Crohn’s Disease Treatment

surgical options, biologics, and yoga
Crohn's can be treated with medications, surgery, and stress-reduction techniques like yoga.iStock (2); Canva

There's no cure for Crohn's disease, but there are several therapies available to help with symptom management.

Most people with Crohn's disease can lead a fairly normal life with treatment.

The treatments your doctor recommends will depend on the severity and type of symptoms you're experiencing, as well as what parts of your digestive tract are affected.

The two main types of treatment for Crohn's disease are medication and surgery.

Medications for Crohn’s Disease

A number of medicines are used to treat Crohn's disease.

Your doctor may recommend one or more drugs, depending on which parts of the digestive tract are causing your symptoms.

Most medications for Crohn's disease reduce inflammation and suppress the immune system.

Some medicines are used to treat flares, when symptoms are at their worst. Other medicines help prevent the return of symptoms once they've gone away.

According to the Crohn’s & Colitis Foundation, here are some common Crohn's medicines.

Aminosalicylates (5-ASAs) These drugs reduce inflammation in the digestive tract, especially in the colon.

Aminosalicylates are generally prescribed for people with mild to moderate symptoms. According to the Crohn’s & Colitis Foundation, they’re most useful as a maintenance treatment to prevent relapses.

Their effects are localized to the colon, and they have fewer side effects than some of the other medications used to treat Crohn's.

Apriso, Asacol HD, Delzicol, Lialda, or Pentasa (mesalamine) and Azulfidine (sulfasalazine) are the most commonly prescribed aminosalicylates used to treat Crohn's disease, although they are not as widely prescribed as they used to be, according to the Mayo Clinic.

Corticosteroids Also known simply as steroids, these drugs reduce inflammation and immune system activity.

They’re generally prescribed for people with moderate to severe symptoms, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Deltasone (prednisone), Medrol (methylprednisolone), and Entocort EC (budesonide) are?corticosteroids commonly prescribed for Crohn’s disease.

Corticosteroids suppress the entire immune system, not just in the digestive tract.

Because they can have significant side effects in both the long and short term, steroids are usually taken only for short periods of time to help control a Crohn’s disease flare, according to the Crohn’s & Colitis Foundation.

Immunomodulators These drugs help reduce inflammation by suppressing the body’s immune system.

Your doctor may recommend an immunomodulator if you have severe symptoms, or if you haven’t seen enough improvement in your symptoms with aminosalicylates and corticosteroids.

These drugs may help you stop taking corticosteroids or maintain remission when other drugs haven’t been effective for this purpose, according to the Crohn’s & Colitis Foundation.

Immunomodulators may take between a few weeks and three months to start working, the NIDDK reports.

According to the Crohn’s & Colitis Foundation, commonly prescribed immunomodulators include Imuran (azathioprine), Purinethol (mercaptopurine), and Prograf (tacrolimus).

Biologic response modifiers (biologics) These drugs prevent inflammation by targeting proteins made by the immune system.

Biologics are commonly used in moderate to severe disease and frequently used in mild disease when other treatments have not worked as well, according to the Crohn’s & Colitis Foundation.

They are given either as monotherapy or in combination with other medications and are given intravenously (by IV) or by injection.

Some of these drugs are injected like a regular shot and others are given as an IV infusion in an infusion center, doctor’s office, or at home.

Commonly prescribed biologics include Remicade (infliximab), Humira (adalimumab), Cimzia (certolizumab), Tysabri (natalizumab), Stelara (ustekinumab), and Entyvio (vedolizumab).

Janus kinase (JAK) inhibitors In May 2023, the FDA approved?Rinvoq (upadacitinib) for adults with moderately to severely active Crohn’s disease who haven’t responded well to or can't tolerate one or more tumor necrosis factor (TNF) blockers.

It’s the first approved oral treatment for Crohn’s disease and is a fast-acting alternative to infusions and injectable drugs. It works by blocking multiple pathways of inflammation caused by inflammatory bowel diseases.

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Surgery for Crohn’s Disease

Your doctor may recommend surgery for your Crohn’s disease if your symptoms aren't getting better with medicine.

As many as 75 percent of people with Crohn's disease will need surgery at some point, according to the Crohn’s & Colitis Foundation.

Surgery isn't a cure for Crohn's disease, but some people experience total relief from symptoms for many years after surgery.

According to the Mayo Clinic, medications after surgery can prevent or delay recurrence of your disease.

Commonly performed surgeries for Crohn's disease include:

Resection and anastomosis In this procedure, a surgeon removes the diseased part of your small intestine or colon and reconnects what remains, according to the Crohn’s & Colitis Foundation.

Strictureplasty This procedure may be used in certain cases to reopen an area of the bowel that has become blocked (usually part of the small intestine) without removing the section altogether, the Crohn’s & Colitis Foundation explains.

Complementary and Alternative Treatments

There's little scientific evidence that complementary or alternative therapies provide clear benefits for people with Crohn's disease, according to the Mayo Clinic.

Some people with Crohn's disease use complementary therapies, together with conventional treatments such as medicine and surgery, to reduce symptoms.

Complementary therapies for Crohn's disease include:

Stress-reduction techniques While stress does not cause Crohn’s disease, it can exacerbate symptoms and trigger flare-ups, according to the Mayo Clinic.

Stress reduction and relaxation techniques like yoga and mindfulness meditation can ease your mind, thereby improving overall health and well-being.

A research review published in the Journal of Psychosomatic Research found that yoga can have a positive impact on mental health in people with IBD, helping to reduce depression and anxiety and improving overall quality of life.

There’s some evidence that meditation has a positive impact on Crohn’s disease symptoms. A study published in 2020 in Scientific Reports?concluded that mindfulness meditation may help reduce inflammation in people with Crohn’s.

Acupuncture?In this ancient practice of traditional Chinese medicine (TCM), a practitioner inserts fine needles in various locations on your body. According to Johns Hopkins Medicine, research has shown that?acupuncture can improve a variety of health conditions.

A research review published in the World Journal of Gastroenterology found that acupuncture — combined with herb burning, called moxibustion — led to significantly less Crohn's disease activity, as shown by self-reporting.

Herbal and plant-based remedies According to an article in the journal Annals of Gastroenterology, herbal and plant remedies that have been shown in studies to reduce active Crohn's disease include wormwood, cannabis, Boswellia serrata, and Tripterygium wilfordii.

Tell your doctor if you use any complementary therapies, especially if you're taking dietary supplements or vitamins.

These products may contain ingredients that could interact with other medications you're taking, and some supplements may contain impurities or have dangerous side effects, according to the Crohn’s & Colitis Foundation.

Additional reporting by Cathy Garrard.

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Resources

  • Medication Options for Crohn’s Disease. Crohn’s & Colitis Foundation.
  • Crohn’s Disease. Mayo Clinic. October 13, 2020.
  • Treatment for Crohn’s Disease. National Institute of Diabetes and Digestive and Kidney Diseases. September 2017.
  • FDA approves first oral treatment for moderately to severely active Crohn’s disease. FDA. May 2023.
  • Surgery for Crohn’s Disease and Ulcerative Colitis. Crohn’s & Colitis Foundation.
  • Small and Large Bowel Resection. Crohn’s & Colitis Foundation.
  • Strictureplasty. Crohn’s & Colitis Foundation.
  • Proctocolectomy and Colectomy. Crohn’s & Colitis Foundation.
  • Ewais T, Begun J, Kenny M, et al. A Systematic Review and Meta-Analysis of Mindfulness Based Interventions and Yoga in Inflammatory Bowel Disease. Journal of Psychosomatic Research. January 2019.
  • Gonzalez-Moret R, Cebolla A, Cortes X. The Effect of a Mindfulness-Based Therapy on Different Biomarkers Among Patients With Inflammatory Bowel Disease: A Randomised Controlled Trial. Scientific Reports. April 8, 2020.
  • Acupuncture. Johns Hopkins Medicine.
  • Bai C, Zhao J, Liu H, et al. Randomized Controlled Trial: Moxibustion and Acupuncture for the Treatment of Crohn’s Disease. World Journal of Gastroenterology. August 21, 2014.
  • Triantafyllidi A, Xanthos T, Papalois A, et al. Herbal and Plant Therapy in Patients With Inflammatory Bowel Disease. Annals of Gastroenterology. April–June 2015.
  • Vitamins, Minerals, and Supplements. Crohn’s & Colitis Foundation.
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