Signs that your Crohn’s disease treatment plan no longer works may include recurring symptom flare-ups and medication side effects. A healthcare professional could help you modify your treatment.
Crohn’s disease is a type of inflammatory bowel disease (IBD) that may affect any part of the digestive tract.
Your treatment plan may include a combination of medications and lifestyle strategies. These aim to help relieve and keep your symptoms in remission, according to the Crohn’s and Colitis Foundation.
That said, you may need to modify your treatment plan for several reasons.
Keep reading to learn more about the signs that your Crohn’s treatment plan is no longer working and what to do.
There’s no cure for Crohn’s disease, but your treatment plan may help keep your symptoms in remission.
Several medications are used to help treat Crohn’s disease, including:
- Aminosalicylates (5-ASA): These are typically used to reduce mild inflammation.
- Corticosteroids: These help relieve inflammation in your digestive system. They work quickly but are only for short-term use.
- Immunomodulators: These reduce overall inflammation in the body but take weeks to months to work.
- Biologics: These are infused or injected medications that target specific immune actions. Biologics are often used only if other treatments aren’t working.
Everyone’s treatment plan is different. Treatment may require a trial-and-error process to see what works best for you.
The goal of treatment is to keep inflammation under control to keep Crohn’s in remission.
However, if your symptoms return frequently or you experience side effects from medications, your treatment plan may not be working.
Speak with a healthcare professional if you experience these effects. A healthcare professional could determine the underlying cause and help develop a new treatment plan that’s right for you.
What happens if anti-inflammatory medications don’t work for Crohn’s disease?
Aminosalicylates (5-ASA) are used to help treat mild to moderate Crohn’s disease. Nearly
However, research suggests that 5-ASAs may not be as effective in treating Crohn’s as it was once believed. These anti-inflammatories don’t work for many people, so corticosteroids are the next option.
What happens if steroids don’t work for Crohn’s disease?
Corticosteroids are medications that help suppress the immune system. Although they’re effective, they have many potential side effects,
Typically, corticosteroids are only used short term to quickly bring down inflammation. They may also be used with immunomodulators, which are effective but take longer to work.
Corticosteroids should not be used long term. An immunomodulator may replace a corticosteroid for long-term use.
What happens if an immunomodulator doesn’t work for Crohn’s disease?
Thiopurines are a type of immunomodulator. The main thiopurine used for Crohn’s disease is azathioprine (Azasan, Imuran).
However, there’s mixed evidence about whether they can bring on remission on their own, notes a 2021 review. There are also concerns about intolerance and adverse reactions: According to the same review, up to 25% of people using thiopurines had an adverse effect and had to stop the treatment.
Thiopurines and biologics often work together to induce remission.
What happens if biologics don’t work?
Biologics are injectable medications that help reduce inflammation by targeting specific proteins released by the immune system.
Anti-tumor necrosis factor (anti-TNF) drugs are a type of biologic used for Crohn’s disease. They include adalimumab (Humira) and infliximab (Remicade).
Researchers estimate that anti-TNF biologics don’t work for
In these cases, a different biologic may work. Switching to another biologic is
If anti-TNFs don’t work or stop working, natalizumab (Tysabri) or vedolizumab (Entyvio) may be options. They’re shown to be
Combination therapies may work better to induce remission in Crohn’s. A 2022 study found that combining vedolizumab (Entyvio) with a thiopurine was more effective than taking it on its own.
Another biologic, infliximab (Remicade, and biosimilars Avsola, Inflectra, IXIFI, Renflexis), is more effective when combined with a thiopurine.
Knowing when to switch treatments is difficult, especially if you’ve been taking the same medications for years and your Crohn’s has been kept in remission.
However, if recurring flare-ups or treatment side effects are affecting your quality of life, speak with a healthcare professional. They could talk with you about treatment options.
Some medications take time to reach their full effect. Make sure you understand how long it may take to start working. After this period, if the treatment is still not effective, it might be time to switch to something else.
It’s essential to have a good relationship with your healthcare team. You want to know your concerns and needs are heard. It’s important to be informed about any medication changes.
Consider asking some of the following questions:
- How do I take this medication?
- Can the dose be adjusted if needed?
- How long does this medication take to start to work?
- What side effects should I watch for?
- How long will I stay on this medication?
- What is the follow-up plan?
What worsens Crohn’s disease?
The exact cause of Crohn’s disease is unknown. However, some triggers may worsen symptoms, such as eating certain foods, smoking, stress, taking certain medications, and having some underlying health conditions.
What is the life expectancy of someone with Crohn’s disease?
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How long can a Crohn’s flare-up last?
There’s no set time for the duration of a Crohn’s flare-up. It may last from several days to weeks or even months.
Crohn’s disease is a chronic condition with periods of remission and symptom flares.
If you’re experiencing more frequent symptom flare-ups or side effects from medications, speak with a healthcare professional. These are signs that your treatment plan may no longer be working.
In some cases, a healthcare professional may increase medication doses. Other times, they may add a new medication to your current plan or replace a medication.
Throughout the process, make sure to stay in touch with your healthcare team. It can be a challenging time, and it’s important to feel supported.