Crohn’s disease is a health condition that affects the gastrointestinal (GI) tract.
According to the Crohn’s and Colitis Foundation, it’s one of the conditions that make up inflammatory bowel diseases (IBDs), which 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 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 in the GI tract the condition affects you.
Because there are different types of Crohn’s, the symptoms will also vary. They may include:
- abdominal pain
- nausea and vomiting
- weight loss
- a frequent need for bowel movements
- feeling like your bowels aren’t empty after a bowel movement
While there’s no cure for Crohn’s disease, medications and other treatment options — including diet and lifestyle changes — can help manage symptoms.
Crohn’s disease often happens in cycles of remission and flare-ups, so treatment plans will require reevaluation 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 come up with a treatment plan to manage your specific Crohn’s symptoms.
One of the primary ways you can manage Crohn’s disease is through medications that suppress your immune system and reduce the inflammation in your GI tract.
The goal of taking medication to lower your immune response is to help ease 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 (NIDDK), 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:
- beclomethasone dipropionate
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. Don’t stop taking steroids without talking with your doctor first because this can lead to additional health concerns.
Aminosalicylates (anti-inflammatory drugs)
Aminosalicylates are often used to treat another IBD called ulcerative colitis, but they may be prescribed for Crohn’s as well. These drugs are thought to reduce inflammation in the intestine lining to ease symptoms.
They’re commonly used in treating mild to moderate episodes of Crohn’s.
These medications can be taken as a suppository, by mouth, or as a combination of both. How you take the medication depends on where 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 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.
Immunomodulator medications (immunosuppressants)
Researchers believe Crohn’s disease is caused by a problem with the immune system. 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.
Doctors may prescribe these types of medications if aminosalicylates and corticosteroids don’t work for you or if you develop fistulas (abnormal openings that form in the bowels).
These medications can help you stay in remission. They may also heal fistulas.
Some common immunosuppressive medications include:
- mycophenolate mofetil
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 your body makes.
Antibiotics can treat many infections, such as bacterial infections caused by Crohn’s. This could include fistulas and abscesses.
Common antibiotics for Crohn’s:
Side effects of antibiotics can include:
- abdominal pain
- loss of appetite
- neuropathy from extended use of metronidazole (or tingling in the hands or feet)
- sensitivity to sunlight from ciprofloxacin
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 (TNF 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
- inhibitors of Janus kinase (JAK inhibitors) such as tofacitinib
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, liver problems, or a higher risk of an infection, especially tuberculosis.
Doctors may prescribe additional medications to help with other symptoms of Crohn’s — for example, an antidiarrheal drug called loperamide that may be taken short term if you have severe diarrhea.
Some people with Crohn’s are also at risk of developing blood clots. Depending on your risk, your doctor may also prescribe a blood thinner to decrease your chance of complications from a blood clot.
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 to enable healing. This may include either 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 done at home or in a hospital, depending on the circumstances and your doctor’s recommendations.
Doctors will first try to manage Crohn’s disease with medication. But because it’s 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
- 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. 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. 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.
- 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’s no clear evidence to recommend it for Crohn’s.
You can make important lifestyle changes 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 condition.
This is because stress can make inflammation worse, according to a
You can try stress management techniques on your own, such as:
- guided meditation apps or videos
- deep breathing exercises
It’s also a good idea to speak with a mental health professional to gain some new stress managements tools and strategies, 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.
If you smoke, it can:
- make symptoms worse
- trigger a flare
- 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, 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 and 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.