Crohn’s disease is an autoimmune disorder that affects the gastrointestinal (GI) tract. According to the Crohn’s and Colitis Foundation, it’s one of the conditions that make up irritable bowel diseases, or IBDs, disorders that affect as many as 3 million Americans.
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 the GI tract, but it most often affects the small bowel and the beginning of the colon. There are different classifications of Crohn’s that are based on where the disorder affects a person in their GI tract.
Because there are different types of Crohn’s, the symptoms will also vary, but may include:
- stomach pain
- nausea and vomiting
- weight loss
While there is no cure for Crohn’s disease, medications and other treatment options, including diet and lifestyle changes, can help manage symptoms.
Treatment for Crohn’s is very personalized, so what works for one person may not work for you.
Crohn’s disease often happens in cycles of remission and flare-ups, so treatment plans will require reevaluation and monitoring.
Work with your doctor to come up with a treatment plan to manage your specific Crohn’s symptoms.
One of the primary ways that you can manage Crohn’s disease is through medications that suppress your immune system and reduce the inflammation in your GI tract.
When you have Crohn’s or other IBD disorders, the immune system has an abnormal inflammatory response that will cause your symptoms.
The goal of taking medication to lower your immune response is to help your symptoms and give your GI tract a chance to rest and heal.
The following are medications that may be prescribed alone or in combination to help manage your Crohn’s disease:
According to the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDKD), corticosteroids are steroids that help reduce both inflammation and your immune response. They’re often used as short-term treatment.
Common corticosteroids used to manage Crohn’s include:
The side effects of corticosteroids can include:
- glaucoma or increased pressure in your eyes
- high blood pressure
- weight gain
- higher risk of getting an infection
- mood changes
Serious side effects, such as loss of bone density (osteoporosis) 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.
Aminosalicylates are often used to treat ulcerative colitis, but may be prescribed for Crohn’s as well. These drugs are thought to reduce inflammation in the intestine lining to ease symptoms.
These medications can be taken as a suppository, by mouth, or as a combination of both. How you take the drug depends on where the disease affects your body.
The possible side effects of aminosalicylates include:
While taking this medication, your doctor may monitor your kidney function. They may also order blood tests to make sure 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.
Researchers believe Crohn’s disease is caused by a problem with the immune system. Cells that normally protect your body 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 before they start working, so you will need to wait some time before you know if they will help you.
Doctors may prescribe these types of medications if aminosalicylates and corticosteroids don’t work or if you develop fistulas. These medications can help you stay in remission. They may also heal fistulas.
Some common immunosuppressive medications include:
- azathioprine (Imuran)
- mercaptopurine (Purinethol)
- cyclosporine (Gengraf, Neoral, Sandimmune)
The side effects of these medications can include:
- higher risk of getting an infection
Some rare side effects are pancreatitis (inflammation of the pancreas), liver problems, and myelosuppression. Myelosuppression is a decrease in the amount of bone marrow you make.
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. They don’t suppress your whole immune system.
Your doctor may prescribe biologics if you have moderate or severe symptoms or if your 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) use of steroid medications.
These medications are most often given by injection at a hospital or an outpatient center every 6 to 8 weeks.
The most common biologic drugs include:
- anti-tumor necrosis factor-alpha therapies
- anti-integrin therapies
- interleukin-23 therapy
You may have redness, swelling, or irritation where you receive the injection. You may also experience:
- low blood pressure
In rare cases, some people have had a toxic reaction to the medication or have a higher risk of an infection, especially tuberculosis (TB).
Doctors may prescribe additional medications to help with other symptoms of Crohn’s.
Antibiotics can prevent abscesses and overgrowth of bacteria in the intestines.
Your doctor may also prescribe an antidiarrheal drug called loperamide to be taken short term if you have severe diarrhea.
Some people with Crohn’s are also at risk of developing blood clots, so depending on your risk, your doctor may also prescribe a blood thinner to decrease your risk of complications from a blood clot.
Your doctor may recommend prescription-strength acetaminophen for relieving pain. Avoid using ibuprofen (Advil), naproxen (Aleve), and aspirin for pain relief, as these can worsen symptoms.
Although doctors will first try to manage Crohn’s disease with medication, because it is a lifelong disorder, many people with Crohn’s will eventually need surgery.
There are different types of surgeries for people who have Crohn’s disease. The exact type of surgery will depend on what type of Crohn’s you have, what symptoms you’re experiencing, and how severe the symptoms are.
Surgeries for Crohn’s include:
- Strictureplasty. This surgery widens a part of your intestine that has become narrowed over time due to inflammation.
- Proctocolectomy. With this surgery for severe cases, both the colon and the rectum are completely removed.
- Colectomy. In a colectomy, the colon is removed, but the rectum is left intact.
- Fistula removal and abscess drainage.
- Small and large bowel resection. Surgery is performed to remove the damaged part of the bowel and reconnect the healthy, unaffected areas of the bowel.
Along with a medication regimen and surgery, there are also some complementary natural remedies you can discuss with your doctor.
- 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 if they are helpful in Crohn’s. You can find omega-3 fatty acids in supplements or in foods such as salmon, sardines, nuts, flax seed, plant oils, and some fortified foods.
- Turmeric. Turmeric is also being studied to see if it benefits Crohn’s because of its anti-inflammatory properties. However, turmeric does have blood-thinning properties, so check with your doctor before adding it to your diet or taking it as a supplement.
- Medical cannabis. According to the Crohn’s & Colitis Foundation, a few small studies have suggested that medical cannabis may help with certain symptoms of IBD, but there is no clear evidence to recommend it for Crohn’s.
There are important lifestyle changes that you can take to help manage your symptoms, some of which are listed here:
Manage your stress
Managing stress is an important part of any healthy lifestyle, but stress management is especially important with a chronic inflammatory disease. This is because
You can try stress management techniques on your own, such as guided meditation apps or videos, deep breathing exercises, or yoga.
It’s also a good idea to speak with a therapist to gain some new stress managements tools as well, especially if you have high levels of stress.
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.
Smoking can make symptoms worse, trigger a flare, and make your medication less effective.
Quitting smoking, no matter how long a person has been smoking and has had Crohn’s, has been found to help manage symptoms.
Keep a food journal
Studies have not found that one specific diet or food helps Crohn’s, but because it is such an individual disorder, there may be certain foods that trigger symptoms for you.
Keping a food journal and eating a healthy, balanced diet can help you get the nutrients you need and identify any foods that might make your symptoms worse.
Limit caffeine and alcohol
Crohn’s disease is a type of IBD that affects everyone differently.
There are different types of Crohn’s that may affect different parts of the GI system. Symptoms will vary depending on which part of the GI tract it affects and how severe it is.
Because Crohn’s is a lifelong disorder that doesn’t affect everyone the same way, you’ll want to work with your doctor to develop an individual treatment plan that might include medication, lifestyle changes, or surgery.