No two Crohn’s or colitis cases are exactly alike, so there is no “one size fits all” approach to medication and treatment. The drugs your doctor prescribes for you, the dosage and the effects you experience are going to be unique to you. You and your physician must work together to sort out what is the most effective regime for you when you are in a flare-up or in remission.
In general, medications fall into one of two very broad categories: drugs that are used to reduce inflammation (and may therefore reduce some of your symptoms) and those that are aimed only at symptom-reduction and do not affect the inflammation in your gut.
a) Drugs that control the inflammation in your gut
Examples of the types of drugs available to combat inflammation include:
· Sulfasalazine and 5-Aminosalicylates (5-ASA): These drugs limit the production of certain chemicals that trigger inflammation. This medicine is generally prescribed to help combat milder attacks of Crohn’s or colitis. Examples include Mesalamines and Sulfalazine.
· Steroids: Steroids aim to reduce inflammation. This medicine is used in cases of moderate to severe attacks of Crohn’s or colitis. Some examples include Prednisone and Hydrocortisone.
· Immunomodulators: This type of medicine alters how the body mounts an inflammatory response. Patients using this type of drug should get into the habit of regular hand washing during the day, as immunomodulators do suppress your ability to fight infections in general. An example of this type of drug is Methotrexate. These drugs are used by patients who have moderate to severe attacks.
· Biologics: These drugs target and block molecules involved in inflammation. Biologics are the latest generation of medications and hold great promise for relieving Crohn’s and colitis. These drugs are used to combat moderate to severe attacks. Some examples include Adalimumab (Humira) and Infliximab (Remicade).
· Antibiotics: Antibiotics do not counteract inflammation directly, but decrease infection that can cause and result from severe inflammation. Examples include Ciprofloxacin and Metronidazole.
b) Drugs that manage symptoms
Note that many of these drugs are available “off the shelf” in your pharmacy. You should NOT self prescribe; talk with your doctor first.
• Antidiarrheals: Do not take these during a flare-up as they may cause other complications! Check with your doctor
• Ointments and Suppositories: Off the shelf ointments can be applied around hemorrhoids to reduce swelling, itching, and inflammation. Most of these ointments contain a steroid such as hydrocortisone and will help to shrink inflamed tissue.
• Antispasmodics: Relax muscles in the wall of the GI tract to reduce cramping
• Bulk formers for stool: Soak up water in the stool, thereby firming it up and lessening looseness as well as frequency.
• Bile Salt Binders: Prevent irritation of the gut by capturing bile salts.
• Stool softeners: For softening feces to ease bowel movements if you have hemorrhoids or anal fissures; talk with your doctor before trying these!
• Analgesics: For pain reduction.
• Non-steroidal anti-inflammatory drugs: For pain control in joints (but note that some people find these drugs aggravate their abdominal pain and diarrhea).
• Acid-reducing drugs: For “heartburn”
• Vitamins and Minerals: May be needed as supplements.
To learn more about any of the drugs listed above, take a look through our Prescription For Health booklet.