Managing Crohn’s Disease: Medicines

Your healthcare provider may prescribe medicine to help control your Crohn’s disease. Medicine can help lessen symptoms. It won’t cure Crohn’s disease, but it can help improve your quality of life. Work closely with your healthcare provider. You may have certain side effects or your symptoms may change. In this case, your medicine or dosage may need to be changed.

Types of medicines

You may be prescribed 1 or more of these types of medicines:

• Corticosteroids

• Immunomodulators

• Biologic agents

• Antibiotics

• Aminosalicylates

You can learn more about each kind below.

Corticosteroids

Your healthcare provider may advise you to take corticosteroids. These help to calm inflammation in your body. This can make your symptoms better quickly. You may take corticosteroids as a pill or liquid by mouth. In some cases, they may be given through an intravenous line (IV). Or they may be given rectally as either a suppository or an enema. You take them for a short time, usually not longer than 8 to 12 weeks. You do not take them when you are in remission. Remission is a long period with no symptoms.

If used for a long time, side effects may include:

• Mood changes

• Trouble sleeping

• Changes in body shape

• Higher chance of developing infections

• Puffy face or acne

• Weight gain

• Stretch marks

• Eye problems

• Bone loss or breaks

• Facial hair in women

• Acne

• High blood pressure

• High blood sugar

• Risk for diabetes

Immunomodulators

These kinds of medicines cause your body’s immune system to be less active. This can help to reduce inflammation and calm your symptoms. They are taken as a pill by mouth. You may not feel their effects until you have taken them for a few months. But you can take them for a long time. You will need to have blood tests every few months to check your liver and blood cell counts.

Side effects may include:

• Nausea

• Body aches

• Inflammation of the pancreas (pancreatitis)

• Low white blood cell count

• Liver problems

• Low folic acid levels

• Infection

• Lymphoma

• Nonmelanoma skin cancer

Biologic agents

These kinds of medicines help stop body chemicals that cause inflammation. One medicine blocks a chemical called tumor necrosis factor (TNF). The medicine is also known as anti-TNF monoclonal antibodies. Another type of medicine blocks white blood cells from getting into the intestinal tissue and causing inflammation. 

New biologics are also being created that target different ways the intestine gets inflamed in Crohn's disease. These medicines may be given different ways. They may be given by vein (IV) every 2 to 8 weeks. They may be given with a shot (injection) once a week or once a month. These medicines can put you at risk for infections. Tell your healthcare provider if you have a chronic infection. You will need to be tested for tuberculosis and hepatitis B infection before taking the medicine.

Side effects may include:

• Flushing, chest pain, shortness of breath, hives, or a drop in blood pressure during IV treatment

• Joint and muscle aches

• Rash

• Fever

• Infection

• Renewal of a previous tuberculosis or hepatitis B infection

• Lymphoma

• Skin cancers

• Liver toxicity

• TNF-induced psoriasis

Antibiotics

These may be used if you also have an infection due to Crohn’s disease, such as an abscess. Antibiotics may be given as a pill taken by mouth. You should stay out of the sun while taking them. You should also not drink alcohol while taking them. Antibiotics may cause severe reactions. These can include nausea, vomiting, and breathing problems. Tell your healthcare provider right away if you have numbness or tingling in your hands. Also tell your healthcare provider if your bowel symptoms become worse.

Side effects may include:

• Nausea

• Diarrhea

• Headaches

• Dizziness

• Dark urine

• Loss of appetite

• Metallic taste in the mouth

• Sensitivity to the sun

Aminosalicylates

This medicine is also known as 5-ASA. It may be used for mild to moderate symptoms. It's useful as maintenance treatment in preventing relapses of the disease. The medicine may be taken either orally or by rectum. It works to decrease inflammation in the intestines.

Side effects may include:

• Headache

• Nausea and vomiting

• Abdominal pain

• Heartburn

• Diarrhea

Managing side effects

Your healthcare provider will explain the side effects of any new medicines. In most cases, side effects are easy to manage. But sometimes they can be so severe that you need to change medicine. Call your healthcare provider if you have any of the below:

• Side effects that are hard to manage

• Severe side effects

• Unexpected side effects