Medications

There are several medications used to treat Crohn's disease, which can be grouped into five categories:

  • Aminosalicylates (5-ASAsAn abbreviation for aminosalicylates, a family of drugs that reduce inflammation.) act by reducing inflammationThe body’s response to injury.. Examples include mesalazine, olsalazine, balsalazide, and sulphasalazine
  • Corticosteroids (often simply called 'steroids') are hormoneA substance produced by a gland in one part of the body and carried by the blood to the organs or tissues where it has an effect.-like drugs with an anti-inflammatoryAny drug that suppresses inflammation action. Examples include prednisolone and budesonide
  • Immunosuppressants alter the activity of the immune systemThe organs specialised to fight infection., so reducing the inflammationThe body’s response to injury. that causes many of the problems in Crohn's disease. Examples include azathioprine, 6-mercaptopurine, methotrexate and ciclosporin
  • Biological therapies are newer types of medications. These treatments, such as infliximab and adalimumab, interfere with specific parts of the inflammationThe body’s response to injury. process
  • Antibiotics to treat infectionInvasion by organisms that may be harmful, for example bacteria or parasites., for example metronidazole, ciprofloxacin and levofloxacin.

Your doctor will prescribe medications based on the stage and severity of your disease, with the aim of:

  • Symptom control to induce remission
  • Preventing the recurrence of symptoms, in other words maintaining remission
  • Treating specific symptoms.

Your doctor will explain which types of drugs are being prescribed, and why. It helps to discuss all the options and the advantages and disadvantages of different treatments with your doctor.

Inducing remission

Aminosalicylates (for example, mesalazine) and steroids Compounds with a common basic structure, which occur naturally in the body. The term may also refer to man-made drugs administered because they act like hormones.(for example, budesonide, prednisolone) are the two main types of drugs that are used to get inflammationThe body’s response to injury. under control (that is, to induce remission). If these treatments are not effective, other drugs such as infliximab or adalimumab may be used.

I began treatment straight away and was put on two medications - a corticosteroid and an aminosalicylate medicine. In two weeks my symptoms improved dramatically. Aimee

Maintaining remission

Your doctor may prescribe immunosuppressants or biological therapiesA group of therapies that interfere with specific parts of the inflammation process. (Called 'biologic therapies' in American English.) to try to keep you in remission. Whether or not these treatments are given largely depends on how many relapses (flare-upsTerm to describe episodes when the symptoms of a condition worsen.) you are having.

It is important that you take medications to prevent flare-upsTerm to describe episodes when the symptoms of a condition worsen. as your doctor instructs, even if you feel perfectly well. It is not advisable to stop taking any medication without speaking to your doctor first.

Treating symptoms

You may experience particular problems over time that can be helped by specific drugs. Your doctor may therefore prescribe one or more of the following medications as needed. It is not usually necessary to take these medications all the time.

  • Diphenoxylate or loperamide to treat diarrhoeaWhen bowel evacuation happens more often than usual, or where the faeces are abnormally liquid.. Dehydration caused by diarrhoeaWhen bowel evacuation happens more often than usual, or where the faeces are abnormally liquid. is treated with fluids along with salt and other minerals that may have been lost as well. In severe cases you may need to stay in hospital to receive fluids through an intravenous dripA means for the continuous injection into a vein.
  • Methylcellulose and sterculia (bulking agents) to relieve constipation
  • Analgesics to relieve pain (for example, paracetamol). Non-steroidal anti-inflammatoryAny drug that suppresses inflammation drugs (NSAIDsA group of drugs that provide pain relief and reduce inflammation. ) such as aspirin and ibuprofen should be avoided, as these can trigger flare-upsTerm to describe episodes when the symptoms of a condition worsen. in Crohn's disease
  • Iron supplements to treat anaemiaA reduced level of haemoglobin, which carries oxygen in the blood. Anaemia causes tiredness, breathlessness and abnormally pale skin.
  • Vitamin and mineral supplements as needed
  • Calcium and vitamin D tablets to prevent osteoporosis A condition resulting in brittle bones due to loss of bony tissue.(thinning of the bones) or bisphosphonate drugs if a bone density scan suggests that you already have this condition.

It is important to discuss your symptoms with your doctor, who can then advise you on the best dosages for you.

Antibiotics

Patients with Crohn's disease are often given antibioticsMedication to treat infections caused by microbes (organisms that can't be seen with the naked eye), such as bacteria. such as ampicillin, ciprofloxacin or metronidazole to treat the growth of bacteriaA group of organisms too small to be seen with the naked eye, which are usually made up of just a single cell. that can develop in a partially obstructed intestineThe section of gut, or gastrointestinal tract, from the stomach to the anus. upstream of a stricture. Antibiotics are also used to treat infectionInvasion by organisms that may be harmful, for example bacteria or parasites. associated with fistulae or perianal Crohn's disease.