Treatment of Crohn's disease
So you have IBD. . .
If you have recently been diagnosed with Inflammatory Bowel Disease (IBD) this could be a scary time in your life. It is normal to be anxious about a recent diagnosis of IBD, but you and your health care team can work together to make you feel better and improve your quality of life. You should not hesitate to ask your health care provider questions.
The following topics help answer questions you might have and to give suggestions on how to manage your life if you have been diagnosed with IBD.
Treatment of Crohn's Disease
At this time there is no cure for Crohn's Disease. The overall goal of the treatment of Crohn's is to relieve abdominal pain, control inflammation, decrease bleeding (if any), decrease number of bowel movements and correct nutritional deficiencies.
Treatment of Crohn's disease is highly individualized. Factors that affect your treatment are:
- Your age
- Overall health
- Extent of the disease
- Your tolerance to specific treatments
- Your expectations of the disease
Medications for Crohn's Disease
The medications that are used are aimed at relieving the symptoms of the disease. Unfortunately, Crohn's disease is a chronic and lifelong disease, and your use of medications will probably also be lifelong. There are several different approaches to medicating Crohn's disease.
These are some of the more common medications used to treat symptoms of Crohn's disease:
- sulfasalazine (Azulfidine)
- olsalazine sodium (Dipentum)
- balsalazide disodium (Colazal)
- mesalamine (Asacol)
- mesalamine CR (Pentasa)
- infliximab (Remicade)
- Budesonide (Entocort)
- Azathioprine (Imuran)
- 6 - mercaptopurine (6-MP)
Surgery for Crohn's Disease
There is no cure for Crohn's, however surgery might be helpful in managing the symptoms of Crohn's or correcting complications. Types of complications of Crohn's disease that surgery is used to correct:
- Stricture - A stricture is a narrowing of the bowel due to the disease processes. This can lead to more severe complications such as a blockage
- Blockage - A blockage is the most common complication of Crohn's disease. This happens because of the swelling and formation of scar tissue. The result is a thickened bowel wall and a significantly narrowed intestinal passage.
- Fistula - A fistula results from a sore, or lesion, that progresses into an opening or a tunnel. This fistula can lead from one loop of the intestine to another, or into other tissues such as the bladder or the vagina. If a fistula occurs, an abscess might result.
- Abscess - an abscess is a pocket of pus and infection that can result from fistulas.
Types of surgeries:
If a section of bowel is affected by Crohn's severely enough it might be necessary to have surgery. Often, it is possible to remove only the affected section of the intestine. This procedure is called a resection. After the affected section is removed the ends are rejoined in a process called anastomosis. A bowel resection may offer many years of symptom relief. However, the disease can return around the anastomosis.
Depending on the severity of your Crohn's disease it may be necessary to remove the rectum. Once the rectum is removed the free end of the colon is attached to the stoma. Stool will be collected in a colostomy bag that will need to be emptied periodically. A colostomy can be an effective way of managing Crohn's. It can be overwhelming change at first, but with time, patience, and good support, you can return to a relatively normal lifestyle. There are many support groups available for people with colostomies such as United Ostomies Association of America, Inc.
Depending on the severity of your Crohn's disease it may be necessary to remove the rectum and the entire colon. Once the rectum and colon are removed the free end of the small intestine, called the ileum, is attached to the stoma. Stool will be collected in an ileostomy bag that will need to be emptied periodically. An ileostomy can be an effective way of treating Crohn's. It can be an overwhelming change at first, but with time, patients, and good support, you can return to a relatively normal lifestyle. There are many support groups available for people with ileostomies such as United Ostomies Association of America, Inc.
Ileoanal reservoir (or J-pouch or Restorative Proctocolectomy)
An ileonal reservoir is an alternative procedure to a permanent ileostomy. This procedure is popular because it does away with external pouches and allows the patient to have bowel movements. This procedure is completed in two surgeries. First, the colon and rectum are removed and part of the small intestine is used to create an internal pouch to hold stool. While the pouch is healing you will have a temporary ileostomy. Once the pouch has healed, the ileostomy is closed. This pouch is attached to the anus. The muscle of the rectum is left in place, so the stool in the pouch does not leak out of the anus. People who have this surgery are able to control their bowel movements.
Stricturoplasty is a surgical procedure performed to remove strictures (narrow places in the intestine) and prevent them from becoming blockages. During the stricturoplasty the surgeon will make a lengthwise incision in the intestine and then close it again by stitching each end of the incision together. This results in more room inside the intestine.
Crohn's Disease Overview | Lifestyle modification