Inflammatory bowel disease (IBD) is an umbrella term for several conditions that affect the intestinal tract. IBD happens when the immune system mistakenly attacks healthy tissue in the intestines.
These are the two main types of IBD:
- Ulcerative colitis. Ulcerative colitis affects the large intestine and rectum.
- Crohn’s disease. Crohn’s disease can affect any part along the digestive tract, from the mouth to the anus.
IBD is a chronic condition that requires lifelong management. There’s no cure for ulcerative colitis or Crohn’s disease.
There are treatments for IBD, with the goals of reducing inflammation, easing symptoms, and reducing flare-ups.
Let’s go over current treatment options for IBD and see what’s on the horizon.
Some medications are meant for short-term use and others can be taken longer. You may require a combination of medicines. Also, your needs will likely change over time based on symptoms, flare-ups, and remissions.
If you have any other conditions or develop one along the way, that must be taken into account. Among the medications used to treat IBD are:
Aminosalicylates, which may help prevent flare-ups and keep you in remission. These include:
Biologic therapies, which help block proteins that cause inflammation. These include:
- anti-tumor necrosis factor-alpha therapies like adalimumab, certolizumab, and infliximab
- anti-integrin therapies like natalizumab and vedolizumab
- anti-interleukin-12 and interleukin-23 therapy like ustekinumab
Other newer therapies are:
- Janus kinase inhibitors (JAK inhibitors) like tofacitinib
- sphingosine 1-phosphate (S1P) receptor modulators like ozanimod
Corticosteroids can help when you’re having a flare-up. They’re fast-acting and meant for short-term use. These include:
Immune system suppressors reduce inflammation and help prevent flare-ups. They can take a few weeks to a few months to start working. These include:
Your doctor may prescribe other medicines for specific symptoms. These may include:
- acetaminophen for mild pain (ibuprofen, naproxen, and aspirin should be avoided because they can actually make matters worse)
- antibiotics for infection due to abscesses and fistulas
- loperamide to treat severe diarrhea
- Small or large bowel resection, a procedure to remove the damaged portion of the intestine and sew the healthy ends together.
- Proctocolectomy, the removal of the large intestine and rectum. Having this procedure means you can no longer move your bowels on your own. Waste will leave your body through an opening in your abdomen. You’ll need to wear a pouch to collect the waste.
Complications of IBD that can be treated surgically include:
- abscess or fistula
- uncontrolled bleeding
- intestinal obstructions
- bowel perforation
Certain lifestyle choices may help with symptoms and affect how you feel overall.
A severe case of IBD can make it difficult to get the nutrients you need through food. But if you’re thinking of taking dietary supplements, speak with a doctor so you can do it safely and effectively.
Depending on your symptoms, your doctor may recommend changes to your diet, such as:
- eating more often, but keeping portions small
- avoiding carbonated beverages but drinking more water and other liquids
- avoiding high-fiber foods, nuts, and vegetable skins
Keeping a food diary can help you figure out which foods cause problems. Creating the right diet plan for you can take time, and it may help to meet with a dietitian.
Mental and emotional health
Stress doesn’t cause IBD. But living with IBD can be stressful, and that can affect you physically. You may be able to reduce the effects of stress by:
More research is needed to assess the effectiveness of these therapies as they relate to IBD. But if you’re feeling stressed out or overwhelmed, you might want to consider seeking help from a qualified therapist. It may also be helpful to join a support group for people with IBD.
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This involves drinking only certain liquids or not eating or drinking anything at all. You may need intravenous (IV) nutrition during this time, so it’s crucial that you do this under a doctor’s care.
Treatment for IBD has come a long way in recent decades. A wider selection of drugs for ulcerative colitis and Crohn’s disease is allowing a more personalized approach to treatment. Still, not everyone responds well to treatment.
The Crohn’s & Colitis Foundation has identified five priorities for research:
- preclinical human IBD mechanisms
- environmental triggers
- novel technologies
- precision medicine
- pragmatic clinical research
There’s also plenty of ongoing research into new and emerging therapies, such as:
- small-molecule drugs
- JAK inhibitors
- stem-cell transplants
- fecal microbiota transplant
- anti-integrin therapy
- IL-12/IL-23 inhibitors
You can keep up with the latest research and clinical trials through The Crohn’s & Colitis Foundation.
Ulcerative colitis and Crohn’s disease are chronic diseases. Either of these can go into remission for long periods —but remission is not a cure. There’s always the chance of a relapse.
There’s no shortage of online or word-of-mouth claims of a cure for IBD. They usually involve sales of expensive:
- dietary supplements
- herbal products
While some of these things may improve symptoms, they are not a cure. And even natural products can interfere with medications or increase symptoms of IBD. Consult with a doctor before making drastic changes to your diet or taking new supplements of any kind.
You can learn more about complementary therapies from the National Center for Complementary and Alternative Medicine.
Maintaining a healthy diet can help manage symptoms. But there’s no specific diet known to cure IBD. It’s important to continue with regular medical check-ups even when you’re in remission.
Ulcerative colitis and Crohn’s disease are the two main types of IBD. Both are chronic, inflammatory conditions that require lifelong management.
Despite claims to the contrary, there’s no cure for IBD. However, there are many medications to help control flare-ups and manage symptoms. And in some cases, surgery can result in long-term remission.
Research into the exact cause of IBD is ongoing. It’s a piece of the puzzle that may eventually lead to a cure. In the meantime, new and more effective treatments are improving quality of life for many people with IBD.
If you have IBD, see your doctor regularly. If your medications aren’t working, ask about the latest advances in treatment, as well as lifestyle adjustments that might help.