Crohn’s Disease Medications
Crohn’s disease (CD) is an autoimmune disorder that affects
the gastrointestinal (GI) tract. In Crohn’s disease, parts of the GI tract
become inflamed. Sores (ulcers or lesions), openings (fistulas), or cracks in
the intestines can develop that block the passage of food and waste. Crohn’s
can affect any part of the GI tract, but it’s usually found in the colon.
People who suffer from Crohn’s disease often experience cramping
or pain in the abdomen, diarrhea, bleeding, and weight loss. Crohn’s is a
chronic disease. The symptoms can vary and people can have flare ups, or times
when the symptoms are intense, and periods of remission, when the symptoms are
less severe or absent.
There’s no cure for Crohn’s. However, there are medications
available to help manage the symptoms and prevent relapse.
Doctors will normally prescribe aminosalicytes to reduce
inflammation and ease the symptoms if you have a mild or moderate form of CD. Sulfasalazine (Azulfidine) and mesalamine (Asacol) are the most commonly prescribed
medications. Olsalazine (Dipentum) and balsalazide (Colazal) are two other medications
that have been developed. These medications can be taken by mouth or as a
suppository or as a combination of both, depending on where CD affects your
The side effects of these medications include:
Some people taking this medication have a lower white blood
cell count or have had problems with their kidneys. If you take these medications,
your doctor may want to monitor your kidney function or order regular blood
tests to make sure your white blood cell count isn’t too low. You should tell
your doctor if you’re allergic to sulfa drugs.
Doctors normally prescribe these types of medications for
the long-term to keep CD in remission. You shouldn’t stop taking your
medications without first consulting your doctor.
Corticosteroids help reduce inflammation in the body.
Doctors prescribe corticosteroids for short-term relief of CD symptoms. Doctors
usually prescribe budesonide (Pulmicort) for
some mild and moderate cases of CD. If you have a more serious case of CD or if
budesonide isn’t effective, your doctor
may prescribe prednisone or methylprednisolone.
The side effects of corticosteroids are:
- intraocular pressure or glaucoma in the eyes
- high blood pressure
- weight gain
There can be some serious side effects if you take corticosteroids
over a period of three months, including a loss of bone density (osteoporosis) and
liver issues. If you have trouble withdrawing from prednisone, your doctor may
prescribe methotrexate to help you stay in remission and to help with the
withdrawal from prednisone. Your doctor may also prescribe calcium and vitamin D supplements to prevent
bone loss if you are taking corticosteroids for a long time.
No one knows the cause of CD. But researchers believe that it’s
caused by a problem with your immune system. Cells that normally protect your
body “attack” the gastrointestinal (GI) tract. Because of this, medications
that suppress or regulate your immune system can help. Sometimes doctors will
prescribe these medications if aminosalicylates and
corticosteroids aren’t effective or if you develop fistulas. These
medications can help CD stay in remission and may even heal fistulas. Some
common immunosuppressive medications are:
The side effects are headache, nausea, vomiting,
and diarrhea. Because these medications suppress the immune system, they could
affect how well your body is able to fight infections. Some rare side effects
are an inflammation of the pancreas (pancreatitis), liver problems, and a
decrease in the amount of bone marrow made by the body (myelosuppression).
Biologics are a new type of
drug used for people with moderate to severe or active CD. Your doctor may
prescribe biologics if other medications aren’t working, or if
you have openings, or fistulas, in your GI tract. They can also be given to
help ease you off of steroid medications. These medications are given
intravenously (IV) or by a shot on a regular basis. They work to reduce
inflammation in specific areas, such as the lining of your intestines, rather
than suppressing your whole immune system. The most common medications are:
- infliximab (Remicade)
- adalimumab (Humira)
- certolizumab pegol
- natalizumab (Tysabri)
Because these are given by IV or injection,
you may experience redness, swelling, or irritation where you received the
injection. You may also get headaches, fever, chills, or develop low blood
pressure. In rare cases, some people have gotten severe infections or tuberculosis
(TB) after receiving this treatment. You should have a TB test before taking
these medications. Let your doctor know if you have TB before taking this
Doctors may prescribe additional medications to help with other
symptoms of CD.
Antibiotics are sometimes prescribed to prevent an
overgrowth of bacteria in the intestines or to prevent abscesses. Your doctor
may also prescribe an anti-diarrheal if you have severe bouts of diarrhea.
Some people with CD are at risk for developing blood clots
or have other blood conditions, such as anemia. In the case of blood clots, your
doctor may prescribe heparin, a blood thinner that prevents clots. If you show
signs of anemia, your doctor may also prescribe iron supplements or vitamin B12
shots to treat the anemia.
As with any medication regime or medical management plan,
work closely with your doctor and follow the instructions as prescribed.