Information about Crohn's Treatment

Q: I have just been diagnosed with Crohn's disease. What's the best medication for me to take?

A: There are two schools of thought: You can start with the most potent drug and work your way down, or you can start with the least potent drug and work your way up. Stronger drugs, of course, carry a greater risk of side effects, and you don't want to take more medication than you need. However, you'll also want to resolve your symptoms as quickly as possible.

Logically, it makes sense to take a milder drug like mesalamine (Pentasa) if you have mild symptoms and a stronger drug if you have more severe symptoms. However, determining disease severity can be difficult. Some people with mild symptoms actually show severe inflammation of the intestine during diagnostic testing, while others have terrible symptoms but only mild damage.

Each case of Crohn's disease is different based on factors like where your inflammation is and whether you have fistulas (abnormal connections between two organs). In addition, some medications just seem to work better for some people than for others.

This question is difficult to answer, because the best medication is the one that works best for you—which you can't know without some trial and error. Your doctor will work with you to determine the best drug for your Crohn's disease. And you may want to talk with him or her about participating in a clinical trial of new medications being developed.

Publication Review By: H. Franklin Herlong, M.D.

Published: 31 Mar 2011

Last Modified: 17 Apr 2014