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Harvard Medical School

Crohn's Disease

Treatment

Medications are very effective at improving the symptoms of Crohn's disease. Most of the drugs work by preventing inflammation in the intestines.

The medication commonly used first is a group of anti-inflammatory drugs called aminosalicylates. They are chemically related to aspirin and suppress inflammation in the intestine and joints. They are given either by mouth (pills) or by rectum, as an enema. Some drugs in this group include sulfasalazine (Azulfidine), mesalamine (Asacol, Pentasa, Canasa, Rowasa) and olsalazine (Dipentum).

Certain antibiotic drugs, particularly metronidazole (Flagyl) and ciprofloxacin (Cipro), help by decreasing the bacterial growth in irritated areas of the bowel. They may have a side benefit of decreasing inflammation, too. If you still have diarrhea, but there is no infection, antidiarrheal medications, such as loperamide (Imodium) may be helpful.

Other more powerful anti-inflammatory drugs may be helpful, but they can also suppress your immune system so that you have an increased risk of infections. For this reason, they are not often used on a long-term basis. These drugs include prednisone (Deltasone, Prednisolone, Orasone) and methylprednisolone (Medrol, Solu-Medrol), budesonide (Entocort), azathioprine (Imuran), 6-mercaptopurine (Purinethol), cyclosporine (Neoral, Sandimmune) and methotrexate (Rheumatrex, Folex).

The newest drugs approved for treatment of Crohn's disease are infliximab (Remicade), Humira (adalimumab) and certolizumab pegol (Cimzia). These medications block the effect of a chemical called "tumor necrosis factor" (TNF) that may be responsible for causing inflammation in the intestine. TNF inhibitors have potentially very serious side effects. In general, they are prescribed for moderate to severe Crohn's disease that is not responding to other therapies.

Surgery is another possible treatment. In general, surgery to remove a section of the bowel is recommended only if a person has bowel obstruction, persistent symptoms despite medical therapy, or a non-healing fistula. Up to 50 percent of people who have Crohn's disease will end up having at least one operation during the course of their disease.

Medications are very effective at improving the symptoms of Crohn's disease. Most of the drugs work by preventing inflammation in the intestines.

The medication commonly used first is a group of anti-inflammatory drugs called aminosalicylates. They are chemically related to aspirin and suppress inflammation in the intestine and joints. They are given either by mouth (pills) or by rectum, as an enema. Some drugs in this group include sulfasalazine (Azulfidine), mesalamine (Asacol, Pentasa, Canasa, Rowasa) and olsalazine (Dipentum).

Certain antibiotic drugs, particularly metronidazole (Flagyl) and ciprofloxacin (Cipro), help by decreasing the bacterial growth in irritated areas of the bowel. They may have a side benefit of decreasing inflammation, too. If you still have diarrhea, but there is no infection, antidiarrheal medications, such as loperamide (Imodium) may be helpful.

Other more powerful anti-inflammatory drugs may be helpful, but they can also suppress your immune system so that you have an increased risk of infections. For this reason, they are not often used on a long-term basis. These drugs include prednisone (Deltasone, Prednisolone, Orasone) and methylprednisolone (Medrol, Solu-Medrol), budesonide (Entocort), azathioprine (Imuran), 6-mercaptopurine (Purinethol), cyclosporine (Neoral, Sandimmune) and methotrexate (Rheumatrex, Folex).

The newest drugs approved for treatment of Crohn's disease are infliximab (Remicade), Humira (adalimumab) and certolizumab pegol (Cimzia). These medications block the effect of a chemical called "tumor necrosis factor" (TNF) that may be responsible for causing inflammation in the intestine. TNF inhibitors have potentially very serious side effects. In general, they are prescribed for moderate to severe Crohn's disease that is not responding to other therapies.

Surgery is another possible treatment. In general, surgery to remove a section of the bowel is recommended only if a person has bowel obstruction, persistent symptoms despite medical therapy, or a non-healing fistula. Up to 50 percent of people who have Crohn's disease will end up having at least one operation during the course of their disease.