have multiple flare-ups and periods of remission.
A Crohn’s disease diagnosis can be a life-changing event. However, there are many options for treatment for Crohn’s disease. And, with proper treatment, or combinations of treatment, Crohn’s sufferers can live a long and satisfying life.