Crohn's Disease Treatment Options
A combination of treatment options can help you stay in control of your disease and help you to lead a full and rewarding life. Remember that there is no standard treatment that will work for all patients. Each patient’s situation is different and treatment must be followed for each circumstance.
Treatment for Crohn’s disease and other IBD varieties can include the use of medication, alterations in diet and nutrition, and sometimes surgical procedures to repair or remove affected portions of your GI tract.
Medication treating Crohn’s disease is designed to suppress your immune system’s abnormal inflammatory response that is causing your symptoms. Suppressing inflammation not only offers relief from common symptoms like fever, diarrhea, and pain, it also allows your intestinal tissues to heal.
In addition to controlling and suppressing symptoms (inducing remission), medication can also be used to decrease the frequency of symptom flare ups (maintaining remission). With proper treatment over time, periods of remission can be extended and periods of symptom flare ups can be reduced. Several types of medication are being used to treat Crohn's disease today.
In some circumstances, a health care provider may recommend adding an additional therapy that will work in combination with the initial therapy to increase its effectiveness. For example, combination therapy could include the addition of a biologic to an immunomodulator. As with all therapy, there are risks and benefits of combination therapy. Combining therapies can increase the effectiveness of IBD treatment, but there may also be an increased risk of additional side effects and toxicity. Your health care provider will identify the treatment option that is most effective for your individual health care needs.
Diet & Nutrition
While Crohn’s disease may not be the result of bad reactions to specific foods, paying special attention to your diet may help reduce symptoms, replace lost nutrients, and promote healing.
For people diagnosed with Crohn’s disease, it is essential to maintain good nutrition because Crohn’s often reduces your appetite while increasing your body’s energy needs. Additionally, common Crohn’s symptoms like diarrhea can reduce your body’s ability to absorb protein, fat, carbohydrates, as well as water, vitamins, and minerals.
Many people who experience Crohn's disease flare ups find that soft, bland foods cause less discomfort than spicy or high-fiber foods. While your diet can remain flexible and should include a variety of foods from all food groups, your doctor will likely recommend restricting your intake of dairy if you are found to be lactose-intolerant. Watch this webcast to learn more about nutrition in inflammatory bowel diseases.
Even with proper medication and diet, as many as two-thirds to three-quarters of people with Crohn's disease will require surgery at some point during their lives. While surgery does not cure Crohn's disease, it can conserve portions of your GI tract and return you to the best possible quality of life.
Surgery becomes necessary when medications can no longer control symptoms, or if you develop a fistula, fissure, or intestinal obstruction. Surgery often involves removal of the diseased segment of bowel (resection), the two ends of healthy bowel are then joined together (anastomosis). While these procedures may cause your symptoms to disappear for many years, Crohn’s frequently recurs later in life.
Key things to know about Surgery:
- Over a span of 5 years, studies have shown that 18% of Crohn's patients may eventually require surgery. This percentage has significantly declined within the last several years.
- Different types of procedures may be performed depending on the reason, severity of illness, and location of the disease.
- For Crohn's disease patients, approximately 31% may require a second resection 10 years after their first resection.
Tsai L, Ma C, Dulai PS, Prokop LJ, Eisenstein S, Ramamoorthy SL, Feagan BG, Jairath V, Sandborn WJ, Singh S. Contemporary Risk of Surgery in Patients with Ulcerative Colitis and Crohn's Disease: A Meta-Analysis of Population-based Cohorts. Clin Gastroenterol Hepatol 2020 Oct 27;S1542-3565(20)31497-X.
Making Informed Decisions
If you're confused about all the medications and therapies out there, you are not alone! IBD is extremely complex, and it is important to review the risks and benefits of all treatment options with your doctor. Learn more about available tools and resources that can help you make informed decisions about your care.