Treatment for Crohn’s Disease

People with Crohn’s disease are seen regularly by a specialist team who manage their treatment. Although there is no cure for Crohn’s disease, symptoms can be improved with dietary changes, drugs or surgery, or a combination of these.

Medicines
Drug treatment is effective for many patients and the disease may respond quickly to medication.

Medicines that reduce inflammation, such as steroids (eg prednisolone) and aminosalicylates (eg sulfasalazine).
Medicines that suppress the immune system (eg azathioprine) may be needed for more serious bouts of the illness. A new drug called infliximab may be used to treat severe Crohn’s disease that does not respond to other drugs.
Anti-diarrhoea medicines, antibiotics and painkillers may be useful during flare-ups.

Diet
An elemental diet may be recommended when the disease is active. An elemental diet is a liquid diet, made up of simple forms of protein, carbohydrates and fats. These can be absorbed without further digestion, and can cause a remission of the illness.

When there are complications, other special diets may be advised. For example, if there is narrowing of the bowel, a low residue diet (low in fibre) may be recommended. When food is not being absorbed well, a low fat diet may be recommended.

Short periods of parenteral feeding (through a route other than the mouth, usually by injection into a vein) in hospital may be needed for people with major complications.

For the rest of the time, it is important for people with Crohn’s disease to eat a balanced diet with a high fibre content.

Vitamin and iron supplements are often necessary as these nutrients may not be properly absorbed from the bowel.

Surgery
Many people with Crohn’s disease require surgical treatment at some time to treat complications such as anal abscesses, or fistulae, to remove areas of narrowed, non-functioning bowel, or when drugs are not controlling the disease.

Surgery aims to remove the least amount of bowel possible and the operation trying to expand narrowed segments, rather than just remove them.

Sometimes an ileostomy is needed. This is when the small bowel is separated from the large bowel and the end of the small intestine is brought out at the skin surface. The faeces are collected in a specially designed bag that fits securely over the skin site. This is not necessarily a permanent procedure but may be used to rest the large bowel while it is intensively treated. The small and large bowel can then be rejoined. A long period of remission can follow.

Women may be less fertile during periods of active disease and at these times may also have an increased risk of miscarriage, but otherwise there is no connection between the disease and problems with pregnancy.



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