Medications for Crohn's Disease
Medications are essential for treating Crohn’s disease. The choice of medication depends on whether a flare-up is present and how severe it is. Doctors use the following medications as “anti-inflammatory agents” during an acute flare-up:
- Corticosteroids (“cortisone”): They are among the most effective anti-inflammatory medications during a flare-up and reduce inflammatory activity.
- Aminosalicylates: Commonly used active ingredients include sulfasalazine and mesalazine. They come in various forms: tablets, suppositories, or enemas.
- Immunosuppressants: These medications suppress the activity of the immune system. Examples of active ingredients include azathioprine and 6-mercaptopurine (6-MP). However, when the immune system is weakened, pathogens have an easier time—increasing the risk of infectious diseases. Patients are more susceptible to colds, pneumonia, urinary tract infections, or fungal infections.
- Anticancer drugs: Methotrexate is an active ingredient that slows cell growth.
- Antibiotics, for example, for purulent abscesses and fistulas when bacteria are involved (antibiotics are ineffective against viruses, by the way).
- Antibodies (biologics), when other medications are not sufficiently effective. Biologics are proteins that are produced through genetic engineering and are very similar to the body’s own substances. That is why they are also called “biological drugs.” Examples of such antibodies include infliximab, certolizumab, and adalimumab. They belong to the class of TNF-alpha blockers. Alternatives include vedolizumab and ustekinumab. The antibodies directly intervene in the inflammatory process in the body, though at different sites.
Even after the acute flare-up has subsided, anti-inflammatory medications are often recommended (e.g., azathioprine or 6-mercaptopurine). They extend the time between two flare-ups and help prevent new flare-ups from occurring. Many patients take them over a long period of several years.
All of the medications listed here—like any medication—have side effects. These can range from skin rashes and skin inflammation to skin cancer. Some medications also weaken the body’s immune system.
Doctors treat typical symptoms of Crohn’s disease, such as diarrhea, with the active ingredient loperamide; iron supplements help with iron deficiency.
Psychotherapy for Crohn's Disease
Crohn’s disease is a chronic condition that affects not only the body but also the mind. Those affected must learn to live well with their lifelong companion. In such cases, psychotherapy can help people cope with their illness and improve their quality of life. Psychological support is also recommended for anxiety and depression.
Surgery is sometimes unavoidable
Sometimes, as the duration of the illness increases, medications and other treatments are no longer sufficient and no longer produce satisfactory results. In that case, surgery can help. However, doctors always try to postpone surgery as long as possible. Surgery is also necessary if complications arise, such as an intestinal obstruction, a perforated bowel, or severe intestinal bleeding. Surgery is also an option for children and adolescents if Crohn’s disease is causing delays in their growth and development. During surgery, surgeons generally remove only the inflamed section of the intestine—that is, as little intestinal tissue as possible. The extensive removal of sections of the intestine has proven to be unnecessary and fraught with many disadvantages.
For Crohn’s disease, we routinely perform surgery laparoscopically, that is, using minimally invasive “keyhole” surgery. This has more than just cosmetic benefits. Patients recover much more quickly after surgery. They experience less pain, spend less time in the hospital, and can therefore return to work sooner.
Diet as a Treatment for Crohn's Disease
People with Crohn’s disease need to pay attention to their diet. Not only to avoid further irritating the inflamed intestine and worsening symptoms, but also to prevent malnutrition. Seek guidance from a specially trained nutritionist (ecotrophologist) or consult a doctor who is well-versed in nutritional medicine. Nutritional counseling is also helpful if you also suffer from a food intolerance or food allergy.
There is no specific diet for people with Crohn’s disease that works equally well for everyone. Try to figure out which foods you can tolerate and which you can’t. After a flare-up, the following diet is recommended:
- Start with foods that are easy to digest and don’t put a strain on the intestines. Carbohydrates are a good choice at the beginning, followed by foods that contain protein and fat.
- Then, light, balanced meals: Examples include low-fat dairy products, lean meat, whole-grain bread, rice, potatoes, pasta, or vegetables such as carrots, tomatoes, or fennel. You can also try some fresh fruit and salads.
- Avoiding processed foods because they contain many artificial additives. Furthermore, not all ingredients are listed on the packaging.
- You should also be careful with foods that are high in sugar (e.g., chocolate, cakes, pastries, cookies, soft drinks).
During an acute flare-up of the disease, artificial feeding via a stomach or intestinal tube is sometimes helpful. However, once the flare-up has subsided, you can gradually return to a normal diet. Gradually reintroduce a normal diet to your digestive system.
