Treatment Options

Treatment for Crohn’s disease and ulcerative colitis include medications and in some cases surgery (see Surgery). The goal of treatment is to reduce the inflammation in your bowels, causing your symptoms to disappear (remission). Continuing on treatment after symptoms have disappeared will help reduce the chance of flares. Your physician may recommend one medication or multiple medications based on the severity of your disease. Some patients are able to start with milder medications first, while others require stronger medications earlier in treatment.

• Aminosalicylates (5-ASA): These medications reduce inflammation in the lining of the intestinal tract. They can be given orally or rectally. Examples include sulfasalazine, balsalazide and mesalamine.
• Steroids: These medications also reduce inflammation. Steroids are effective in treating flare episodes on a short-term basis. They have numerous potential side effects, therefore it is not recommended to take steroids for a long period of time. Steroids can be given orally, rectally and intravenously. Examples include prednisone, budesonide, and Uceris.
• Antibiotics: These medications may be used to treat infections such as abscesses or draining fistulas. Examples include Flagyl and Cipro.
• Immune system suppressors (immunomodulators): These medications reduce inflammation by suppressing the immune system. They can be given alone or in combination with other medications and are typically taken long-term. If you are prescribed one of these medications your physician will order blood work on a routine basis to monitor for side effects. Examples include mercaptopurine, azathioprine, and methotrexate.
• Biologic Therapies: These medications are proteins that target other specific proteins involved in the inflammatory process. Biologics are typically prescribed for patients with moderate to severe disease. They are given intravenously (IV) or by injection (shot) and are considered a long-term treatment. Biologic therapies can suppress the immune system; therefore, certain tests must be performed prior to starting treatment to check for tuberculosis and hepatitis. Your physician will order blood work on a routine basis and see you in the office every 6 months to monitor for side effects. Patients on biologics are also assigned to a nurse case manager. Examples include Remicade, Humira, Cimzia, Simponi, Tysabri and Entyvio.