Crohn’s disease (CD) a condition in which long-term inflammation can cause symptoms and complications affecting the digestive tract, anywhere from the mouth to the anus, as well as affecting other parts of the body. CD is a very complicated autoimmune condition that affects every person in a unique way. This means that finding the best way to treat it can also be a very complex process that involves trying a range of different strategies in order to find the most effective one. CD is also a disease that changes over time, so a treatment strategy that works for a person at one stage may not work as well (or at all) at a different time.
Treatment for CD may involve:
Who are the healthcare providers involved in treating CD?
Many different types of healthcare providers may be involved in creating, maintaining, and adjusting a patient’s CD treatment plan.1 Some of those may include:
- Primary care providers focus on providing preventative, non-emergency healthcare to patients on an on-going basis
- Gastroenterologists are medical specialists who have completed extensive training to diagnose and treat conditions related to the digestive tract
- Rheumatologists are physicians who specialize in the diagnosis and treatment of diseases that affect the body’s connective tissue
- Colorectal surgeons are specialists in surgically treating conditions that affect the lower part of the digestive tract, including the large intestine (colon), rectum, and anus
What medications are used to treat CD?
A primary part of any patients CD treatment plan are medications that are used to directly treat the disease as well as the inflammation that it causes.2 Patients may need to try different types of medicines, or combinations of medicines, in order to find the regimen that works most effectively to treat their disease and manage their symptoms. The goals of treatment with CD medications are:
- To treat and manage the symptoms of active CD during flare-ups
- To help to keep CD in remission
- To increase the time between flare-ups
Five categories of medications are most commonly used to treat CD. These are:
- Aminosalicylates are anti-inflammatory medicines generally used for longer-term treatment of people with mild-to-moderate CD
- Corticosteroids are very strong anti-inflammatory medicines generally used for shorter-term treatment of moderate-to-severe active disease
- Antibiotics can be used as short-term therapy to treat complications of CD, such as abscesses or wound infections, or as longer-term therapy for people with mild or moderate CD
- Immunomodulators are drugs that work by changing a person’s immune system response in order to reduce inflammation and improve symptoms, mainly for patients with moderate-to-severe CD
- Biologic therapies contain antibodies that target the disease at its source; they are generally used by people for whom treatment with other types of medications is not effective enough
What surgical procedures are used to treat CD?
Research shows that around three-quarters of people with CD will eventually need to have one or more surgeries to treat the disease.3 The most common types of surgeries include:
- Bowel resection
- Proctocolectomy with ostomy
- Surgery for fistulas
- Procedures to drain abscesses
What are common forms of CD symptom management?
Some people with CD may use other types of over-the-counter medicines or supplements to help with symptom relief, such as:
- Pain relievers
- Iron supplements
- Vitamin B12
- Calcium and vitamin D supplements
However, these forms of symptom management should never be used instead of the patient’s primary CD medications. This is because types of symptom management do nothing to treat the underlying cause of the symptoms, which is inflammation due to CD.
What are complementary or alternative therapies?
Complementary and alternative therapies are healthcare practices and products that are not presently considered part of conventional medicine in the Western world. Generally, they are not yet supported by scientific research. However, some people with CD may choose to supplement (but not replace!) their medication with these types of therapies under the supervision of their healthcare providers. Common forms of complementary or alternative therapies include:
- Herbal supplements
- Probiotics and prebiotics
- Fish oil