Crohn's disease - Treatment

Treatment-Crohn's disease

There's currently no cure for Crohn's disease, but treatment can control or reduce the symptoms and help stop them coming back.

Medicines are the main treatments, but sometimes surgery may be needed.

Steroids

Most people with Crohn's disease need to take steroids (such as prednisolone) from time to time.

Steroid medicines:

can relieve symptoms by reducing inflammation in your digestive system – they usually start to work in a few days or weeks
are usually taken as tablets once a day – sometimes they're given as injections
may be needed for a couple of months – don't stop taking them without getting medical advice
can cause side effects like weight gain, indigestion, problems sleeping, an increased risk of infections and slower growth in children

The charity Crohn's and Colitis UK has more on steroids.

Liquid diet

For children and young adults, a liquid diet (enteral nutrition) can also help reduce symptoms.

This involves having special drinks that contain all the nutrients you need, instead of your usual diet, for a few weeks.

It avoids the risk of slower growth that can happen with steroids.

Enteral nutrition has few side effects, but some people may feel sick or have diarrhoea or constipation while on the diet.

Crohn's and Colitis UK has information on food and Crohn's disease, which has more on enteral nutrition.

Immunosuppressants

Sometimes you might also need to take medicines called immunosuppressants to reduce the activity of your immune system. Common types include azathioprine, mercaptopurine and methotrexate.

Immunosuppressants:

can relieve symptoms if steroids on their own aren't working
can be used as a long-term treatment to help stop symptoms coming back
are usually taken as a tablet once a day, but sometimes they're given as injections
may be needed for several months or years
can cause side effects like feeling and being sick, increased risk of infections and liver problems

Crohn's and Colitis UK has more on azathioprine and mercaptopurine.

Biological medicines

If other medicines aren't helping, stronger medicines called biological medicines may be needed.

The biological medicines for Crohn's disease are adalimumab, infliximab, vedolizumab and ustekinumab.

Biological medicines:

can relieve symptoms if other medicines aren't working
can be used as a long-term treatment to help stop symptoms coming back
are given by injection or a drip into a vein every 2 to 8 weeks
may be needed for several months or years
can cause side effects like increased risk of infections and a reaction to the medicine leading to itching, joint pain and a high temperature

Crohn's and Colitis UK has more on adalimumab and more on infliximab.

Surgery

Your care team may recommend surgery if they think the benefits outweigh the risks or that medicines are unlikely to work.

Surgery can relieve your symptoms and help stop them coming back for a while, although they will usually return eventually.

The main operation used is called a resection. This involves:

Making small cuts in your tummy (keyhole surgery).
Removing a small inflamed section of bowel.
Stitching the healthy parts of bowel together.

It's usually done under general anaesthetic (while you're asleep). You may be in hospital for about a week and it might take a few months to fully recover.

Sometimes you may need an ileostomy (where poo comes out into a bag attached to your tummy) for a few months to let your bowel recover before it's stitched back together.

Crohn's and Colitis UK has more on surgery for Crohn's disease.