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Crohn’s Disease Treatment

Medically reviewed by Asma Khapra, MD, Susan Kerrigan, MD and Marianne Madsen on January 8, 2023

Oh no, not again! You’re out and about somewhere when all of a sudden you feel that all-too-familiar stomach gurgle and flash of pain. You know the ones. When you feel like this you need to drop whatever you’re doing and find a restroom quickly!


If you’ve come across this article, presumably you are well familiar with what Crohn’s disease is and how it negatively affects your day-to-day life. And you might be wondering what you can do about it. While the symptoms can be debilitating, Crohn’s disease can be fairly manageable long term with various treatment options available. 


Medicating Your Crohn’s


Most doctors will tell you that medication is the first line of treatment when getting your Crohn’s under control. If you have between mild to moderate symptoms of Crohn’s Disease, your doctor may prescribe aminosalicylates (5-ASA). They may not be super effective if your Crohn’s is in the small intestines, but they work well in the colon and can help by decreasing inflammation in the lining of your GI tract. Commonly prescribed 5-ASAs are: Sulfasalazine, Mesalamine, Olsalazine, and Balsalazide.

Additional help to calm down your disease may also be needed. In this case, Corticosteroids are given for cases of Crohn’s that are moderate to severe, and can help suppress your immune system. But keep in mind that this form of treatment has negative side effects: instead of only targeting the parts of your immune system that aren’t functioning as they should, it targets the entire immune system. This means that you have to take extra precautions when it comes to potential exposure to infectious diseases, such as during flu season or if you’re around children, you may want to ask your doctor what you can do to boost your immune response. Prednisone and Methylprednisolone are both types of Corticosteroids that may be prescribed, and they are available in both oral and rectal formats. Corticosteroids are only used as a brief treatment and not long term maintenance strategy due to their side effects.


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Crohn's Disease - Medication Options

Crohn's Disease - Medication Options

Have you already been prescribed the first two classes of medications but find that they aren’t effective? Biologics and Immunomodulators are your next option but be aware that they can take a few months to get working, so don’t give up on them so easily. This class of medication suppresses the immune system’s response so that it cannot continue to cause inflammation. Some names you may recognize in this category are: Infliximab, Adalimumab, Certolizumab, Vedolizumab, Ustekinumab, Risankizumab, Azathioprine, 6_mercaptopurine and Cyclosporine. There are many new medications in the pipeline as well.


Does this list seem overwhelming? Don’t despair! Your physician will go over all applicable medication options with you and discuss the positives and side effects of each one. They will then help you figure out the best course of treatment. You don’t have to do this alone.


Recommended Diet For Crohn’s Disease


There are many people who see success in treating their Crohn’s disease via a special diet. The first step in managing your diet is figuring out what, if any, foods seem to trigger symptoms. If you find them on your own, great! If not, your doctor or nutritionist may suggest that you try out the FODMAP diet. This is a rather strict elimination diet that can also be used for other bowel issues such as IBS. The goal of this diet is to reduce the consumption of foods that are not easily digested by the body. Avoiding foods like certain types of cruciferous vegetables (sorry cauliflower and cabbage, you’re off the list!), fermented foods such as kefir and yogurt (now is not the time to be trendy), honey, and certain members of the onion family can help manage symptoms such as gas, bloating, and constipation. Other diets such as the Mediterranean Diet, Autoimmune Protocol Diet, and Specific Carbohydrate Diet have also been suggested as possibly beneficial. However no specific diet has been proven to be successful in alone treating Crohn’s disease.


Other Steps To Treating Crohn’s Disease


If you’re someone who was just diagnosed or the diet hasn’t helped relieve your symptoms, another treatment option in the lineup is a variety of medications. Crohn’s disease is a specific form of inflammatory bowel disease, and as such, anti-inflammatory medications are given to reduce the inflammation that is causing your symptoms. At the same time, you may be prescribed other medications to help control your symptoms better. For instance, you may be recommended acetaminophen for pain, antibiotics if you have an infection, and something shorter term to control diarrhea. These are just a few of the medications that are available to help relieve symptoms, so work with your healthcare provider to find the medications that work best for you.


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Crohn's Disease - OTC Medications

Crohn's Disease - OTC Medications

So you were helped by altering your diet and/or taking medications? Great! But some people are not. Or need additional treatments to help successfully manage their symptoms. 


Next up in line is something called bowel rest. And it is exactly what it sounds like. Your doctor prescribes you a very specific diet to give your overworked bowels a rest, improve your nutrition, and reduce the inflammation in your bowels in a more targeted way. This may be done either at home or in a hospital and may involve either a feeding tube or specific injections. You may also be recommended a low-fiber diet to help control the size of your stools. 


Eventually, you may wind up needing surgery despite previous attempts at intervention. Be aware that surgery will still not cure your Crohn’s disease completely, but instead it gives the surgeon a chance to remove the part of your digestive tract that was damaged and reconnect the healthy ones. You may experience some relief for a limited period of time. 


Crohn’s disease may at first seem like a life sentence. But with a competent medical team, it can be very manageable for the long term. 

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