Crohn’s disease medications can help suppress the immune system and reduce inflammation. Changes to diet and other lifestyle factors can also help. In some cases, a doctor may recommend surgery.

Crohn’s disease is a health condition that affects the gastrointestinal (GI) tract.

Doctors still aren’t completely sure what causes Crohn’s, but it’s thought to be an overreaction of the immune system in the GI tract.

Crohn’s disease can affect any part of your GI tract, but it most often affects the small bowel and the beginning of the colon.

There are different classifications of Crohn’s based on where the condition affects the GI tract.

The symptoms also vary because there are different types of Crohn’s. Symptoms may include abdominal pain, blood in the stool, diarrhea, nausea, and vomiting.

While there’s no cure for Crohn’s disease, medications and other treatment options — including diet and lifestyle strategies — can help manage symptoms.

Crohn’s disease often happens in cycles of remission and flare-ups, so treatment plans require evaluation and monitoring. Treatment for Crohn’s is very personalized, so what works for someone else may not work for you and vice versa.

Work with your doctor to devise a treatment plan to manage your specific Crohn’s symptoms.

One primary way to manage Crohn’s disease is through medications that suppress the immune system and reduce inflammation in the GI tract.

Taking medication to lower your immune response can help ease your symptoms and give your GI tract a chance to rest and heal.

The following are medications your doctor may prescribe alone or in combination to manage Crohn’s disease:

Corticosteroids

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), corticosteroids help reduce inflammation and your immune response. They’re often used as short-term treatment.

Common corticosteroids used to manage Crohn’s include:

  • beclomethasone dipropionate
  • budesonide
  • hydrocortisone
  • methylprednisolone
  • prednisone
  • prednisolone

The side effects of corticosteroids can include:

  • glaucoma, which is increased pressure in your eyes
  • swelling
  • high blood pressure
  • weight gain
  • higher risk of getting an infection
  • acne
  • mood changes

Long-term side effects, such as loss of bone density (osteoporosis), infections, or liver issues, can occur if you take corticosteroids for more than 3 months.

Because of this, your doctor may have you take corticosteroids for only a certain period of time.

Don’t stop taking steroids without talking with your doctor first, though. Doing so can lead to additional health concerns.

Aminosalicylates (anti-inflammatory drugs)

Aminosalicylates are often used to treat another inflammatory bowel disease (IBD) called ulcerative colitis, but your doctor may prescribe them off-label to manage Crohn’s as well. They’re mostly used for mild to moderate terminal ileitis or colitis.

These drugs reduce inflammation in the intestinal lining to ease symptoms. Aminosalicylates can be taken as suppositories, enemas, by mouth, or in combination. How you take the medication depends on how Crohn’s affects your body.

Common aminosalicylates used to manage Crohn’s are:

The possible side effects of aminosalicylates include:

While taking this medication, your doctor may monitor your kidney and liver function. They may order blood tests to ensure your white blood cell level isn’t too low.

Let your doctor know if you’re allergic to sulfa drugs before taking any aminosalicylate drug.

Immunomodulator medications (immunosuppressants)

Experts believe a problem with the immune system causes Crohn’s disease. Cells that usually protect your body instead attack the GI tract.

Because of this, medications that suppress or regulate your immune system can help treat Crohn’s.

However, these drugs can take up to 3 months to start working, so you’ll need to wait some time before you can know whether they’ll help you. They are often prescribed with biologics to induce remission.

Doctors may prescribe these types of medications if aminosalicylates and corticosteroids don’t work or if you develop fistulas. Fistulas are abnormal openings that form in the bowels.

Some common immunosuppressive medications include:

The side effects of these medications can include:

  • headache
  • nausea
  • vomiting
  • diarrhea
  • higher risk of getting an infection

Some rare side effects are:

  • pancreatitis, or inflammation of the pancreas
  • liver problems
  • myelosuppression, which is a decrease in the amount of bone marrow your body makes

Antibacterial medications

Antibiotics can treat many bacterial infections, including bacterial infections caused by Crohn’s disease, such as fistulas and abscesses.

Common antibiotics for Crohn’s include:

Side effects of antibiotics can include:

  • abdominal pain
  • diarrhea
  • indigestion
  • loss of appetite
  • nausea
  • neuropathy (tingling in the hands or feet) from extended use of metronidazole
  • sensitivity to sunlight from ciprofloxacin

Biologics

Biologics are a type of drug used for people with moderate to severe Crohn’s or active Crohn’s.

They work to reduce inflammation in specific areas, such as the lining of your intestines. Generally, biologics tend to suppress your immune system, so infection can be a concern.

Your doctor may prescribe biologics for you if you have moderate or severe symptoms or if other drugs aren’t working. They may also prescribe them if you have fistulas in your GI tract.

Biologics can also help taper (gradually decrease) the use of steroid medications.

These medications are often given as an infusion at a hospital or an outpatient center every 4 to 8 weeks.

The most common biologic drugs include:

  • tumor necrosis factor-alpha (TNF-alpha) inhibitors, such as adalimumab, certolizumab, infliximab
  • anti-integrin therapies, such as natalizumab and vedolizumab
  • anti-interleukin-12 and anti-interleukin-23 therapy, such as ustekinumab
  • Janus kinase (JAK) inhibitors, such as tofacitinib

You may have redness, swelling, or irritation after the injection. You may also experience:

  • headaches
  • fever
  • chills
  • low blood pressure

In rare cases, some people have had a toxic reaction to the medication, liver problems, or a higher risk of an infection, especially tuberculosis. Doctors usually check people for hepatitis B and tuberculosis before starting these medications.

Other medications

Doctors may prescribe additional medications to help with other symptoms of Crohn’s. For example, they may prescribe an antidiarrheal drug called loperamide that may be taken short term if you have severe diarrhea.

Your doctor may recommend prescription-strength acetaminophen (Tylenol) for relieving pain. Avoid using ibuprofen (Advil), naproxen (Aleve), and aspirin for pain relief since these can worsen symptoms.

During severe flare-ups, you may need to rest your bowels. This may include a full or partial liquid diet managed by your doctor.

Bowel rest treatment may include:

  • drinking nutritious liquids
  • enteral nutrition, or nutrition via a feeding tube inserted into the stomach or intestine
  • intravenous (IV) nutrition into the veins

Liquid nutrition may be administered at home or in a hospital, depending on your circumstances and your doctor’s recommendations.

Doctors first try to manage Crohn’s disease with medication. Because it’s a chronic condition, many people with Crohn’s eventually need surgery.

There are different types of surgeries for Crohn’s disease. The exact type of surgery depends on:

  • the type of Crohn’s
  • your symptoms
  • how severe your symptoms are

Surgeries for Crohn’s include:

  • Strictureplasty: This surgery widens a part of your intestine that has narrowed over time due to inflammation.
  • Proctocolectomy: In this surgery for severe cases, both the colon and the rectum are removed.
  • Colectomy: The colon is removed, but the rectum is left intact.
  • Fistula removal and abscess drainage: Several methods of fistula removal exist, including a medical plug or glue to close the fistula and a thin surgical cord to allow for drainage.
  • Small and large bowel resection: The damaged part of the bowel is removed, and the healthy, unaffected areas of the bowel are reconnected.

You can discuss natural remedies with your doctor to complement your medication regimen and any surgery procedures.

Some natural remedies include:

  • Supplements: Calcium and vitamin D supplements can help prevent bone loss if you’ve been taking a corticosteroid for a long time.
  • Omega-3 fatty acids: Omega-3 fatty acids, such as those in fish oil, are known to have anti-inflammatory properties, so they’re being studied to see whether they can help Crohn’s. You can find omega-3 fatty acids in supplements or foods such as salmon, sardines, nuts, flax seeds, plant oils, and some fortified foods.
  • Cannabis: According to the Crohn’s & Colitis Foundation, a few small studies suggest that cannabis may help with certain symptoms of IBD, but there’s no clear evidence to recommend it for Crohn’s.

You can make lifestyle changes to help manage your symptoms as well.

Manage your stress

Managing stress is an important part of any healthy lifestyle, but stress management is especially important with a chronic inflammatory condition like Crohn’s.

According to a 2017 review, stress can worsen inflammation, which worsens symptoms.

You can try stress management techniques on your own, such as:

It’s also a good idea to speak with a mental health professional to learn new stress management tools and strategies, especially if you have high stress levels.

Take acetaminophen for pain

For mild discomfort and pain, such as when you have a headache or a sore muscle, it’s recommended that you take acetaminophen (Tylenol).

Avoid ibuprofen (Advil), naproxen (Aleve), and aspirin because these can cause a flare-up.

Stop smoking

If you smoke, it can:

  • worsen symptoms
  • trigger a flare
  • make your medication less effective

Quitting smoking — no matter how long you’ve been smoking and have had Crohn’s — can help manage Crohn’s symptoms, according to a 2013 study.

Keep a food journal

Studies have not found that one specific diet or food helps Crohn’s. Because it’s such an individual condition, certain foods may trigger symptoms for you but not for someone else and vice versa.

Keeping a food journal and eating a nutrient-dense, balanced diet can help you get the nutrients you need and identify foods that might worsen your symptoms.

Limit caffeine and alcohol

Heavy caffeine and alcohol use may worsen symptoms, especially during a flare.

Here are some frequently asked questions about medications for Crohn’s disease.

What is the primary treatment for Crohn’s disease?

The best treatment for Crohn’s depends on the disease and severity. Consulting a doctor is always best to discuss a treatment option that is individualized and right for you.

What is the new pill for Crohn’s disease?

According to Crohn’s and Colitis UK, new medications are continually being developed, but they may take years to become available. Some newer medications on the horizon include upadacitinib, risankizumab, and mirikizumab.

Crohn’s disease is a type of IBD. It affects everyone differently.

Different types of Crohn’s may affect different parts of the GI system. Symptoms vary depending on which part of the GI tract it affects and how severe it is.

Because Crohn’s is a chronic condition that doesn’t affect everyone the same way, you’ll want to work closely with a doctor to develop an individual treatment plan. Treatment might include medication, lifestyle changes, or surgery.

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