Crohn’s disease, an autoimmune disease that causes inflammation in the digestive tract, has no cure, at least for now. That said, successful treatment for Crohn’s disease can help you reach remission—a state of no or mild disease activity and symptoms.
Before your doctor can recommend a treatment plan to help you alleviate Crohn’s disease symptoms, they have to assess the severity, extent, and type of Crohn’s disease that you’re experiencing, according to David P. Hudesman, MD, associate professor in the Department of Medicine and medical director of the IBD Center at NYU Langone Health.
The goal of treatment, according to Dr. Hudesman, is two-fold: “First, we want people to feel great; we want the patient to feel well. And second, we want the patient to be healed inside.” That essentially means addressing the inflammation in the lining of the digestive tract, which can not only relieve symptoms, but also help prevent other complications (such as colon cancer).
Medications to Treat Crohn’s Disease
“We have a variety of medications that decrease inflammation,” says Dr. Hudesman.
One major class of medications for moderate to severe Crohn’s disease is biologics, which work by preventing the immune system from attacking the intestine, thus preventing inflammation, damage, and symptoms. There are several different types of biologics, including anti-TNFs, anti-integrins, and anti-IL-12/23s. The names refer to their ability to target specific proteins that are involved in inflammation.
Another common medication for Crohn’s disease is immunosuppressants or immunomodulators. While biologics are more targeted at turning off the immune response against the digestive tract, immunosuppressives have a more general action at suppressing the immune system.
Both biologics and immunosuppressants are used for long-term maintenance of Crohn’s disease. For short-term treatment of flares, your doctor may prescribe corticosteroids. They work by suppressing the entire immune system and can be very effective at reducing symptoms during a flare, but they have significant side effects if taken for too long.
Surgery to Treat Crohn’s Disease
“In some people with Crohn’s, surgery might be the best option, and one of the first options chosen for therapy,” says Dr. Hudesman.
One reason to choose therapy is if Crohn’s symptoms are being driven by fibrosis, which is essentially scar tissue in the digestive tract. All the above medications are great for addressing inflammation, but not fibrosis. This is where surgery can play a big role.
“If somebody comes to the office that has a narrowing or stricture, that looks mainly scarred down, [we can help by] just doing surgery and taking out that small piece of intestine,” says Dr. Hudesman. “Their symptoms will go away and they’ll feel great for a very long time.”
That said, symptoms can return after surgery. That’s why it’s important to continue attending follow-up appointments with your doctor and taking any medications as prescribed. Following healthy lifestyle habits for Crohn’s disease may also help.
“Working with your provider, there’s no reason you can’t live a completely normal life—take whatever job you want, travel, have a relationship,” says Dr. Hudesman. “The vast majority of our patients do very well.”