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Inflammatory Bowel Disease (IBD) Treatments

Posted: April 1, 2006

Doctors treat IBD in order to improve symptoms and decrease the amount of inflammation. Treatment for IBD may include:
- Dietary changes
- Lifestyle changes like stress reduction
- Medicine
- Surgery

The recommended treatment for IBD depends on the type and severity of symptoms, the location of disease and any complications.

People who have mild or no symptoms may not need treatment at all. But most people with IBD take medicine to control their symptoms. And many people with severe IBD need surgery to control the disease.

What medicines are used to treat IBD?
Treating IBD with medicine is complicated. You may need to take several different medicines before you find the one that works best for you. It is very important to keep track of how well the drugs are working, the side effects you are having, and report all details to your doctor.

The following kinds of medicines are used to treat IBD:
Aminosalicylates
Most people with mild to moderate IBD are first treated with medicines called aminosalicylates. These drugs help control inflammation. Aminosalicylates contain a substance called 5-aminosalicyclic acid (5-ASA). They come in many forms including pills, enemas, and suppositories.

Sulfasalazine was one of the first medicines in this group to be used for IBD. While it improves symptoms, sulfasalazine (which contains sulfa) also causes a lot of side effects. These include heartburn, nausea, vomiting, diarrhea, and headaches. Many people are allergic to sulfa drugs and cannot take these medicines.

Newer 5-ASA medicines include balsalazide, mesalamine, and olsalazine. These products have fewer side effects than the original 5-ASAs and still help many people with mild to moderate IBD.

Corticosteroids
Corticosteroids are used to treat people with more severe IBD and those who do not respond to 5-ASA medicines. These medicines help people with IBD by reducing inflammation. But they also have many side effects. These include bone loss, weight gain, acne, high blood pressure, mood swings, and a higher risk of infection. Prednisone, methyl prednisolone and hydrocortisone are commonly used steroids.

Budesonide is the first in a new group of corticosteroids called topical or non-systemic steroids. These medicines help people with IBD with fewer of the side effects of traditional corticosteroids.

Antibiotics
Antibiotics are also used to treat IBD. No one is sure how these medicines improve the symptoms of IBD. But many researchers think they give relief by interfering with the immune system and changing the type of bacteria in the digestive system.

Metronidazole and ciprofloxacin are antibiotics often used to treat IBD. They can cause nausea, diarrhea and vaginal yeast infections as side effects.

Immune System Modulators
Medicines called immunomodulators are often used to treat moderate to severe IBD. These drugs reduce inflammation by blocking the immune system. Azathioprine and 6-mercaptopurine (6-MP) are commonly used immunomodulators.

Immunomodulators take a long time (3 to 6 months) to work. So, they are often taken along with corticosteroids. These medicines can be toxic to the bone marrow. They can also cause serious side effects including liver and pancreas problems and increased risk of infection. So doctors carefully monitor people taking immunomodulators.

Over-the-counter medicines
Drugs like antidiarrheals, laxatives, and pain relievers are sometimes used to treat IBD. It is important to talk with your doctor before taking any of these medicines. Some can actually make symptoms worse.

Surgery
Sometimes severe IBD does not get better with medicine. In these cases, doctors may suggest surgery to fix or remove damaged parts of the intestine.

Source: U.S. Department of Health & Human Services’ Office on Women’s Health

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