Crohn's disease - Choosing treatments

This page provides an overview of the treatment options for Crohn's disease.  Use the left-hand menu to see more details about individual treatment options.

When it comes to treating Crohn's disease, several options are available. The choice of therapy depends on which part of your gastrointestinal tractThe gut, which begins at the mouth and ends at the anus. is affected, the severity of your condition, any complications you may have developed and how well you have responded to previous treatments.

Crohn's disease can be treated with a combination of drugs, nutritional supplements, lifestyle changes and possibly surgery. It is important to attend appointments with your doctor as advised to monitor your symptoms and treatment because Crohn's disease requires life-long attention. Even when you are in remission, it is still important to keep up with the therapy that your doctor has recommended.

The first stage of treatment for Crohn's disease is to get the problems under control, also known as 'induction of remission'. The second stage is to prevent problems from flaring up again, or 'maintenance of remission'.

Most people find that problems caused by Crohn's disease can be successfully treated with medication. If this is not possible, surgery may be required.

Over time, the best treatments for your condition may change. Sometimes, new drugs and treatments become available and your doctor may recommend them to you. Learn more about new treatments on the horizon.

Medications

Medication can be very effective in relieving symptoms, preventing recurrences and extending remission in Crohn's disease.

There are several categories of medication, each covering a number of different drugs that act in various ways to help you to live with your condition, for example:

  • Treating the symptoms to induce remission
  • Preventing recurrence of symptoms to maintain remission. You will usually take these medications all the time, even if you are feeling well
  • Controlling particular problems associated with your condition, such as diarrhoeaWhen bowel evacuation happens more often than usual, or where the faeces are abnormally liquid.. These may be taken as needed.

Your doctor can explain about the choices of medications to you in detail. Different drugs require different doses and schedules. It is possible that you will need to try several different combinations before finding the right combination and type for you. The aim is to keep you in remission without causing unwanted side effects.

It is important that you follow your doctor's instructions exactly. You will have to remember to take your medication correctly, and at the right time and intervals. If you are going away, you need to remember to take your medications with you.

Learn more about medications.

Other therapies

Several other treatments have been suggested for Crohn's disease. These include nutritional therapy, herbal medicines and supplements, and other options such as relaxation, hypnotherapyAny form of psychotherapy that uses hypnosis. and acupunctureA complementary therapy in which fine sterile needles are inserted into the skin at specific points..

Managing stressRelating to injury or concern. can help you to cope better with the discomfort and inconvenience associated with Crohn's disease. Techniques that may help include relaxation exercises, meditation and yoga.

If you intend to use or are using any nutritional supplements or complementary therapies, it is best to discuss them with your doctor to check that they will not affect any existing treatment you are receiving. Your doctor may suggest supplements or complementary treatments that might support, or complement, your current regime.

Surgery

For some people, Crohn's disease can be managed with the right medication alongside diet and lifestyle changes. However, when this is not the case, surgery may be needed.

If surgery is required, the aim will be to save as much of the healthy intestines as possible, allowing you to lead as healthy and normal a life as possible. There are a number of surgical procedures that can help. These are often used to treat complications of Crohn's disease such as fistulae or bleeding, or to treat blockages caused by strictures.

Your surgeon can guide you in making an informed decision about which procedure is best for you. The presence of any complications, the area of intestineThe section of gut, or gastrointestinal tract, from the stomach to the anus. affected, and the severity of disease will all influence this decision.

Surgery can be very effective in treating Crohn's disease. Discuss your outlook (prognosis) with your surgeon to understand the pros and cons of all treatment options.

Types of surgery

There are several types of surgery used to manage Crohn's disease. These include:

These operations are always major procedures that require a hospital stay to recover, and a period of convalescence afterwards. It is important to take the advice of your doctors about how to recover effectively through rest and rehabilitationThe treatment of a person with an illness or disability to improve their function and health..

Open surgery is the conventional method, but, for some patients, keyhole or laparoscopic surgery may be another option. This involves making small cuts (incisions) in the skin, so that the surgeon can use special long-handled instruments to reach the operation site. The surgeon can see inside the abdomenThe part of the body that contains the stomach, intestines, liver, gallbladder and other organs. during the procedure using a tiny camera that is linked to a monitor.

In some cases your surgeon may have to perform open surgery, even if the procedure decided upon was keyhole surgeryA type of minimally invasive surgery.. You will be asked to give your consent for this before any surgery begins.

Outcomes of surgery

Surgery cannot cure Crohn's disease because, after removing one affected part of the gastrointestinal tractThe gut, which begins at the mouth and ends at the anus., the disease might appear in another area of the intestines.

As with any surgery, there is a possibility that complications may arise. With surgery for Crohn's disease these complications can include:

  • Poor wound healing
  • Infection
  • Adhesions
  • Leaking from an anastomosis (where two sections of healthy intestineThe section of gut, or gastrointestinal tract, from the stomach to the anus. have been joined together after the removal of a problematic section of intestineThe section of gut, or gastrointestinal tract, from the stomach to the anus.)
  • Ileostomy or colostomySurgery that involves bringing part of the large intestine through the abdominal wall, through an opening called a stoma. Faeces are collected by a bag worn over the hole..

Ileostomy

Some surgical procedures may result in you having to wear an ostomy bag (sometimes known as an ileostomySurgery that involves bringing part of the small intestine, the ileum, through the abdominal wall. The intestinal contents are collected by a bag worn over the hole, or stoma. or colostomySurgery that involves bringing part of the large intestine through the abdominal wall, through an opening called a stoma. Faeces are collected by a bag worn over the hole. bag). The advantages of this type of surgery almost always outweigh the problems caused by the disease itself.

See Coping with a stoma and an ostomy bag

Surgery and fertility

Surgery for Crohn's disease may affect a woman's chances of becoming pregnant. If having children is important to you, discuss this with your doctor or specialist before having the operation.