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Treatment of Crohn’s Disease

written by: Emma Lloyd • edited by: Leigh A. Zaykoski • updated: 6/27/2010

Crohn’s disease is an autoimmune disorder which has no medical cure. However, there are several treatment options that can alleviate symptoms.

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    What is Crohn’s Disease?

    Crohn’s disease is a type of inflammatory bowel disease in which the digestive tract is chronically inflamed, causing a range of gastrointestinal symptoms. Long-term, the inflammation can affect the deep tissue of the digestive tract, and the disease may eventually become life-threatening.

    The current thinking on Crohn’s disease is that the immune system is involved in some way. One theory is that Crohn’s disease is a chronic response to an infection with a microorganism such as Mycobacterium avium paratuberculosis, an intestinal bacterium of cattle. Another theory is that Crohn’s disease is an autoimmune disorder.

    There is also a possibility of a genetic component to the development of Crohn’s disease. Around 20% of people with Crohn’s disease have a close relative who also has the condition. In addition, people with Crohn’s disease frequently have a mutation in a gene called NOD2/CARD15. This gene codes for a protein which is a component of the immune system.

    Symptoms of Crohn’s disease include diarrhea, abdominal cramping, blood in the stool, reduced appetite, weight loss, and ulcers.

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    Treatment Options for Crohn’s Disease

    There is no cure for Crohn’s disease, but there are several options for treatment. Drug therapy can help ease the symptoms of the disease, and in some cases can even cause the disease to go into remission. In some cases, people with Crohn’s disease may eventually require surgery.

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    Medication

    The goal of using medication to treat Crohn’s disease is to reduce inflammation and side effects, and help the digestive tract to heal.

    Anti-inflammatory drugs are usually the first line of medication therapy for Crohn’s disease. These drugs are usually non-steroidal anti-inflammatory drugs, but if NSAIDS are not effective, corticosteroids may be indicated for short-term use. When used in conjunction with other medications, corticosteroids can allow the body to enter remission.

    Immunosuppressants are drugs that suppress the immune system. These drugs are effective in treating Crohn’s disease symptoms because inflammation is an immune response. Immunosuppressants are often used following corticosteroid treatment to help induce remission.

    Antibiotics are used when abscesses or fistulas form, as these are likely to become infected.

    Other medications used depend on symptoms. Anti-diarrhea medication, laxatives, pain medication are all recommended by doctors depending on circumstances. Nutritional supplements may also be recommended.

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    Surgery

    For some people, lifestyle changes, medication, and other types of treatment don’t provide relief from symptoms of Crohn’s disease. In these cases, surgery may be indicated.

    During surgery, a surgeon may remove a badly damaged part of the digestive tract, and then connects up the ends of the healthy tissue. In another type of surgery, called strictureplasty, sections of intestine that have become narrow due to the formation of scar tissue are widened.

    In other cases, surgery might be required to close a fistula or remove scar tissue that might be causing further problems. A fistula occurs when inflammation is so extensive that a hole forms in the digestive tract, forming a “tunnel” from the digestive tract into nearby spaces such as the bladder or vagina.

    Successful surgery for Crohn’s disease can help the body enter into a remission that might last several years. However, the benefits of surgery are almost always temporary, as the disease will recur somewhere in the digestive tract. Up to 75% of people with Crohn’s disease require at least one surgery, and of those, around half will undergo two or more separate procedures.

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    References

    Crohn’s Disease information from the National Institute of Diabetes and Digestive and Kidney Diseases at the National Digestive Diseases Information Clearing House

    The Mayo Clinic on Crohn’s Disease