While there is no cure for Crohn’s disease, several treatments can help to reduce symptoms and increase the possibility of long-term remission. Treatment for Crohn’s disease is individualized, depending on each patient’s symptoms and the areas of the digestive tract and/or other parts of the body affected.
Treatments for Crohn’s disease may include anti-inflammatory drugs, immune system suppressors, antibiotics, pain relievers, anti-diarrheal medications, iron supplementation, Vitamin B12 injections, calcium and Vitamin D supplements, nutritional therapy, and surgery.
Anti-inflammatory drugs – Anti-inflammatory drugs are often the first-line treatment for Crohn’s disease and include corticosteroids, such as prednisone and budesonide (Entocort EC), which can reduce inflammation and induce remission, and oral 5-aminosalicylates, such as sulfasalazine (Azulfidine) and mesalamine (Asacol HD, Delzicol, and others).
Immune system suppressors – Immune system suppressors can reduce inflammation by targeting the immune system, are often used in combination, and include azathioprine (Azasan, Imuran), mercaptopurine (Purinethol, Purixan), infliximab (Remicade), adalimumab (Humira), certolizumab pegol (Cimzia), methotrexate (Trexall), natalizumabe (Tysabri), vedolizumab (Entyvio), and ustekinumab (Stelara).
Antibiotics – Antibiotics can help to heal abscesses and fistulas (abnormal openings) caused by Crohn’s disease and include ciprofloxacin (Cipro) and metronidazole (Flagyl).
Pain relievers – Acetaminophen (Tylenol) may be prescribed for mild pain caused by Crohn’s disease; however, other pain relievers, such as ibuprofen (Advil, Motrin) and naproxen sodium (Aleve), must be avoided as they can worsen the disease.
Anti-diarrheal drugs– Fiber-based supplements, such as psyllium powder (Metamucil) or methylcellulose (Citrucel), can help relieve mild diarrhea associated with Crohn’s disease. Loperamide (Imodium A-D) may be recommended for more severe diarrhea and should be used with caution under the care of a doctor.
Iron supplements, Vitamin B injections, Calcium and Vitamin D supplements – Iron supplements may be prescribed for anemia related to Crohn’s disease, while Vitamin B12 shots may be necessary to counteract Vitamin B12 deficiency caused by Crohn’s disease. Calcium and Vitamin D supplements may be also be necessary to decrease the risk of osteoporosis associated with Crohn’s disease and its treatment.
Nutrition therapy – Some patients with Crohn’s disease may need a special diet which is temporarily administered through a feeding tube (enteral nutrition) to allow the bowel to rest and to reduce inflammation. A low-fiber diet may also be prescribed to reduce the risk of bowel obstruction.
Surgery – More than half of patients with Crohn’s disease may require surgery to remove damaged areas of the digestive tract, or to drain abscesses or repair fistulas (abnormal openings). Specific types of surgery may include small bowel resection (removal of part of the small intestine) via laparoscopy or open surgery, subtotal colectomy (removal of part of the large colon), proctocolectomy (removal of entire colon and rectum), and ileostomy, which is a permanent opening in the abdomen (stoma) with the application of a pouch to collect stool.