Crohn's Disease (cont.)
How is Crohn's disease treated?
The symptoms and severity of Crohn's disease vary among patients. Patients
with mild or no symptoms may not need treatment. Patients whose disease is in
remission (where symptoms are absent) also may not need treatment.
There is no medication that can cure Crohn's disease. Patients with Crohn's
disease typically will experience periods of relapse (worsening of inflammation)
followed by periods of remission (reduced inflammation) lasting months to years.
During relapses, symptoms of abdominal pain, diarrhea, and rectal bleeding
worsen. During remissions, these symptoms improve. Remissions usually occur
because of treatment with medications or surgery, but occasionally they occur
spontaneously without any treatment.
Since there is no cure for Crohn's disease, the goals of treatment are to 1)
induce remissions, 2) maintain remissions, 3) minimize side effects of
treatment, and 4) improve the quality of life. Treatment of Crohn's disease
and ulcerative colitis with medications is similar though not always identical.
Medications for treating Crohn's disease include 1) antiinflammatory agents
such as 5-ASA compounds, corticosteroids, topical antibiotics, 2) immuno-modulators, 3) other medications.
Antiinflammatory medications
Antiinflammatory medications that decrease intestinal inflammation are
analogous to arthritis medications that decrease joint inflammation. Different
types of antiinflammatory medications used in the treatment of Crohn's disease
are:
- 5-ASA compounds such as sulfasalazine (Azulfidine) and
mesalamine (Pentasa, Asacol,
Dipentum, Colazal, Rowasa enema, Canasa suppository) that act via direct
contact (topically) with the inflamed tissue in order to be effective.
- Corticosteroids that act systemically (without the
need for direct contact with the inflamed tissue) to decrease inflammation
throughout the body. Systemic corticosteroids have important and predictable
side effects if used long-term.
- A new class of topical corticosteroid (for example,
budesonide) that acts via direct contact (topically) with the inflamed tissue.
This class of corticosteroids has fewer side effects than systemic
corticosteroids which are absorbed into the body.
- Antibiotics such as metronidazole (Flagyl) and
ciprofloxacin (Cipro) that
decrease inflammation by an unknown mechanism
Next: 5-ASA (mesalamine) oral medications »
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