cephalosporin, or tetracycline can prove effective in controlling
bacterial growth in the intestines. Diarrhea causes dehydration.
Doctors prescribe antidiarrheal agents like loperamide,
diphenoxylate, and codeine and lots of fluids and electrolytes to
combat diarrhea. Some fiber preparations like psyllium and
methylcellulose can help reduce cramps and pain. However, not all
can tolerate these medications.
Antibiotics prove effective in controlling bacterial growth in the
intestine. Bacterial growth increases in cases of various fistulas,
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strictures, and surgeries. Doctors prescribe Tacrolimus and
cyclosporine as alternative medications if your fistulas do not close.
Although these drugs are primarily for patients with organ
transplantation, they also provide relief for patients with Crohn’s
disease. This is specifically true for patients using steroidal
medications.
Nutrition Supplements
Children with Crohn’s disease show slow growth due to lack of
sufficient absorption of nutrients. Nutritional supplements can prove
beneficial for treating such children. Nutritional supplements are
available in the form of high calorie liquid formulas. Doctors advise
intravenous feeding of such supplements.
Such nutritional supplements can prove to be good alternatives for
your regular intake of food. You can take this through a catheter, a
tiny tube directly inserted into your blood vein in the chest.
Otherwise, you can take this intravenously through injections. Such
intravenous feeding helps provide sufficient rest to your intestines
and helps in thorough absorption of nutrients. Those suffering from
Crohn’s disease should better stay away from spicy foods, milk
products, alcohol, and foods of bulky grains.
Surgery
Surgery proves necessary at some or other time for all Crohn’s
disease patients. Rather, it is the only treatment option available
after all medications cease to be effective. Surgery can prove
effective in treating Crohn’s disease in two ways.
It can provide relief from inherent symptoms or correct Crohn’s
disease complications like perforations, blockages, bleeding, and
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abscesses. Surgery can remove abscesses, repair fistulas, or
remove obstructions in the intestine. Surgical removal of the
infected part of the intestine does not offer any permanent cure.
Inflammation soon starts at other parts of the intestine.
Surgical removal of the intestine can be either complete removal of
the intestine or cutting away the diseased part and rejoining
remaining parts of the intestine. Colectomy is the surgical removal
of the entire intestine. Doctors make a small hole near the
abdominal wall. This is a stoma. Doctors then connect the end of
the small intestine to the stoma. You need to wear a pouch near the
stoma. Waste accumulates within the pouch and you have to empty
the pouch when necessary. This bag is for life. It collects all waste
that can no longer pass through the anus. This treatment becomes
essential if you stop responding to all other treatment options.
Sometimes, it is sufficient to cut away diseased parts and connect
remaining intestine ends. However, surgical treatment for Crohn’s
disease may not suit all patients. You have to discuss post surgery
effects with your doctor. You can also take the help of group
therapists and other support groups.
Surgery is not a single time affair. You may require one or two
surgeries. It all depends on the severity of Crohn’s disease.
However, a major factor of Crohn’s disease is the possibility of
excessive infection. Around five to ten percent of patients suffering
from Crohn’s disease die of infection.
Alternative Therapies
Crohn’s disease causes lot of pain and discomfort. Alternative
therapists suggest a mind and body approach to combat and fight
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away pain. Such mind and body treatments include hypnotherapy,
biofeedback, sound and music therapy, guided imagery, and
relaxation techniques.
Tai Chi, postural therapies, and exercises help you concentrate on
specific choreographed movements that ease pain and discomfort.
These do not form any rigorous exercise regimen and offer soothing
relief from pain. Similarly, acupressure and acupuncture are also
remedial therapies for Crohn’s disease.
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Surgery for Crohn's Disease
Around two-thirds to three–quarters of people suffering from
Crohn’s disease require surgery at some point. Surgery cannot cure
your disease. It only alleviates pain and discomfort synonymous
with Crohn’s disease. Surgery could be a better option for some if
medications fail to produce desired results in controlling abscesses,
fistulas, perforations, and other blockages.
Before going for surgical treatment of Crohn’s disease, you should
weigh all the pros and cons. Surgery cannot offer any permanent
cure from Crohn’s disease. Surgery is only a temporary solution. All
symptoms of Crohn’s disease could reoccur a few years after
surgery. It is therefore best to collect all possible information from
medical journals, physicians, and other people facing or having
faced similar situations in the past.
The main aim of surgery is to conserve as much of the bowel as
possible. Surgery tries to bring down your dependence on steroids
and other medications and help you be free of their serious side
effects.
Surgery and Crohn’s Disease
There are four common types of surgery for Crohn’s disease.
These are:
1) Partial bowel resection
2) Correction of Fistulas
3) Strictureplasty
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4) Draining of Abscess
Partial bowel resection
Resection becomes necessary if a permanent partial obstruction
forms within your intestine. This is normally found in your terminal
ileum, ileocecal valve, and a part of the large intestine. Normally,
doctors cut out the diseased part of your intestine and rejoin the
healthy ends.
In some cases, there could be a mild inflammation all through the
intestine. It then becomes necessary to cut off infected parts of
intestine and rectum. Doctors instead create a small incision or hole
near the abdominal wall. They then connect the ileum to this hole or
stoma. They attach a pouch to this hole where all waste drains into
this pouch. You can empty the contents when it is necessary. This is
an ostomy.
In some cases, a temporary ostomy could be useful. After a period
of three to six months of initial surgery, doctors reattach bowels and
normalize processes. However, in severe cases, this may not be
possible. You would have to carry the pouch permanently. However,
clothing can cover your pouch and you can lead perfectly normal
lives even after ostomy.
In very severe cases of Crohn’s disease, doctors need to remove the
entire bowel. This is colonectomy. Surgery does not signify the end
of Crohn’s disease. It can crop up after few years and affect healthy
intestines. This relapse could be close to the place of your surgery.
However, you can take Pentasa or 6-MP to lessen the possibilities of
a relapse of Crohn’s disease after surgery.
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Correction of Fistulas
Crohn’s disease creates inflammation of the intestinal lining. This
inflammation could create channels within the intestine or between
parts of the intestine and other supporting organs. Fistulas then
become easy channels for waste to flow from one organ to another
thereby causing infection. Correction of fistulas involves closing
them to prevent intestinal contents from flowing through all nearby
organs.
Strictureplasty
This refers to surgical removal and opening of strictures. Strictures are small blockages in intestines. These restrict intestinal passage
and prevent easy flow within the intestine. Strictures cause
alternations between areas of normal intestine and damaged
intestine. Damaged and strictured parts of the intestine block
movement of digested food. Normal parts of the intestine push
against the strictured part. This causes severe pain and cramps.
Strictureplasty involves making an incision in a stricture. Doctors
pull together the incision lengthwise and sew it across. This shortens
the intestine but clears the blockage thereby helping in easy flow.
Draining of Abscess
An abscess is an eruption on the intestinal wall. These erupt due to
inflammation of the intestines. These eruptions contain fluids, which
are infectious. Doctors use medications initially to drain away the
abscess. If medications fail, surgery becomes essential as abscesses
spread infection.
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Surgical treatment of an abscess includes insertion of a needle to
draw out infectious material. Sometimes, surgeons remove
infectious material and place a wick inside to ease drainage and help
the abscess heal thoroughly.
You can treat recurrence of Crohn’s disease with regular
medications. Nevertheless, occasionally, a second surgery could also
be necessary to overcome Crohn’s disease.
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Medication for Crohn's Disease
There is no cure for Crohn’s disease. You can take medications to
alleviate symptoms and get relief. All medications for Crohn’s
disease have their own side effects. You can try using the ones that
suit your condition the best.
If you refrain from using medications, it would only worsen Crohn’s
disease. Medications can help keep the disease in check and prevent
excessive spreading.
Types of Medication for Crohn’s Disease
There are two main categories of medications for Crohn’s disease.
They are:
1) Drugs that reduce Inflammation
2) Drugs that treat symptoms
Inflammation Reducing Drugs
Major drugs under this group consist of Sulfasalazine, steroids, 5-
Aminosalicylate (5-ASA), antibiotics, immunosuppressive drugs, and
Infliximab.
Sulfasalazine: This drug restricts production of certain
inflammation causing chemicals that cause diarrhea. It can reduce
your flare-ups, although not all patients may have the same effect.
Common side effects of Sulfasalazine include vomiting, nausea,
allergic reaction, poor appetite, and possible bone-marrow
shutdown.
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Steroids: Glucocorticosteroids or glucocorticoids can treat
inflammation in patients with Crohn’s disease. These prove
beneficial in giving relief in patients with moderate and severe
attacks of Crohn’s disease. Common side effects of these steroids
include increased appetite and subsequent weight gain, acne,
redness of face, rounding of face, insomnia, night sweats, softening
of bones, glaucoma, ulcers, high blood pressure, mood changes,
and others.
5-ASA (5-Aminosalicylate): This drug helps treat moderate to
severe cases of Crohn’s disease. It can help reduce production of
diarrhea causing chemicals. Additionally, it disables oxygen radicals
that destroy tissue. Common side effects include headaches,
nausea, allergic reactions, and kidney damage if used for long
periods.
Antibiotics: Although a number of antibiotics can treat Crohn’s
disease, metronidazole is the most common of them. This antibiotic
is very effective against anaerobes, which are intestinal bacteria. It
can treat fistulas and abscesses forming near the anus region. This
antibiotic is primarily useful in controlling Crohn’s disease flare-ups
and suppresses chronic symptoms. It also delays or in some cases
prevents relapse of Crohn’s disease after surgery.
Common side effects of metronidazole include poor appetite,
constipation, nausea, vomiting, indigestion, and diarrhea. Prolonged
intake of this antibiotic can disrupt body balance due to extensive
damage to nerves in the legs. However, you can reverse this
damage, although only after months of discontinuing the antibiotic.
Side effects are more pronounced if you consume alcohol regularly.
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You could suffer from nausea, headaches, breathlessness, rapid
heartbeats, and excessive flushing of the face.
Immunosuppressive Drugs: Doctors prescribe these drugs only if
other anti-inflammatory drugs don’t get the desired results. Doctors
normally prescribe small dosages of this drug. Although there is no
conclusive proof of how it reduces inflammation,
Immunosuppressive drugs can control inflammation extensively.
The greatest side effect of immunosuppressive drugs is a reduced
immune system. You lose your resistance against infections. You
should consult your doctor for any minor ailments like cold, fever,
persistent sore throat, and similar other ailments. This drug poses
problems if you become a victim of any undiagnosable infection.
Infliximab: Doctors prescribe this anti-inflammatory drug if you do not respond to any other medication or treatment. This is the most
recent drug approved by U.S. Food and Drug Administration for
treatment of Crohn’s disease. This drug primarily reacts against
TNF-Alpha, which is the main inflammation-causing component.
Symptom Treating Drugs
There are certain medications that can treat symptoms of Crohn’s
disease. These eliminate or reduce symptoms rather than reducing
inflammation. Such drugs include antidiarrheal, bile salt binders,
and bulk formers.
Antidiarrheal Drugs: These drugs reduce muscle activity of the
small and large intestines. It can make waste materials pass
through slowly. These drugs therefore control cramps, diarrhea, and
similar urgencies effectively. These prove safer than drugs that
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reduce inflammation. Doctors however do not prescribe these drugs
during flare-ups due to possible complications.
Common side effects of antidiarrheal drugs include abdominal pain,
constipation, and a sense of bloating. Among all antidiarrheal drugs,
Loperamide is the safest. Dosage is once or twice a day. You can
purchase it over-the-counter, as it does not require a prescription.
Bile-Salt Binders: Bile salts are liver products that help digest fat in the intestine. Ileum absorbs most of the bile salts. However, in
Crohn’s disease patients, the ileum does not function properly.
Therefore, most of the bile salts reach the colon and cause
excessive irritation. This leads to diarrhea. Bile salt binders help
bind the bile salt and thereby reduce diarrhea. Common side effects
of bile salt binders include nausea, digestion problems, vomiting,
abdominal pain, constipation, and bloating.
Bulk Formers: These are products of a natural fiber source like
psyllium seed. They are available in granules of various flavors.
These drugs help soak water content in stools and bind them. This
reduces frequency and looseness of stools. These drugs prove most
beneficial for patients with mild Crohn’s disease. It can help correct
looseness of stools, although frequency may be high.
A side effect of Bulk formers is that it could make you feel gassy
and bloated. These drugs give out a fine dust that could make you
allergic and cause serious reactions.
Although various effective drugs control symptoms and
inflammation of Crohn’s disease, a balanced, high nutrition diet is
essential. Physical exercise and an optimistic nature can help too.
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Cure Research for Crohn's Disease
Researchers and scientists are continuously trying their best to find
a cure for Crohn’s disease.
Antibiotics: Although doctors prescribe these for bacterial
infections that come with Crohn’s disease, researchers suggest that
antibiotics could prove to be the main source of treatment for
Crohn’s disease soon.
Anti-TNF: Body immune system produces a protein, tumor necrosis
factor (TNF). This is present in cells affected by Crohn’s disease.
TNF could be responsible for inflammations. Researchers feel Anti-
TNF could combat TNF and prevent it from reaching intestines and
causing inflammation. This could also close fistulas.
Interleukin 10(IL-10): This is a cytokine present in the body, which can reduce inflammation. Researchers are studying
effectiveness of synthetic IL-10 in treating Crohn’s disease.
Methotrexate and cyclosporine: These immunosuppressive drugs
treat Crohn’s disease. These seem to work faster than other
immunosuppressive drugs.
Zinc: Doctors believe that free radicals could be cause for
inflammation in Crohn’s disease. Free radicals are molecules
produced by your body due to stress, infection, and fat metabolism.
These damage body cells on interaction with other body molecules.
Zinc removes these free radicals from your bloodstream.
Researchers are therefore trying to study extent of zinc
supplementation in reducing inflammation.
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Budesonide: This corticosteroid proves as effective as usual
corticosteroids. However, the major benefit is that it causes fewer
side effects.
Medications: Researchers are trying to delve deeper into
effectiveness of various medications for treating Crohn’s disease.
Common medications include Neoral, Cyclosporine, SangCya, and
Sandimmune. As genetic factors play a role in Crohn’s disease,
researchers are trying to analyze their effect and how to combat
them.
Helminth Treatment: Helminths are parasites that breed in the
intestines. Researchers formed a formula using helminths found in
pig intestines and gave it to six people. Five of these experienced
remissions of Crohn’s disease symptoms while the sixth experienced
substantial reduction in symptoms. However, after all helminths
passed away through stools, all six people experienced reoccurrence
of all symptoms of Crohn’s disease.
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Complementary and Alternative
Treatments for Crohn’s Disease
Most Crohn’s disease treatments cause serious side effects. Many
Crohn’s disease patients prefer trying alternative and
complementary therapies to treat Crohn’s disease. National
Institutes of Health established the National Center for
Complementary and Alternative Medicine (NCCAM) to look for such
treatment options that could provide necessary relief.
Common complementary therapies include music or art therapy,
acupuncture or acupressure, tai chi, yoga, guided imagery,
massage, and hypnosis. The focal point of these therapies is not to
address the problem area alone. Instead, it addresses the entire
body and system as a whole. It alleviates pain and associated stress
from your mind thereby bringing relief in various Crohn’s disease
symptoms.
Stress does not cause Crohn’s disease; however, stress can
exaggerate flare-ups and other symptoms. Simple digestive
processes undergo noticeable changes due to stress. Stress can be
in the form of loss of job, death of a loved one, change of place, or
similar situations. Stress is unavoidable no doubt; nevertheless, you
can reduce its effects substantially. Simple stress busters include
biofeedback, exercise, meditation, yoga, and massage.
Biofeedback techniques reduce muscle tension and put you in a
relaxed state of mind. With a little help, you can practice such
techniques independently and reduce stress levels substantially.
Mild exercises are very beneficial. Exercises can be in the form of
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simple walking, stretching, or jogging. Exercises can reduce tension
and ease bowel functions extensively.
Yoga and deep breathing allows greater flow of air in and out of
your muscles. This helps in clearing passages within your body and
allows your abdominal muscles to function easily. This normalizes
bowel function extensively.
Practicing hypnosis through a trained professional is highly
beneficial. Professionals guide you to reach a relaxed state and
thereafter help you imagine your intestinal muscles becoming
smooth and easy. Although there is no set rule for these techniques,
the best recourse is to set aside a minimum of half an h