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Anti–inflammatories
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- There is no known cure for IBD. However, many medications may help to relieve the symptoms.
- Sulfasalazine (Azulfidine ®): Sulfasalazine (Azulfidine ®) has been used to treat the symptoms of Crohn's disease. Adverse effects include nausea, vomiting, heartburn and headache. Individuals should avoid this medication if they are allergic to sulfa medications.
- Mesalamine and olsalazine: Mesalamine (like Asacol ® or Rowasa ®) and olsalazine (Dipentum ®) have been used to decrease inflammation in the gastrointestinal tract caused by IBD. They are typically taken orally or rectally in the form of enemas or suppositories. Olsalazine may cause or worsen existing diarrhea in some people.
- Balsalazide (Colazal ®): Balsalazide (Colazal ®) has also been used to decrease inflammation in the gastrointestinal tract caused by IBD.
- Corticosteroids: Corticosteroids have shown to effectively reduce inflammation of the gastrointestinal tract in IBD patients. They may also be used in conjunction with other forms of medications. For instance, in some cases, a physician may prescribe steroid enemas to treat symptoms in the lower colon or rectum. Corticosteroids should only be used as short–term medication. Treatment generally lasts about two weeks.
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Immunosuppressive medications
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- Azathioprine and mercaptopurine:
Azathioprine (Imuran ®) and mercaptopurine (Purinethol ®) have been used for years to treat Crohn's disease. However, their efficacy for ulcerative colitis is still being researched. Since these medications are slow–acting, they are occasionally combined with a corticosteroid.
- Cyclosporine:
Cyclosporine (like Neoral ® or Sandimmune ®) is usually only prescribed to individuals who are not responding to other medications. Cyclosporine begins working within one to two weeks. However, severe side effects may include kidney and liver damage, fatal infections and an increased risk of lymphoma.
- Infliximab (Remicade): The U.S. Food and Drug Administration approved infliximab (Remicade ®) in September 2005 for the treatment of ulcerative colitis. The drug neutralizes a protein produced by the immune system, known as tumor necrosis factor (TNF). Infliximab removes TNF from the bloodstream before it can cause inflammation in the gastrointestinal tract.
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Other medications
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- Anti–diarrheals: A fiber supplement like psyllium powder (Metamucil ®) or methylcellulose (Citrucel ®) may help relieve symptoms of mild to moderate diarrhea. For more severe diarrhea, loperamide (Imodium ®) may be effective.
- Laxatives:
Inflammation may cause the intestines to narrow, resulting in constipation. Laxatives may be taken to relieve symptoms of constipation. Oral laxatives like Correctol ® and sigmoidoscopy ® have been used.
- Pain relievers: A qualified healthcare provider may recommend acetaminophen (Tylenol ®) for mild pain. Avoid nonsteroidal anti–inflammatories (NSAIDs) like aspirin, ibuprofen (like Advil ® or Motrin ®) or naproxen (Aleve ®). Researchers have found a strong relationship between NSAIDs and IBD flare–ups. Therefore, NSAIDs should not be taken.
- Surgery: If all other treatments fail to relieve symptoms, a qualified healthcare provider may recommend surgery. Surgery is more commonly performed in ulcerative colitis patients because inflammation is limited to the colon.
- During the procedure, the entire colon and rectum is removed (proctocolectomy). A new procedure, known as ileoanal anastomosis eliminates the need for recovered patients to wear a bag to collect stool. This new procedure involves attaching a pouch directly to the anus, allowing the patient to expel waste normally. However, the patient may have as many as five to seven watery bowel movements a day because there is no longer a colon to absorb water. Between 25 and 40% of patients with ulcerative colitis eventually need surgery.
- Ssome Crohn's patients may experience blockages in the intestine that require surgery to remove the diseased portion of the gastrointestinal tract.
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