Crohn's Disease

Treatment

Currently there is no cure for Crohn's disease and treatment is based on symptom management. Although Crohn's can be cured, treatment is being developed to control the disease by inducing remission, meaning the disease is inactive. Crohn's is different in every patient and therefore treatment is different for everyone and can include any number of the following methods to achieve a desired response. Treatments used include bowel rest, pharmacological therapies ( Drug therapy), stress and anxiety management, dietary changes and in some cases surgical interventions.

Bowel Rest is an important part of healing and can be accomplished in many ways. It may be by using specialized or elemental diets and in more severe cases fasting. As nutrition is one of the most important parts of overall digestive health, it is especially important when it is compromised by Crohn's and therefore attention must be directed at special diets and supplements. When a patient cannot tolerate oral or enteral (by tube directly into the stomach) patients may require Total Parenteral Nutrition (TPN) via intravenous feeding. TPN allows the digestive system to rest completely as all the nutrients are being given via solutions of carbohydrates, protein, lipid, electrolytes, fluid, vitamins, and trace elements. Each of the solutions is designed specifically for the patient's needs.

Pharmacological Therapies can be categorized into two types of treatments anti-inflammatory or symptomatic. The goal of anti-inflammatory treatment is reducing and eliminating inflammation within the digestive tract and inducing remission. Symptomatic control aims to reduce symptoms and improve quality of life for Crohn's patients. Treatments included in pharmacological symptom control include:

• Pain management often through analgesia, acetaminophen (Tylenol) is preferred
• Anti-diarrheal medications, either by altering muscle activity in the intestines or bulk formers that adjust the looseness of stool (soak up water) and frequency
• Treatment of anemia through vitamin and iron supplements

Management of stress and anxiety is also important as the brain sends messages to the bowel if a person is stressed or anxious and this can aggravate the bowels.

Dietary management is crucial to the treatment of Crohn's as some foods may be irritating and increase symptoms. Dieticians can provide personalized advice on dietary issues including caloric intake, supplementation and compensation for malabsorption and to address food that may be irritants. Also patient with Crohn's should strive for overall health and this includes quitting smoking if you are currently a smoker.

Surgery is may be necessary when medical management of Crohn's is not working. Since Crohn's has a high rate of recurrence even if the affected portions have been removed surgery is often limited to complications including obstruction, fistulae, and abscess formations or failure of medical management. Several factors need to be considered and discussed between patient and doctor before surgery. These factors include a patient's ability to look after family, work, overall health, nutritional status, and the pro's and con's of surgery.