Crohn’s is a lifelong condition requiring continued management and monitoring. It’s important that you feel comfortable talking to your gastroenterologist. You’re a part of your own care team, and your appointments should leave you feeling empowered.
Finding a doctor who is the right fit for you is an important step in successful disease management. Keep a journal for jotting down questions for your doctor as they arise and bring it with you to each appointment. You can start with the six questions below.
The more knowledge you have, the better equipped you’ll be to manage your condition, and the more insight you’ll gain into your doctor’s treatment approach.
Your doctor should be able to give you information about the treatment options available for Crohn’s disease. Crohn’s isn’t curable, so the goal of treatment is to put the condition into remission by reducing inflammation. This can be done several ways:
There are medications you can take to treat Crohn’s:
- Aminosalicylates (5-ASA) decrease inflammation in the lining of the colon.
- Corticosteroids suppress the overall immune system.
- Immunomodulators reduce inflammation by suppressing the immune system.
- Antibiotics treat infections like abscesses.
- Biologic therapies target and reduce the inflammation response.
Each medication has advantages and side effects your doctor can explain.
Food and Crohn’s disease have a complicated relationship. Certain dietary items can trigger flares, making them items to avoid. Examples include dairy, fat, and fiber. In severe cases, treatment may include temporary bowel rest.
This approach generally requires taking a break from some or all foods and receiving nutrients through intravenous fluids.
Intestinal inflammation can interfere with nutrient absorption. That’s why malnutrition is a complication of Crohn’s. Your doctor can give you strategies for dealing with the Crohn’s dietary puzzle.
Sometimes surgery is required to treat Crohn’s. This is done to repair or remove diseased sections of the gastrointestinal tract, or to treat an emergency such as a bowel obstruction. Ask your doctor for the criteria you should meet before surgery is an option.
Biologics are the latest treatment innovation for Crohn’s. They are medications made from living cells, and they work by targeting the inflammation process.
Some of them target tumor necrosis factor (TNF) to reduce the inflammation it creates. Others block the movement of inflammation particles to inflamed areas of the body, like the gut, giving these areas time to rest and recover.
Biologics come with side effects, primarily relating to suppressed immunity. Ask your doctor about the pros and cons of this treatment approach to see if it’s a good fit for you.
Recommendations for treating Crohn’s disease are based on a person’s symptoms and the overall outlook of their condition. Your doctor will also consider the results of your medical tests. The medications that will work best for you are determined by all of these factors.
Depending on the severity of your Crohn’s disease, your doctor might recommend a biologic right away. For more mild cases of Crohn’s, steroids might be the first medication your doctor prescribes.
Be prepared to discuss all of your Crohn’s symptoms with your doctor so they can help determine the best treatment for you.
Managing remission involves monitoring your condition and protecting you from new flares. Ask your doctor what kind of regular assessments you will have, ranging from clinical observation to blood and stool tests.
Traditionally, doctors have relied on symptoms alone to tell if you’re in remission. Sometimes symptoms don’t match the level of Crohn’s activity, and more testing provides better information.
Ask your doctor about continuing with medication during remission. This is the most frequently recommended approach. The goal is to protect you from experiencing new flares.
In many cases, your doctor will advise you to stay on the same medication that put you in remission, and to continue taking it as long as it doesn't have any adverse effects.
If you used a steroid to achieve remission, your doctor will likely take you off the steroid and start an immunomodulator or biologic instead.
Research has yet to demonstrate that alternative therapies can effectively replace conventional treatment. If you do decide to try things like fish oil, probiotics, or herbal supplements, check with your doctor first to make sure that they don’t interfere with your medication.
Also, complementary approaches shouldn’t replace your medication.
Lifestyle has a tangible impact on any condition, and Crohn’s is no exception. Ask your doctor about stress reduction, exercise, and other helpful changes you can make such as quitting smoking.
The success of your treatment can hinge on your involvement and the relationship you have with your doctor. Ask questions and try to learn as much as you can. The more you know, the better able you will be to manage your disease.