Crohn’s disease treatment

There is no cure for Crohn’s disease, but treatments are available to help reduce the inflammation of the lining of the digestive system it causes, reduce symptoms and to manage any nutritional deficiencies.

Treatment might involve drugs, nutritional supplements, surgery, or a combination of these.

Treatment choices depend on where the disease is located and how severe it is. They also depend on the complications associated with the disease and the way the person has responded in the past to treatment when symptoms reoccurred.

What kinds of drugs are used to treat Crohn's disease?

There are several types of drugs used to treat Crohn's disease. The first step usually involves reducing inflammation. Sulfasalazine is a type of aminosalicylic acid drug (5-aminosalicylic acid, or 5-ASA). Other 5-ASA’s include olsalazine, balsalazide and mesalazine.

Corticosteroids such as prednisolone are another class of drugs that reduce inflammation. A doctor is likely to prescribe an initial large dose of prednisolone when the disease is very active. The dose is then tapered off. 

Crohn's disease may also be treated with drugs that stop the immune system from causing inflammation. Immunosuppressants decrease the activity of the immune system. Immunosuppressants prescribed for Crohn's disease include azathioprine, 6-mercaptopurine, tacrolimus, and methotrexate.

Biological drugs, infliximab and adalimumab, may be recommended when a person with Crohn's disease does not respond to the standard treatments of mesalazine-containing drugs, corticosteroids, and immunosuppressants. These ‘biologicals’ attach to the inflammation-promoting protein, tumour-necrosis factor-alpha (TNF-alpha) preventing the inflammation that occurs in Crohn’s disease.

Other treatments that may be recommended to treat Crohn's include:

• Antibiotics to treat bacterial infections and overgrowth of bacteria in the small intestine
• Antidiarrhoeal agents to stop diarrhoea
• Fluid replacements to counteract dehydration
• Nutritional supplements to provide the nutrients that may not be being absorbed properly
• Surgery to remove diseased parts of the gut