There is no
cure for Crohn’s disease. Treatment is
aimed at controlling inflammation, preventing vitamins
and minerals deficiencies, and relieving symptoms.
Treatment options include a combination of drugs, biologic
therapies, nutritional supplements, and surgery.
Individuals with mild to moderate Crohn’s disease
are usually treated first with
anti-inflammatory drugs
such as sulfasalazine (Azulfidine) or mesalamine (Asacol,
Rowasa, Canasa).
Individuals with moderate to
severe Crohn’s disease often are prescribed corticosteroid
drugs. Prendisone (Deltasone, Orasone, Meticorten)
is often the corticosteroid of choice.
These
drugs have significant side effects and cannot be used
for long-term suppression of symptoms. Antibiotics
are used to treat infection that may develop, for example,
from fistula formation.
Biologic therapies use manmade antibodies.
Infliximab (Remicade) is a laboratory-made antibody
that blocks the production of an immune system factor
that causes inflammation.
This treatment is relatively
new, but appears to have a good success rate for
relieving symptoms. Additional biologic therapies for Crohn’s disease are under development.
Medical treatment becomes less effective over
time. When medical treatment fails or if the intestine
becomes thickened and so that blockages occur, surgery
may be necessary. About 80% of all people with
Crohn’s disease eventually need surgery.
Surgery to
remove part of the intestine usually relieves symptoms
for a few years, but surgery is not a cure for Crohn’s
disease, and symptoms almost always return within a
few years.
People with Crohn’s disease tend to have vitamin
and mineral deficiencies because damage to the lining of
the intestine interferes with the absorption of nutrients,
and chronic diarrhea hastens the loss of other nutrients.
These deficiencies can cause specific disorders in other
parts of the body. In addition, children with Crohn’s
disease also may need special high-calorie, high-nutrient
liquid supplements to maintain normal growth.
A nutritionist
consulting with the patient’s gastroenterologist
can help determine the best diet and supplements to
prevent nutritional deficiencies.
Although eating certain foods does not cause
Crohn’s disease, specific foods can worsen symptoms.
Many people with Crohn’s disease become lactose
intolerant and must limit or eliminate dairy products
from their diet.
Alcohol, high fiber foods such as popcorn,
and spicy foods can worsen diarrhea and abdominal
cramping. Individuals must be alert to the effect of
food on their symptoms until they figure out which
foods to avoid.
Crohn’s disease can be very disruptive. Individuals
may be reluctant to go places or do certain things
because frequent diarrhea requires them to be near a
toilet.
Support groups, either on the Web or in person,
help many people adjust to the difficulties of living
with this chronic disease.
Other people find that psychotherapy
(talk therapy) guided by a psychologist or
psychiatrist experienced in the stresses of chronic illness
can help them make a better adjustment to life
with Crohn’s disease.
Crohn’s disease is a life-long disease. Symptoms
may improve or disappear for periods, but overall,
symptoms and complications tend to worsen,
although the disease itself is rarely fatal.
Most people
with this disease eventually need surgery as the
disease becomes less and less responsive to medication.
Living with Crohn’s disease can be a difficult
challenge that requires major lifestyle adjustments.
