Crohn’s Disease Medication Options
Successful medical treatment accomplishes two important goals: it allows the intestinal tissue to heal and it also relieves the symptoms of fever, diarrhea, and abdominal pain.
Once the symptoms are brought under control (this is known as inducing remission), medical therapy is used to decrease the frequency of disease flares (this is known as maintaining remission, or maintenance).
Several groups of drugs to treat Crohn’s disease today. They are:
These include medicationsthat contain 5-aminosalicylate acid (5-ASA).Examples are sulfasalazine, mesalamine,olsalazine, and balsalazide.These drugs arenot specially approved by the Food and DrugAdministration (FDA) for use in Crohn’s. However,they can work at the level of the liningof the GI tract to decrease inflammation.They are thought to be effective in treatingmild-to-moderate episodes of Crohn’s diseaseand useful as a maintenance treatmentin preventing relapses of the disease. Theywork best in the colon and are not particularlyeffective if the disease is limited to thesmall intestine.
Prednisone and methylprednisolone are available orally and rectally. Corticosteroids nonspecifically suppress the immune system and are used to treat moderate to severely active Crohn's disease. (By "nonspecifically," we mean that these drugs do not target specific parts of the immune system that play a role in inflammation, but rather, that they suppress the entire immune response.) These drugs have significant short- and long-term side effects and should not be used as a maintenance medication. If you cannot come off steroids without suffering a relapse of your symptoms, your doctor may need to add some other medications to help manage your disease.
This class of medicationsmodulates or suppresses the body’s immunesystem response so it cannot cause ongoinginflammation. Immunomodulators generallyare used in people for whom aminosalicylatesand corticosteroids haven’t been effective orhave been only partially effective. They maybe useful in reducing or eliminating the needfor corticosteroids. They also may be effectivein maintaining remission in people whohaven’t responded to other medicationsgiven for this purpose. Immunomodulatorsmay take several months to begin working.
Antibiotics may be used wheninfections—such as abscesses—occur inCrohn’s disease. They can also be helpful with fistulas around the anal canal and vagina.Antibiotics used to treat bacterial infection in the GI tract include metronidazole, ampicillin, ciprofloxacin, others.
Also known as anti-TNFagents, these represent the latest class oftherapy used for people suffering from moderate-to-severe Crohn’s disease. Tumornecrosis factor (TNF) is a chemical producedby our bodies to cause inflammation. Antibodiesare proteins produced to attach tothese chemicals and allow the body to destroythe chemical and reduce the inflammation.