There are a variety of treatments for IBD. If you are diagnosed with ulcerative colitis or Crohn's disease, your physician will discuss a treatment plan with you that may include medication or surgery, along with nutritional planning and emotional support.
Medication for IBD
Currently, there is no cure for IBD, however, medications are available that decrease the inflammation of the colon lining and control the symptoms of IBD. These medications can relieve diarrhea, rectal bleeding and abdominal pain, and allow the colon to heal.
The main classes of medication used today to treat IBD are:
- Aminosalicylates (5-ASA): Effective in treating mild to moderate episodes of ulcerative colitis, these medications are also useful in preventing relapses of this disease. Examples include sulfasalazine and oral formulations of mesalamine (Asacol®, Colazal®, Dipentum®, Pentasa®). 5-ASA drugs also may be administered rectally (Canasa® and Rowasa®).
- Corticosteroids: Prednisone and methylprednisolone nonspecifically suppress the immune system, meaning they suppress the entire immune system, not one particular area.
- Immune modifiers: Sometimes called immunomodulators, these medications are used to help decrease corticosteroid dosage and patients' dependence on corticosteroids. They also may help maintain remission in some patients who do not respond to standard medications. Examples include Azathioprine (Imuran®), 6-MP (Purinethol®), and methotrexate Immune modifiers.
- Antibiotics
- Biologic therapies (Crohn's disease): In August 1998, the FDA approved infliximab (Remicade®), the first biologic therapy for Crohn's disease. This medication is used for moderately to severely active Crohn's patients who have not responded adequately to conventional therapy, or for reducing the number of draining enterocutaneous fistulas. This medication can also be used to maintain remission.
IBD Infusion Therapy
IBD infusion therapy is a therapeutic intravenous procedure administered in a comfortable setting by an expert clinical team with special training in infusion therapy.
Infusion therapies may include the following:
- Remicade® therapy
- Stem cell infusion therapy
- Medications for chronic pain
- Ion infusions
- Hydration therapy
- Nutrition therapy
Surgery for IBD
Surgery may be appropriate for patients who do not respond to a treatment plan of medication and nutritional planning. Based on the patient's type of IBD and the extent of disease, options for surgery include:
- Resection and Anastomosis: The diseased segment of bowel and any associated abscess are removed, and the two ends of healthy bowel are joined together in a procedure called anastomosis.
- Proctocolectomy: The entire colon and rectum are removed, with the creation of an ileostomy, or external stoma (an opening on the abdomen through which wastes are emptied into a pouch that is attached to the skin with adhesive).
- Restorative Proctocolectomy: This procedure also calls for removal of the colon, but it avoids an ileostomy. By creating an internal pouch from the small bowel and attaching it to the anal sphincter muscle, the surgeon can preserve bowel integrity and eliminate the need for the patient to wear an external ostomy appliance.