There is no cure for Crohn's disease, but treatment can help control the disease. Treatment for Crohn's disease usually involves medication and/or surgery. The treatment depends upon many things:

• Location of the disease
• Problems that the disease may be causing
• How the patient responds to treatment
• The amount of inflammation that is present

The goal of the treatment is to:

• Control the inflammation
• Correct problems the patient may be having with nutrition
• Relieve symptoms such as pain, diarrhea or rectal bleeding
• Help keep the disease in remission

Treatment may include drugs, nutrition supplements, surgery, or a combination of these options. The goals of treatment are to control inflammation, correct nutritional deficiencies, and relieve symptoms like abdominal pain, diarrhea, and rectal bleeding. At this time, treatment can help control the disease by lowering the number of times a person experiences a recurrence, but there is no cure. Treatment for Crohn’s disease depends on the location and severity of disease, complications, and the person’s response to previous medical treatments when treated for reoccurring symptoms.

Some people have long periods of remission, sometimes years, when they are free of symptoms. However, the disease usually recurs at various times over a person’s lifetime. This changing pattern of the disease means one cannot always tell when a treatment has helped. Predicting when a remission may occur or when symptoms will return is not possible.

Overview

Treatment for Crohn's disease involves medications to prevent flare-ups, or maintain remission, of the disease. A few people have severe, persistent symptoms or complications that may require additional medications or surgery. The type and severity of symptoms also guide treatment.

Initial treatment

Your health professional usually will start you on the traditional first-line treatment for Crohn's disease and add or replace medications if initial measures do not control your symptoms and keep the disease from flaring up.

Mild symptoms may respond to an antidiarrheal medication such as loperamide (Imodium A-D, for example), which slows or stops the painful spasms in your intestines that cause symptoms.

For mild to moderate symptoms, you also will take aminosalicylates (such as sulfasalazine or mesalamine). These medications help manage symptoms for many people who have Crohn's disease, especially if the colon or the ileocecal area, where the small and large intestines join, is affected.

Corticosteroids (such as hydrocortisone or prednisone) may be given by mouth for a few weeks or months to control inflammation. However, corticosteroids generally are not used for long-term treatment because they have serious side effects, such as high blood pressure, osteoporosis, and increased risk of infection, and they stop being effective after long periods of use.

Moderate to severe symptoms may be treated with corticosteroids by vein (intravenous, IV). If fistulas are a significant problem, you also may take infliximab (Remicade), a new medication to heal fistulas and treat Crohn's disease that does not respond to other medications.

Ongoing treatment

Ongoing treatment is designed to find a medication or combination of medications that keeps Crohn's disease in remission.