Diagnosis & Treatment

Treatment for Crohn's disease depends on the location, severity, complications and response to earlier treatment. The goal of the IBD Pogram's specialists is to control inflammation, correct nutrition problems and relieve symptoms of pain, diarrhea and rectal bleeding. At this time, treatment can control the disease but not cure it.

Some patients have long periods, sometimes years, when the symptoms go away. However, Crohn's disease usually appears several times randomly over the course of a person's lifetime. This makes it hard for doctors to know for certain whether a treatment helped or not. Patients may need medical care for a long time, including regular visits to the doctor's office.

While there is no cure currently available, ulcerative colitis can usually be controlled with home treatment and medication. Medications used to treat Crohn’s disease are directed at quieting the immune system in the GI tract. Some children may be able control mild symptoms by simply altering their diet to avoid foods that upset their stomach.

Medical Treatment Options

Medication is the treatment of choice for most patients. Medications can control and/or prevent inflammation of a child’s intestines and help:

• Relieve symptoms
• Promote the healing of damaged tissue
• Put the disease in remission
• Keep the disease from flaring up
• Postpone surgery

Nutritional Therapy: Exclusive or partial nutritional therapy has been shown to induce and maintain remission in patients with CD. This novel therapy can be critical for children who have growth failure and are at risk of nutritional failure due to CD.

Steroids: Most commonly used for patients with moderate to severe IBD

• Prednisone
• Budesonide

Anti-inflammatory: 5-Aminosalicylic Acid (5-ASA): These medications have been widely used for IBD patients to decrease inflammation in the bowel. They are weaker agents but may help in maintaining disease remission. (Examples include: Mesalamine, Sulfasalazine, asacol)

Immunomodulators

• Thiopurines: 6-Mercaptopurine (6-MP) or Imuran: This medication is given to those individuals who do not respond to or are unable to take the 5-ASA or steroid medications. It directly inhibits the immune system that causes the intestinal damage of IBD.
• Methotrexate
• Tacrolimus

Biologic Medications: These medications act against chemicals that cause inflammation in our body and are provided as IV infusions or injections (examples: Infliximab — Remicade or Adalimumab — Humira)

Surgical Treatment Options 

Surgery may be needed if a child’s medication is ineffective; a child has severe side effects from the medication; or a child develops complications such as fistulas, abscesses or bowel obstructions. Surgery may help correct complications and improve a child’s well-being and quality of life, but Crohn’s disease cannot be cured so the patient must be prepared in case the disease returns.

If a child experiences severe symptoms and does not respond to medication, he may need surgery to remove all or part of his colon. Most people with ulcerative colitis never need surgery. If it does become necessary, many patients find comfort in knowing that after surgery, ulcerative colitis can potentially be cured and they can resume their normal, active lives.

Our IBD-trained surgeons will recommend removal of the colon when there is massive bleeding, severe illness, a rupture of the colon, risk of cancer or when drug treatments fail or cause side effects that threaten the patient's health. Several types of surgeries may be done. Patients are encouraged to consider all factors (needs, personal lifestyle and expectations) before making the decision to go ahead with surgical options.