What You Need to Know about Treating Crohn’s Disease

The treatment for Crohn's Disease centers around relieving its symptoms through various methods. 
Crohn’s Disease treatment aims to prevent new outbreaks and control those that do appear. Due to the fact that the cause of Crohn’s is unknown, there is no established cure. However, easing and reducing its symptoms is manageable.

There are several types of treatment for Crohn’s disease:

  • Medication
  • Dietary treatment
  • Surgical treatment
  • Others
Crohn's Disease treatment

Pharmacological treatment

Of the different alternatives, the primary Crohn’s Disease treatment is though medication.

The most common pharmacological groups for treating the disease are the following:

  • Antibiotics
  • 5-ASA
  • Glucocorticoids
  • Immunosuppressants
  • Biological therapies

Antibiotics

Doctors prescribe this group of medication for treating excessive bacterial growth in the small intestine. Complications from Crohn’s — restrictions, fistulas or prior surgeries–  as well as anal or perianal infections cause this unusual bacterial growth.

Among this group of antibiotics, the most common for treating this diseases are:

  • Metronidazole
  • Ciprofloxacin
  • Ampicillin
  • Sulfonamides

Common side-effects are:

  • Nausea
  • Metallic taste in mouth
  • Adverse reactions when mixed with alcohol

5-Aminosalicylates

The 5-ASA, or 5-aminosalicylates, make up a group of non-steroidal anti-inflammatory drugs (NSAID) that reduce colon inflammation in Crohn’s Disease cases. 

Surgery doesn’t completely cure the disease, but it’s necessary in the cases of perforation, abscesses, hemorrhages, failure of medical treatment, intestinal obstruction or fistulas.

The most common 5-ASAs are sulfasalazine and mesalazine. Both are oral drugs that also are available as suppositories or enemas. They are a good alternative for patients who don’t respond to steroids.

The most common side-effects are:

Glucocorticoids

Glucocorticoids


Glucocorticoids are a hormonal treatment that help to reduce inflammation. Doctors administer glucocorticoids in acute phases of the disease, but once under control, they discontinue their use due to their possible side-effects.

The most frequently used are the following:

  • Budesonide: This drug is used to treat affectations of the terminal ileum due to its targeted action.
  • Prednisone: Used in more serious cases.

These drugs often lead to the following side-effects:

  • Liquid retention
  • Osteoporosis
  • Gastritis
  • Ance
  • Cataracts

Steroids have a rebound effect, which makes gradually reducing the dose crucial as opposed to suddenly stopping the treatment.

Immunosurppressive drugs

Immunosurppressive drugs weaken the immune system in order to prevent an inflammatory reaction; this helps reduce inflammation in the long term. These drugs are used to prevent new breakouts and also when corticosteroids fail to work.

Among this drug group, the most used are the following:

  • Azathioprine
  • 6-Mercaptopurine: despite the fact that its primary use to is treat leukemia, this drug acts as a immunosuppressant for Crohn’s patients. Unfortunately, it has common side-effects such as the ones listed here:
  • Methotrexate: if this drug is administered, treatment must be completely stopped 3 months prior to trying to conceive. Both men and women risk teratogenic defects in the embryo with its use.

Unfortunately, the consequence of using these kinds of medications is risking more infections, because they work to suppress the immune system.

Biological therapies

Biological therapies

In this case, monoclonal anti-TNF-α antibodies eliminate TNF (Tumor Necrosis Factor), a protein that causes inflammation.

These antibodies are paired with immunosuppressive drugs if they aren’t potent enough or in the cases in which treatment or surgery fails.

The most commonly used biological drugs to treat Crohn’s Diseases are:

  • Infliximab: administered as an infusion. It can cause allergic reactions.
  • Adalimumab: administered as an injection one every two weeks.
  • Certolizumab.

Dietary treatment

Dietary treatment

Diet is an important factor in Crohn’s patients because they tend to suffer from loss of appetite or malabsorption.

These patients should take special care to eat a balanced diet, just as people without Crohn’s, especially because of the additional complications that are associated with the disease.

A balanced diet consists en obtaining 50-55% of all nutrients through carbohydrates, 30-35% through lipids or fats, 12-15% through proteins and certain amounts of fiber (low quantities), as well as vitamins and minerals according to the needs of each patient. Patients should eat at multiple times during the day and drink plenty of water.

Crohn’s patients should avoid foods spicy foods and those rich in fiber, in addition to carbonated, caffeinated or alcoholic drinks.

Despite following a balanced diet, people suffering from Crohn’s can develop severe malnutrition. In those cases, they might require specialized dietary products or visits to the hospital for parenteral nutrition.

Let food be thy medicine and medicine by thy food.

-Hippocrates-

There are several foods that frequently cause side-effects, which is why it’s best to avoid them entirely. Among them are the following:

  • Casein: a protein found in dairy products
  • Gluten
  • Wheat
  • Corn
  • Yeast
  • Some fruits and vegetables

The diets that have had the most success in controlling Crohn’s symptoms are gluten-free and FODMAP-restriction diets (diets low in short chain carbohydrates that are poorly absorbed in the small intestine).

Vitamin supplements can be taken to relieve symptoms during outbreaks of the diseases or to induce remission. In particular, vitamin D supplements show a strong connection to Crohn’s Disease. 

Calcium supplements are controversial due to its risk of arterial calcification and myocardial infarction.

Surgical treatment

The main objection of surgery in the treatment of Crohn’s disease is recover health and well-being when complications arise and to avoid extending pharmacological treatment that shows little improvement.

Surgery isn’t a definitive cure for the disease, but it’s necessary in the cases of perforation, abscesses, hemorrhages, failure of medical treatment, intestinal obstruction or fistulas.

The operation consists in removing the inflamed section of the digestive tract and reconnecting the remaining sections. 

Other alternatives for Crohn’s Disease

Rather than other treatments used for treating the illness’ symptoms, the alternatives consist in healthy habits recommend for patients. On the list we can find:

  • Quitting smoking
  • Rest: reducing emotion stress with rest helps soothe outbreaks is just as helpful as pharmacological treatment.

Despite the fact that Crohn’s is a chronic disease with severe episodes, patients should partake in daily activities as normally as possible.

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