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Get answers to your Crohn's disease questions.
Inflammatory bowel disease - Crohn's disease
Crohnâ ' s disease cannot be cured, but appropriate treatment can help suppress the inflammatory response and manage symptoms. A treatment plan for Crohnâ ' s disease includes:
Malnutrition is very common in Crohn's disease. Patients with Crohn's disease experience reduced appetite and weight loss. In addition, diarrhea and poor absorption of nutrients can deplete the body of fluid and necessary vitamins and minerals.
Patients should strive to eat a well-balanced healthy diet and focus on getting enough calories, protein, and essential nutrients from a variety of food groups. These include protein sources such as meat, chicken, fish or soy; dairy products such as milk, yogurt, and cheese (if the patient is not lactose-intolerant); and fruits and vegetables.
Depending on your nutritional status, your doctor may recommend that you take a multivitamin or iron supplement. Although other types of dietary supplements, such as probiotics (“healthy bacteria” like lactobacilli) and omega-3 fatty acids, have been investigated for Crohnâ ' s disease, there is no conclusive evidence that they are effective in controlling symptoms or preventing disease relapses.
Certain types of foods may worsen diarrhea and gas symptoms, especially during times of active disease. While people vary in their individual sensitivity to foods, general guidelines for dietary management during active disease include:
In cases of severe malnutrition, particularly for children, patients may need enteral nutrition. Enteral nutrition uses a feeding tube that is inserted either through the nose and down through the throat or directly through the abdominal wall into the gastrointestinal tract. It is the preferred method for feeding patients with malnutrition who cannot tolerate eating by mouth. Enteral nutrition can be effective for helping maintain remission.
The goal of drug therapy for Crohnâ ' s disease is to:
Depending on the severity of the condition, different types of drugs are used. The main medications for Crohnâ ' s disease include:
Other types of drugs may also be used to treat specific conditions and symptoms. Antibiotics, usually ciprofloxacin or metronidazole, may be used to treat fistulas. Anti-diarrheal medications such as loperamide (Imodium) may be given to help control diarrhea.
Drug therapy for Crohnâ ' s disease is considered successful if it can push the disease into remission (and keep it there) without causing significant side effects. The patient's condition is generally considered in remission when the intestinal lining has healed, and symptoms, such as diarrhea, abdominal cramps, and tenesmus (painful defecation), are normal or close to normal.
Most patients with Crohnâ ' s disease eventually require some type of surgery. However, surgery cannot cure Crohn's disease. Problems with fistulas and abscesses may occur after surgeries. New disease usually recurs in other areas of the intestine. Surgery may be helpful for relieving symptoms and to correct intestinal blockage, bowel perforation, fistulas, or bleeding.
Basic types of surgery used for Crohnâ ' s disease include:
Akobeng AK. Crohn's disease: current treatment options. Arch Dis Child. 2008;93(9): 787-92.
Akobeng AK and Thomas AG. Enteral nutrition for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev. 2007;(3): CD005984.
Baumgart DC and Sandborn WJ. Inflammatory bowel disease: clinical aspects and established and evolving therapies. Lancet. 2007;369(9573): 1641-57.
Behm BW, Bickston SJ. Tumor necrosis factor-alpha antibody for maintenance of remission in Crohn's disease. Cochrane Database Syst Rev. 2008;(1):CD006893.
Benchimol EI, Seow CH, Steinhart AH and Griffiths AM. Traditional corticosteroids for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2008;(2): CD006792.
Butterworth AD, Thomas AG, Akobeng AK. Probiotics for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD006634.
Clark M, Colombel JF, Feagan BC, Fedorak RN, Hanauer SB, Kamm MA, et al. American gastroenterological association consensus development conference on the use of biologics in the treatment of inflammatory bowel disease, June 21-23,2006. Gastroenterology. 2007 Jul;133(1):312-39.
Cummings JR, Keshav S and Travis SP. Medical management of Crohn's disease. BMJ. 2008;336(7652):1062-6.
Feagan BG, Sandborn WJ, Mittmann U, Bar-Meir S, D'Haens G, Bradette M, et al. Omega-3 free fatty acids for the maintenance of remission in Crohn disease: the EPIC Randomized Controlled Trials. JAMA. 2008;299(14):1690-7.
MacDonald JK and McDonald JW. Natalizumab for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2007;(1):CD006097.
Mahid SS, Minor KS, Soto RE, Hornung CA and Galandiuk S. Smoking and inflammatory bowel disease: a meta-analysis. Mayo Clin Proc. 2006;81(11):1462-71.
Rahimi R, Nikfar S, Rahimi F, Elahi B, Derakhshani S, Vafaie M, et al. A meta-analysis on the efficacy of probiotics for maintenance of remission and prevention of clinical and endoscopic relapse in Crohn's disease. Dig Dis Sci. 2008;53(9):2524-31.
Sandborn WJ, Feagan BG, Stoinov S, Honiball PJ, Rutgeerts P, Mason D, et al. Certolizumab pegol for the treatment of Crohn's disease. N Engl J Med. 2007 Jul 19;357(3):228-238.
Schreiber S, Khaliq-Kareemi M, Lawrance IC, Thomsen OO, Hanauer SB, McColm J, et al. Maintenance therapy with certolizumab pegol for Crohn's disease. N Engl J Med. 2007 Jul 19;357(3):239-250.
Seow CH, Benchimol EI, Griffiths AM, Otley AR and Steinhart AH. Budesonide for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2008;(3):CD000296.
Strong SA, Koltun WA, Hyman NH, Buie WD; Standards Practice Task Force of The American Society of Colon and Rectal Surgeons. Practice parameters for the surgical management of Crohn's disease. Dis Colon Rectum. 2007;50(11):1735-46.
Yamamoto T, Fazio VW, Tekkis PP. Safety and efficacy of strictureplasty for Crohn's disease: a systematic review and meta-analysis. Dis Colon Rectum. 2007;50(11):1968-86.
Zachos M, Tondeur M and Griffiths AM. Enteral nutritional therapy for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2007;(1):CD000542.
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