Treatment for IBD
There is no cure for inflammatory bowel disease and the goal of treatment is to reduce symptoms and inflammation. Treatment often depends on the type, location, and severity of the condition. IBD treatments that improve the condition in one patient may not be helpful for other patients. Lifestyle changes, medications, and surgery often are used to treat IBD.
Lifestyle Modifications & IBD
For many patients who have inflammatory bowel disease, lifestyle changes (e.g., stress reduction, regular exercise, adequate rest, dietary changes) can help reduce symptoms. Dietary changes that may be helpful include the following:
- Avoid foods that are high in fat (e.g., fried foods) or dietary fiber (e.g., nuts, seeds, raw fruits and vegetables)
- Eat smaller, more frequent meals
- Limit dairy products (e.g., milk, cheese, and ice cream)
Patients who have inflammatory bowel disease often do not get adequate nutrients from food. Nutritional supplements can help prevent malnutrition in these patients. Patients with IBD should follow the advice of a qualified health care provider regarding diet and other lifestyle modifications.
Medications to Treat IBD
Treatment for inflammatory bowel disease often involves medications. Because IBD varies from patient to patient, it may take a period of time to determine which medicine or combination of medicines is most effective. In some cases, over-the-counter (OTC) pain relievers, laxatives, and anti-diarrheal medicines are used to reduce symptoms of IBD.
Drugs called aminosalicylates can be used to treat mild-to-moderate IBD. These medications contain 5-aminosalicyclic acid (5-ASA), which helps reduce inflammation in the intestines. Depending on the location of the intestinal inflammation, aminosalicylates can be given orally (in pill form) or can be inserted into the rectum (e.g., suppository, enema).
Types of 5-ASA drugs include the following:
- Balsalazide (Colazal)
- Mesalamine (e.g., Canasa, Lialda, Rowasa)
- Olsalazine (e.g., Dipentum)
- Sulfasalazine (e.g., Azulfidine)
Sulfasalazine contains sulfa and should not be used in patients who are allergic to sulfa drugs. Side effects include nausea, vomiting, diarrhea, rash, and headache. Newer 5-ASA drugs (e.g., balsalazide, mesalamine, olsalazine) usually cause fewer side effects. These medications may cause abdominal pain, diarrhea, and headache.
Moderate-to-severe inflammatory bowel disease and IBD that does not improve with 5-ASA medications may be treated using corticosteroids (e.g., prednisone, hydrocortisone, budesonide). These drugs also reduce inflammation, but long-term use may cause severe side effects, including the following:
- Bone loss (e.g., osteoporosis)
- High blood pressure (hypertension)
- Personality changes (e.g., mood swings)
- Weight gain
Antibiotics also may be used to treat inflammatory bowel disease. These drugs, which are used to treat infections, may reduce inflammation by interfering with the abnormal immune system response or by destroying bacteria in the GI tract.
Types of antibiotics used to treat IBD include metronidazole (e.g., Flagyl) and ciprofloxacin (Cipro). Side effects of these medications include nausea, diarrhea, and in women, yeast infections.
Surgery to Treat IBD
Surgery may be used to treat inflammatory bowel disease that does not respond to other therapies. According to the U.S. Department of Health and Human Services, about 20–40 percent of patients who have ulcerative colitis and 75 percent of patients who have Crohn's disease require surgery.
Surgery to treat IBD often involves removal of the affected portion of the intestines; however, this treatment does not cure the condition and inflammation may develop in other areas of the GI tract. In some cases, patients require an ostomy (e.g., colostomy, ileostomy) following surgery for IBD.
Types of surgery include the following:
- Colectomy (removal of part of the colon, or the entire colon and rectum)
- Proctocolectomy (removal of the entire colon, including the rectum and anus)
- Small bowel resection (removal of the damaged part of the small intestine)
In some cases, a procedure called stricturoplasty is performed to widen a portion of the intestines that has become too narrow because of chronic inflammation.
Surgery for IBD can cause serious complications, including infection, excessive bleeding, damage to surrounding organs, and bowel perforation (rupture).