Exploring Crohn’s disease treatments.
While there is no cure for Crohn’s disease, there are several kinds of prescription treatment options to help treat it. Finding the right treatment option can take time, but setting treatment goals can help you stay on target. Understanding the severity of your Crohn’s and the treatment options available can help you and your gastroenterologist work toward your treatment goals.
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A good prescription for success: Setting goals
Before you and your gastroenterologist discuss treatment plans, it’s important to discuss treatment goals. And there’s a valid reason why: there’s more to a treatment plan than managing symptoms.
Treat Crohn’s symptoms at the source
You might remember that the body can trigger an immune response that produces inflammation in the gastrointestinal (GI) tract. This active inflammation contributes to Crohn’s symptoms and may cause more severe disease.
So, with controlling inflammation in mind, what goals should you and your doctor try to achieve with a treatment? Consider the following:
GET SYMPTOM RELIEF
Controlling inflammation can help you achieve clinical remission. This means you are experiencing little to no Crohn's symptoms such as diarrhea, abdominal pain, fatigue, fever, and weight loss.
IMPROVE INTESTINAL LINING
Improving the lining of your GI tract is possible when inflammation is reduced, which your doctor will be able to monitor during an endoscopy. You’ll have achieved endoscopic remission when there’s little to no intestinal damage, or you have mild or inactive disease that’s visible in the lining of your GI tract.
ACHIEVE LONG-TERM REMISSION
Research suggests that there's a link between seeing improvement in inflammation and maintaining clinical remission—meaning you have achieved longer-term symptom relief.
Treatment options for Crohn’s disease
Now that we understand the relationship between inflammation and Crohn’s disease, let’s look at some available treatment options and the different ways they work to control inflammation:
Aminosalicylates (5-ASAs)
These drugs, given orally or rectally, are anti-inflammatory compounds that contain 5-aminosalicylic acid (5-ASA). They decrease inflammation at the wall of the intestine. Examples of 5-ASAs include sulfasalazine, balsalazide, mesalamine, and olsalazine.
Biologics
Biologics for Crohn’s are designed to work on the immune system to reduce inflammation. Some biologics work by targeting specific proteins, called cytokines, which play a role in causing inflammation. Other biologics work by preventing certain white blood cells from getting into inflamed tissues. Biologics are usually used for people with moderate to severe Crohn's disease.
Corticosteroids (steroids)
Prednisone, prednisolone, and budesonide are a few examples of this type of medication. They can affect the body’s ability to initiate and help maintain an inflammatory process—keeping the immune system in check. While steroids are effective for short-term flare-ups, they’re not recommended for long-term use.
Immune modifiers
(immunomodulators)
These suppress the body’s immune system activity to stop it from causing ongoing inflammation. These drugs (including azathioprine, 6-mercaptopurine [6-MP], and methotrexate) are usually used for people who have only responded to steroids.
Targeted oral small molecules
Targeted oral small molecules help reduce inflammation by targeting specific parts of the immune system. The different parts that these medications target in the body can play a role in reducing inflammation. They're taken by mouth and are usually used for people with moderate to severe Crohn's disease in whom certain treatments did not work well.
Learn more about targeted oral small molecules and how they work
Finding the right treatment plan for you
A treatment plan includes many things to help manage your disease—and can include medications, diet, and healthy lifestyle practices. Everyone’s experience with Crohn’s is different. Share your Crohn’s symptoms with your gastroenterologist. They can help determine if your treatment plan is meeting your goals.
Talk to your gastroenterologist about your Crohn’s symptoms to see what treatment options may be right for you.
What about surgery for Crohn’s?
It’s possible to find a Crohn’s treatment that can help you achieve remission without surgery. In fact, medication is usually the first treatment option.
There may be times when people with Crohn’s need surgery in addition to medication; for example, to treat an intestinal blockage or an abdominal abscess. Depending on the location of the disease in the GI tract, different types of surgery may be needed, but it’s important to know that surgery won’t cure Crohn’s disease.
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