Medicines for treating inflammatory bowel disease (IBD) reduce the inflammation, relieve symptoms, and prevent flare-ups. Every patient is different. What may work for one person with IBD may not work for another. You may need to try several different medicines before you find one or more that work best for you. You should keep track of how well the drugs are working, any side effects, and report all details to your doctor. The following kinds of medicines are used to treat IBD:
Aminosalicylates
Most people with mild to moderate cases of IBD are first treated with medicines called aminosalicylates (uh-MEE-noh-suh-LISS-uh-layts). They are given as pills, through an enema, or in a suppository, depending on which part of the digestive tract is inflamed. Possible side effects include nausea, vomiting, heartburn, diarrhea, and headache.
Corticosteroids
Corticosteroids (KOR-tih-koh-STEER-oids) are powerful and fast-acting drugs that suppress the immune system. They are given for short periods of time to treat IBD flare-ups. They are not given long-term because of possible serious side-effects. Side effects may include increased risk of infection, bone loss, diabetes, and high blood pressure. Corticosteroids are usually taken as pills. But for people who do not respond to the pills, they may be given through an enema, in a suppository, or injected into the blood.
Immunomodulators
Like corticosteroids, immunomodulators (ih-myuh-noh-MAH-juh-lay-turs) suppress the immune system. They can take a long time to work (as much as 6 months for full effect). But, unlike corticosteroids, they can be taken long-term to prevent relapse. They are often given along with corticosteroids. As the disease is brought under control and the immunomodulator starts working, the corticosteroid dose is slowly reduced. Like corticosteroids, these medicines may raise the risk of infection. Other side effects are uncommon but may include nausea, vomiting, and headache. Immunomodulators are usually taken as pills, but some are injected.
Biologic Therapies
Biologic therapies are proteins that block substances in the body that help cause inflammation. Biologics used to treat IBD block a substance called tumor necrosis factor alpha (TNF-alpha). Anti-TNF-alpha therapies have been used for years to treat Crohn's disease and are now being used for ulcerative colitis. Blocking TNF-alpha can reduce inflammation, which can improve the symptoms of IBD. Anti-TNF-alpha therapies like infliximab (in-FLIK-sih-mab), adalimumab (A-duh-LIM-uh-mab), and certolizumab (SER-toe-LIZ-oo-mab) are used to treat people with moderate to severe IBD when other therapies don't work. Infliximab has also been used to treat people with Crohn's disease who have open, draining fistulas.
Infliximab is given intravenously (into the vein) by a doctor or nurse. But adalimumab and certolizumab can be taken at home by injecting under the skin.
These therapies may lower your body's ability to fight diseases. This can raise your chances of having a serious, or even life-threatening infection. Other side effects may include stomach pain, rash, and nausea.
Antibiotics
Antibiotics are used to treat people with Crohn's disease but are usually not given to people with ulcerative colitis. Antibiotics can reduce bacterial growth in the small intestine caused by stricture, fistulas, or surgery. Experts think that antibiotics may also help by suppressing the immune system.
Antibiotics are usually taken as pills. Side effects may include nausea, vomiting, and diarrhea. Long-term use of one type of antibiotic can cause tingling of the hands and feet. If you develop this side effect, tell your doctor right away. The medicine should be stopped and not restarted.
Other treatments
Drugs that relieve diarrhea and pain are sometimes used to treat IBD symptoms. But it is important to talk with your doctor before taking any over-the-counter drugs. Some can make your symptoms worse.
Patients who are dehydrated because of diarrhea may be treated with fluids and minerals. People with Crohn's disease are sometimes given nutritional supplements. Source: U.S. Department of Health and Human Services
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