Posts Tagged ‘Medical Treatment’

Treatment for Crohns Disease

04.29.10

Crohns Disease treatment is a life-long commitment, as this chronic condition is marked by flare-ups and remission periods that sufferers will unfortunately be forced to deal. Crohns Disease symptoms, and possibly one or more stays in a hospital.

All of that works together with the general stress of life to affect the course of your disease. When it all combines together — you get fatigue. You feel tired, listless. I know. I’ve been there. Proper Crohns Disease treatment is crucial, and it is important to learn everything you can about this debilitating condition.

The goal of medical treatment is to reduce the inflammation that triggers your signs and symptoms. In the best cases, this may lead not only to symptom relief but also to long-term remission. Treatment for Crohns disease usually involves drug therapy or, in certain cases, surgery.

Doctors use several categories of drugs that control inflammation in different ways. But drugs that work well for some people may not work for others, so it may take time to find a medication that helps you.

In addition, because some drugs have serious side effects, you’ll need to weigh the benefits and risks of any treatment.
Anti-inflammatory drugs
Anti-inflammatory drugs are often the first step in the treatment of inflammatory bowel disease.

They include:
• Sulfasalazine (Azulfidine). Doctors have used this drug for many years to treat Crohns disease. Although it can be effective in reducing symptoms of the disease, it has a number of side effects, including nausea, vomiting, heartburn and headache. Don’t take this medication if you’re allergic to sulfa medications.
• Mesalamine (Asacol, Rowasa). This medication tends to have fewer side effects than sulfasalazine has. You take it in tablet form or use it rectally in the form of an enema or suppository, depending on which part of your colon is affected.
• Corticosteroids. Corticosteroids can help reduce inflammation anywhere in your body, but they have numerous side effects, including a puffy face, excessive facial hair, night sweats, insomnia and hyperactivity.

More serious side effects include high blood pressure, type 2 diabetes, osteoporosis, bone fractures, cataracts and an increased susceptibility to infections. Long-term use of corticosteroids in children can lead to stunted growth.

Also, these medications don’t work for everyone with Crohns disease. Doctors generally use corticosteroids only if you have moderate to severe inflammatory bowel disease that doesn’t respond to other treatments.

A newer type of corticosteroid, budesonide (Entocort EC), works faster than do traditional steroids and appears to produce fewer side effects. Entocort EC is effective only in Crohns disease that involves the lower small intestine and the first part of the large intestine (ileocolitis).

Corticosteroids aren’t for long-term use. They can be used for short-term symptom improvement for about three to four months. They’re also used in conjunction with other medications as a means to induce remission.

For example, corticosteroids may be used with an immune system suppressor — the corticosteroids can induce remission, while the immune system suppressors can help maintain remission.

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Crohns Disease and Pregnancy

09.07.09

Women with Crohns disease who are considering having children can be comforted to know that the vast majority of such pregnancies will result in normal children. Research has shown that the course of pregnancy and delivery is usually not impaired in women with Crohns disease.

Even so, women with Crohns disease should discuss the matter with their doctors before pregnancy. Most children born to women with Crohns disease are unaffected. Children who do get the disease are sometimes more severely affected than adults, with slowed growth and delayed sexual development in some cases. Women with ulcerative colitis have normal fertility.

In Crohns disease, fertility may be reduced when the disease is active. Sulphasalazine can cause men to become less fertile. Fertility usually returns to normal when the drug is stopped. If possible, women should try to get pregnant when the disease is in remission. Flare-ups can occur during pregnancy but they are usually mild and will respond to medical treatment. Clinical experience has shown that the risk from steroids and sulphasalazine to the baby is extremely low.

Some doctors advise women to avoid pregnancy while on azathioprine because of theoretical risks, though many successful pregnancies have been recorded while taking the drug. Some doctors would suggest that a woman with inactive Crohns disease should stop taking her medication(s) during pregnancy, resuming an appropriate regimen only if a flare-up occurs.

Others might have different advice. Any woman who has Crohns disease and wants to become pregnant should discuss the issue of treatment during pregnancy with her health-care providers, where her personal medical history and treatment requirements can be taken into account. Women with Crohns disease whose disease is in remission at the time they conceive may experience increased symptoms during their third trimester, if they have symptoms at all. Many women suffer flare-ups immediately after giving birth. Doctors believe this is due to the hormonal changes of the pregnancy and postpartum period. “If Crohns disease flares up during pregnancy, sulphasalazine and steroids are permitted. Azathioprine and metronidazole should be avoided unless advised by a specialist.

However, note that there is no convincing proof that azathioprine has been responsible for foetal abnormalities and many inflammatory bowel disease specialists now recommend continuing the drug for those patients in whom relapse would be a major problem.There is no predicatable pattern to inflammatory bowel disease in pregnancy. Patients with inflammatory bowel disease often seem to be healthier during pregnancy, but at a risk of a flare-up in the postpartum period. The chance of a flare-up is not increased by pregnancy however it is advised to wait until disease is inactive before conception.

If patients conceive during a flare of Crohns disease:
- about 1/3 get better, 1/3 get worse and 1/3 stay the same

Women with Crohns disease tend to have more preterm births and babies with lower birth weights ”

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