Treating and managing Crohn’s disease is a lifelong journey. Since symptom onset can be unpredictable and complications can develop over time, treatment options may need to change throughout the course of a person’s illness.
So far, the most promising treatments for Crohn’s disease include different types of medication, surgery, and lifestyle modifications. Other treatments may be necessary to correct, prevent, or manage additional health complications. Treatments furthermore need to be customized to meet the needs of each individual patient. Healthcare providers should also consider factors such as disease severity, type of Crohn’s disease, age, overall health status, and patient response to past interventions.
Healthcare providers may prescribe a range of medications to help manage symptoms, decrease inflammation and pain, and prevent or treat infections caused by the condition. These medications include:
- Aminosalicylates (5-ASA): these drugs (including sulfasalazine, balsalazide, mesalamine, and olsalazine) can be given orally or rectally and are intended to reduce inflammation in the digestive tract; they may be more effective for ulcerative colitis than for Crohn’s disease
- Corticosteroids: these drugs (including prednisone, prednisolone, and budesonide) may be useful for decreasing inflammation during acute flare-ups, but many healthcare providers recommend avoiding long-term use due to the risk of adverse effects
- Immunomodulators: these drugs (including azathioprine, 6-mercaptopurine, and methotrexate) are used to control and modify the immune system in order to prevent overactivity and excessive inflammation
- Tumor necrosis factor (TNF) inhibitors: these drugs (including adalimumab, certolizumab pegol, and infliximab) are used to treat many types of autoimmune disorders and intended to block inflammation; TNF inhibitors can have intense side effects, and for Crohn’s they are typically only prescribed to patients with moderate to severe cases that are not responding well to other therapies
- Biologic therapies: these drugs act on certain parts of the immune system (such as inflammatory proteins or white blood cells) to reduce inflammation
- Antibiotics: these drugs (including metronidazole and ciprofloxacin) are used to treat infections, particularly in people with Crohn’s disease that affects the colon and anus
According to the Crohn’s and Colitis Foundation, as many as 66 to 75 percent of people diagnosed with Crohn’s disease will undergo surgery for their condition at some point in their life. Surgery may be necessary to remove disease or damaged parts of the digestive tract (called a resection) or to correct complications, such as non-healing fistulas, toxic megacolon, bowel perforation, and bowel obstructions.
Some patients with Crohn’s disease undergo a type of surgery called an ileostomy (involving the small intestine) or colostomy (involving the large intestine). During an ileostomy or colostomy, a surgeon will remove damaged parts of the small or large intestine, then create a hole (stoma) in the abdomen. The surgeon will then attach the remaining healthy end of the intestine to the hole. This way, waste gets expelled through the hole instead of through the rectum. Waste is collected in a bag called an ostomy bag, which is attached to the outside of the surgical hole. This process allows the digestive tract to “rest” and heal. In some cases, this procedure is reversible.
A healthy lifestyle can’t cure Crohn’s disease, but it can help people living with this condition improve their physical and mental well-being and manage their symptoms. For example, many people are advised to adopt certain dietary changes during a Crohn’s flare-up, such as a low-salt, low-fiber, low-fat, and/or lactose-free diet.
That said, no specific foods are proven to worsen or trigger Crohn’s disease. Foods can affect people differently, so individuals living with Crohn’s disease may want to keep a food diary to help them learn how different foods affect them. Eating smaller meals and avoiding carbonated beverages may also help people manage symptoms.
It’s also important for people with Crohn’s to work with their healthcare providers and ensure they are getting enough of the vitamins, minerals, electrolytes, and other nutrients they need, since issues like diarrhea and decreased absorption in the small intestine may impair their nutrient levels.
In addition to modifying their diet, people with Crohn’s disease are also encouraged to manage stress, stay physically active, and stay smoke-free, since all of these lifestyle habits can improve their general well-being.
What is the best treatment for Crohn’s disease?
The best treatment for Crohn’s disease is individualized to each patient’s needs, health status, and disease type and severity. In most cases, treatment will include a combination of medications, lifestyle modifications, and psychological support and counseling. Research shows that the majority of people with Crohn’s will end up needing at least one or more surgeries to manage their condition.
Can Crohn’s disease kill you?
Crohn’s disease itself doesn’t kill people directly. But it can lead to potentially fatal complications and increase the risk for certain life-threatening issues including colorectal cancer, infections, and severe malnutrition.
How serious is Crohn’s disease?
Crohn’s disease can be mild, moderate, or severe. It can get better or worse throughout a person’s life, and may go through periods of remission lasting for weeks or even up to several years.