Living with an inflammatory bowel disease (IBD) like Crohn’s and colitis can mean fighting a constant battle with symptoms that interfere with normal activities. While it can be frustrating to deal with these conditions, medications can help relieve persistent and debilitating symptoms, such as abdominal pain and diarrhea, and improve your quality of life.
Medications can’t cure Crohn’s and colitis, but they can help you achieve and maintain remission. Remission involves the control or reduction of inflammation, which leads to symptom relief. When effective, medications can also reduce complications and prevent these lifelong diseases from becoming worse.
Since everyone experiences Crohn’s and colitis differently, no single treatment works for all patients. Instead, successful treatment requires finding the right medication for your version of the disease.
Inflammatory bowel disease specialist Nina Paonessa, DO, of Paonessa Colon & Rectal Surgery PC, in Brielle and Manahawkin, New Jersey, helps Crohn’s and colitis patients achieve relief and remission with medications. With extensive expertise in the treatment of IBD, Dr. Paonessa considers your medical history, disease severity and location, along with other characteristics of your condition to find the medication that works best for you.
Several classes of medications are effective in the treatment of Crohn’s and colitis. Find out more about how they can work to make a difference in your life.
Having Crohn’s or colitis makes you susceptible to complications from Clostridium difficile, also known as C.diff, a bacterium that attacks the intestine, causing fever, cramping, diarrhea, and bloody stools.
Antibiotics are used to treat C.diff and other types of bacterial infections that occur in the intestine with IBD. They help reduce and change the composition of bacteria in your intestines, which may contribute toward symptom relief.
In Crohn’s, antibiotics are often used to treat infections that result from complications like abscesses, which are pockets of pus, and fistulas, which are abnormal connections of your intestine to other parts of your body, like the anal canal.
Common antibiotics used to treat Crohn’s and colitis include metronidazole, ampicillin, and ciprofloxacin.
Aminosalicylates contain the active ingredient 5-aminosalicylic acid (5-ASA). These medications are bowel-specific anti-inflammatory drugs typically used for the management of mild to moderate cases of Crohn’s and colitis. Aminosalicylates reduce inflammation in the lining of the intestine.
Aminosalicylates are often considered the safest medications for treating IBD. The type of aminosalicylate prescribed depends on where the inflammation is located in your GI tract.
Common aminosalicylates used to treat Crohn’s and diabetes include sulfasalazine, mesalamine, balsalazide, and olsalazine.
Biologics and biosimilars
Biologics are a relatively new class of drugs for treating IBD and other inflammatory diseases. These medications are genetically engineered antibodies created in the laboratory. They are called biologics, or biological medications, because they’re derived from living cells from blood, proteins, viruses, and living organisms.
Rather than treating your whole body, biologics treat your symptoms more selectively by targeting the proteins known to be involved with Crohn’s and colitis.
It may take a few doses for you to respond to treatment with biologics. Since it’s not possible to determine which biologics will work best for you, you may have to try more than one before you achieve results. Biologics are often reserved for use when you don’t respond well to conventional therapies.
Biologics used to treat Crohn’s and colitis include adalimumab, certolizumab pegol, infliximab, natalizumab, rituximab, ustekinumab, vedolizumab, and etanercept.
Biosimilars are a category of biologics. Biosimilars are very similar to a previously FDA-approved reference biologic drug with regard to safety, potency, and purity.
Biosimilars used to treat IBD include three infliximab biosimilars (infliximab-dyyb, infliximab-abda, and infliximab-qbtx) and three adalimumab biosimilars (adalimumab-atto, adalimumab-adbm, and adalimumab-adaz).
Corticosteroids lower the activity of your immune system and reduce inflammation in the GI tract. These medications are fast-acting anti-inflammatory agents that are used for acute flares of IBD.
Corticosteroids are not used long-term to maintain remission because they pose several serious complications such as osteoporosis, glaucoma, and avascular bone necrosis. When prescribed, corticosteroids are tapered once remission is accomplished.
Corticosteroids used to treat Crohn’s and colitis include prednisone, prednisolone, budesonide, and methylprednisolone.
Immunomodulators are medications that modify your immune system. The effect decreases your body’s inflammatory response, the source of symptoms and complications in Crohn’s and colitis, for long-term remission.
Immunomodulators can take up to three to six months to produce results, so you may begin steroids at the same time you begin immunomodulators. Ultimately, they may be used to decrease a patient’s dependence on steroids for long-term treatment and prevention of recurring flares.
Common immunomodulators used to treat Crohn’s and colitis include azathioprine, 6-mercaptopurine, methotrexate, cyclosporine A, and tacrolimus.
Find out more about medications that can help you achieve and maintain remission of Crohn’s and colitis. Schedule an appointment online or over the phone today.