Treatments

There are very effective treatments available that may control your IBD and even place it into remission.

These treatments work by decreasing the abnormal inflammation in the GI system. This permits the system to heal. It also relieves the symptoms of diarrhea, rectal bleeding, and abdominal pain.

The two basic goals of treatment are to achieve remission and, once that is accomplished, to maintain remission. If remission cannot be established, then the next goal is to decrease the severity of disease in order to improve the patient’s quality of life. Some of the same medications may be used to accomplish this, but they are given in different dosages and for different lengths of time.

There is no “one size fits all” treatment for everyone with IBD. The approach must be tailored to the individual, because each person’s disease is different. Medical treatment can bring about remission, which can last for months to years. But the disease will flare up at times from the reappearance of inflammation or from a particular trigger. A disease flare may also be triggered from a complication such as a fissure, fistula, stricture, or abscess. Flares of IBD may indicate that a change in medication dose, frequency, or type is needed.

Physicians have been using some medications for the treatment of IBD for many years. Others are recent breakthroughs. The most commonly prescribed fall into five basic categories:

Aminosalicylates

These include medications that contain 5-aminosalicylate acid (5-ASA). Examples are sulfasalazine, mesalamine, olsalazine, and balsalazide.These drugs can work at the level of the lining of the GI tract to decrease inflammation. They are thought to be effective in treating mild-to-moderate episodes of IBD and useful as a maintenance treatment in preventing relapses of the disease. They work best in the colon and are not particularly effective if the disease is limited to the small intestine.

Corticosteroids

These medications affect the body’s ability to launch and maintain an inflammatory process. In addition, they work to keep the immune system in check. They are effective for short-term control of flareups; however, they are not recommended for long-term or maintenance use because of their side effects. If you cannot come off steroids without suffering a relapse of your symptoms, your doctor may need to add some other medications to help manage your disease. With steroids it is very important not to stop abruptly.

Immunomodulators

This class of medications modulates or suppresses the body’s immune system response so it cannot cause ongoing inflammation. Immunomodulators generally are used in people for whom aminosalicylates and corticosteroids haven’t been effective or have been only partially effective. They may be useful in reducing or eliminating the need for corticosteroids. They also may be effective in maintaining remission in people who haven’t responded to other medications given for this purpose. Immunomodulators may take several months to begin working.

Biologic therapies

Also known as anti-TNF agents, these represent the latest class of therapy used for people suffering from moderate- to-severe IBD. Tumor necrosis factor (TNF) is a chemical produced by our bodies to cause inflammation. Antibodies are proteins produced to attach to these chemicals and allow the body to destroy the chemical and reduce the inflammation.

Antibiotics

Antibiotics may be used when infections—such as abscesses—occur in IBD. They can also be helpful with fistulas around the anal canal and vagina.