Treatments

Couple sitting by a lake. Women holding a bunch of balloons.

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

These treatments work by decreasing the abnormal inflammation in the gastro-intestinal (GI) system. This permits the system to heal. It also relieves the symptoms of diarrhoea, 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 people 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. The reappearance of inflammation, or a ‘flare’, can be due a number or reasons 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 on going 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. Tumour Necrosis Factor, or TNF, is produced by white blood cells to regulate the body’s immune system. If the immune system is not working properly, it can produce too much TNF and create inflammation. Biologic therapies work by reducing excess TNF. This can reduce the inflammation that causes the signs and symptoms of IBD.

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.

 

For more information about Treatments and many other great resources visit OwnYourIBD.co.nz. OwnYourIBD is an information portal for New Zealanders with, or caring for someone with, Crohn’s disease or ulcerative colitis, which are both inflammatory bowel diseases (IBD).

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