Here are the current categories of nonbiologic treatments for Crohn's disease (CD):
Aminosalicylates, Also Known as 5-ASAs or Anti-inflammatories
These medicines can be effective in achieving and maintaining remission for people
with mild to moderate disease. You can take 5-ASAs in tablet form or in the form of an
enema or suppository, depending on which part of your colon is affected. Remember
that patients who stop their 5-ASAs are likely to suffer a relapse, so only stop your
medication if your doctor gives you the okay.
Antibiotics
Researchers also believe that antibiotics help reduce harmful intestinal bacteria and suppress the intestine's immune response, which can trigger symptoms of CD. Antibiotics are also prescribed to help heal fistulas and abscesses in Crohn's patients.
Corticosteroids
Corticosteroids, which help reduce inflammation, are valuable during acute situations. Doctors generally use them only if you have moderate to severe disease that doesn't respond to other treatments. Because of their side effects, corticosteroids are generally given in the lowest possible dosage for the shortest amount of time.
Immunomodulators
These medications are used to reduce inflammation, to treat fistulas, and to allow your physician to prescribe you a lower dosage of corticosteroids. Your doctor may pair an immunomodulator with a corticosteroid to speed up response during active flares of disease. This combination requires lower doses of the steroid, which produces fewer side effects. Corticosteroids also may be withdrawn more rapidly when combined with immunomodulators. That's why you may hear immunomodulators referred to as "steroid-sparing" drugs.
Over-the-Counter Medications and Supplements
Your doctor may prescribe antidiarrheals, laxatives, and pain relievers to help you manage symptoms during flare-ups. If you have chronic intestinal bleeding, an iron supplement may be used to replenish your iron levels and reduce iron-deficiency anemia once your bleeding has stopped or diminished. A vitamin B12 shot may also be used to help prevent anemia, promote normal growth and development, and maintain proper nerve function. Finally, your doctor may want you to take a calcium supplement with vitamin D. This can help counteract the increased risk of osteoporosis that can come from CD and the steroids used to treat it.
Most alternative therapies such as supplements and probiotics aren't regulated by the FDA, meaning they’re not proven to be safe and effective. That’s why it’s so important to talk to your doctor before trying these types of treatments.
Nutrition Therapies
Your doctor may prescribe enteral nutrition, which is a special diet given via a feeding tube. He or she may also prescribe parenteral nutrition, which means nutrients injected into a vein. Both of these help boost your nutrition and give your bowel a break, which can help bring inflammation under control in the short term. These 2 methods of nutrition are usually used to improve the health of patients before surgery or when other treatments aren’t working.
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