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Inside Crohn's
Symptoms of Crohn's
Diagnosing Crohn's
Treating Crohn's
Drug Therapy
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Drug Therapy

5-ASA Agents

When someone is first diagnosed with Crohn’s, he or she may be treated initially with drugs containing mesalamine, which helps control inflammation. Sulfasalazine is the most commonly used of these drugs. If you do not benefit from sulfasalazine or cannot tolerate it, you may be put on other drugs that contain mesalamine, generally known as 5-ASA agents.

Possible side effects of drugs containing mesalamine include nausea, vomiting, heartburn, diarrhea, and headache. However, 5-ASA agents are usually well tolerated. These drugs are frequently effective for mild to moderate, but not severe, inflammation.

Antibiotics

Antibiotics are used to treat bacterial overgrowth in the small intestine caused by strictures, fistulas, or prior surgery. They are also used to treat any bacterial infections that are present, including abscesses. Your gastroenterologist may prescribe one or more of the following antibiotics: ciprofloxacin, metronidazole, and ampicillin.

Antidiarrheal medications

Diarrhea and abdominal pain are often relieved when the inflammation subsides, but you may need additional medication. Several antidiarrheal agents may be prescribed by your gastroenterologist, including diphenoxylate, loperamide, and codeine. If you are dehydrated because of diarrhea, you will be treated with fluids and electrolytes.

Biologic

Treatments such as monoclonal antibodies inhibit a substance called tumor necrosis factor alpha (TNF-alpha), a protein produced by the immune system that plays a central role in the inflammation associated with Crohn's disease.

Corticosteroids

Corticosteroids help control inflammation and are very effective for active Crohn's disease, even if severe. If you respond to steroid treatment, your gastroenterologist will usually try to gradually lower the dose of the steroid in order to avoid some of the significant side effects of this class of drugs, which include increased blood pressure, cataracts, premature osteoporosis, and excessive weight gain. Corticosteroids are not recommended for long-term therapy.

Immunomodulators

Drugs that modulate or alter the immune system are also used to treat Crohn's disease. Most commonly prescribed are 6-mercaptopurine (6-MP) and a related drug, azathioprine. Immunomodulators work by blocking the immune reaction that contributes to inflammation. You may experience side effects such as nausea, vomiting, and diarrhea, as well as low white blood cell count and reduced resistance to infection.

If you take these drugs, it is recommended to have your blood count monitored on a regular basis. It often takes a few months of treatment for immunomodulators to take effect.