As there is no cure for Crohn’s disease, treatment focuses on treating the symptoms and preventing flare-ups. Crohn’s disease is primarily treated with anti-inflammatory drugs and immunosuppressants.
Frequently antibiotics, acetaminophen, anti-diarrheal drugs and laxatives are used for treating the symptoms of the ailment.
Medications To Treat Crohn’s Disease
Anti-Inflammatory Medications
Reducing inflammation of the intestines is the first step in the treatment of Crohn’s disease.
Mesalamine
Mesalamine is used in the form of tablets and suppositories for reducing inflammation of the large intestine. This is one of the safer and effective anti-inflammatory drugs used in treatment of Crohn’s disease that affects the small intestine.
Side effects of mesalamine use include nausea, vomiting, headache, joint and muscle ache, constipation, gas, heartburn, dry mouth, hair loss, acne, hemorrhoids and sleeping difficulties.
Sulfasalazine
The anti-inflammatory drug sulfasalazine is occasionally used for treating inflammation of the colon. People with a history of sulfa drug allergy should avoid this drug. Men on sulfasalazine may experience temporary infertility problems. Stomach upset, diarrhea, stomach pain, appetite loss, vomiting and headache are possible side effects of sulfasalazine.
Corticosteroids
Inflammations of the intestines that do not respond to the aforementioned anti-inflammatory drugs are usually treated with corticosteroids. Corticosteroids are powerful anti-inflammatory drugs that rapidly reduce inflammation. Budesonide, prednisone, prednisolone, dexamethasone, and hydrocortisone are corticosteroids used for reducing inflammation.
In addition to corticosteroid pills, corticosteroids are used as enema, suppositories or topical creams for treating Crohn’s disease that affects the lower colon or rectum. Intravenous corticosteroid injections are prescribed by doctors for treating severe flare-ups. However, corticosteroid use is associated with severe side effects such as hyperactivity, osteoporosis, diabetes, high blood pressure, growth of facial hair, glaucoma, cataract and increased risk of infections. Given the harmful side effects of corticosteroids, they are recommended only for short-term use.
Immunosuppressant
While the anti-inflammatory drugs reduce inflammation of the intestine, recurrent flare-ups are treated with immunosuppressant drugs that suppress the activities of the immune system. Usually, immunosuppressant drugs are used along with anti-inflammatory medications for treating Crohn’s disease.
Infliximab
Infliximab is an antibody that neutralizes the activities of a pro-inflammatory substance called tumor necrosis factor (TNF) alpha. It is administered intravenously in people suffering from moderate to severe Crohn’s disease flare-ups or fistulizing Crohn’s disease.
Infliximab is unsafe for people suffering from cancer, multiple sclerosis and heart failure. By suppressing the immune system, it increases the risk of infections.
Certolixumab pegol
Certolixuman pegol is an alternative to infliximab. It is used in the same way as infliximab and share similar side effects.
Adalimumab
Adalimumab treats moderate to severe inflammations of the intestines by suppressing the activities of TNF alpha.
It is usually recommended when treatment with infliximab or Certolixumab fails to produce the desired result. Side effects of adalimumab injection are same as that of infliximab.
Azathioprine
This immunosuppressant drug is frequently prescribed by doctors for treating autoimmune diseases. Diarrhea, nausea and vomiting are common side effects of the drug. It also increases the risk of infections.
Mercaptopurine
Occasionally, mercaptopurine is used for preventing recurrent Crohn’s disease flare-ups. It works by inhibiting production of white blood cells. This drug is considered toxic for the bone marrow.
People on mercaptopurine are susceptible to infections. Vomiting, nausea, hair loss and rash are common side effects of the drug.
Cyclosporine
Fistulizing Crohn’s disease that does not respond to other drugs is usually treated with cyclosporine. Liver and kidney damage, increased risk of infections and seizures are serious side effects of this immunosuppressant drug. Given the serious side effects of the cyclosporine, it is recommended only for short-term use.
Natalizumab
Natalizumab is only prescribed for treating moderate to severe symptoms of Crohn’s disease that do not respond to common immunosuppressants and TNF blockers.
It works by inhibits immune molecules called integrins from attaching to the lining of the intestine. Chronic inflammation of the intestines is often attributed to integrins binding to the intestinal lining. Natalizumab increases the risk of brain infections.
Other medications
Antibiotics
Antibiotics such as ciprofloxacin and metronidazole are occasionally prescribed by doctors for killing the harmful bacteria in the intestines that tend to worsen the symptoms of Crohn’s disease. Antibiotics are also recommended for treating abscesses and fistulas. They may even help to obstruct the activity of the immune substances in the intestines.
Anti-diarrheal
Mild diarrhea associated with Crohn’s disease is treated with fiber supplements. Your physician may recommend loperamide to treat moderate to severe diarrhea.
Laxative
If swelling of the intestine causes constipation, your physician may ask you to take mild laxative to ease bowel movement.
Acetaminophen or paracetamol
Acetaminophen or paracetamol can be taken to reduce mild pain.
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