Treatments for Crohn’s Disease

It is important that you know what a treatment is supposed to do for you and how it will affect your Pedi Crohn’s disease. Always remember to get the correct spelling of any new medications and clear dosing instructions so you know exactly what you are taking and how to take it.Treatments work best if you take them when and how you are supposed to.

When you begin any new treatment for your Pedi CD, it is helpful to discuss the following points with your doctor and make a plan that you understand and decide on together as a team.

  • What is the goal of this treatment?
  • How long will I be on the treatment before it should work?
  • How will my doctor know how well the treatment is working?
  • What common side effects of the treatment should I know about?
  • What serious side effects of the treatment should I get immediate medical attention for?

Make sure that your expectations, or what you think the treatment is going to do for you, are realistic. And know when you should be experiencing the treatments effects. This helps you to avoid getting frustrated when you think a treatment isn’t working fast enough.

Understand that treating your Pedi CD is a way to manage the disease and not cure it. Though research is making new discoveries every day, there is no cure for Pedi CD at this time. 

Your doctor can treat your Pedi CD with: 

  • drugs
  • nutrition supplements 
  • surgery
  • combination of these options

Drug Therapies
ANTI-INFLAMMATION DRUGS
Active Ingredient – Mesalamine

Most children with Pedi CD are first treated with drugs containing mesalamine, a substance that helps control inflammation such as Sulfasalazine, 5 ASAs (Asacol, Pentasa).

The goal of anti-inflammation drugs is to control inflammation.

Possible side effects of drugs with mesalamine in them can include nausea, vomiting, heartburn, diarrhea, headache.

CORTISONE OR STEROIDS (CORTICOSTEROIDS)
Cortisone drugs and steroids, or corticosteroids, can be used when your Pedi CD is flaring as a way to get symptoms under control quickly. These drugs have serious side effects and are not to be used for the long-term management of your Pedi CD.

Prednisone is a common generic name of one of the drugs in this group of medications. 

Side effects of corticosteroids can include:

risk of colds, flu and infections

  • bigger appetite
  • stomach upset
  • more anxiety
  • mood swings
  • acne
  • osteoporosis or brittle bones
  • hypertension
  • weight gain

IMMUNE SYSTEM SUPPRESSORS
These drugs help to suppress your immune system. The most common immune system suppressing drugs are 6-mercaptopurine (azathioprine).

Immunosuppressive agents work by blocking the immune reaction that causes inflammation. 

Side effects of immunosuppressive drugs can be nausea, vomiting, diarrhea, pancreatitis.

BIOLOGICS 
Remicade, Enbrel, Humira
This group of medications blocks the body’s inflammation response. 
This is the newest form of treatment for Pedi CD. 

ANTIBIOTICS (AMPICILLIN, CEPHALOSPORIN, TERTRACYCLINE, METRONIDAZOLE)
Antibiotics are used to treat bacteria in your small intestine than can be caused by stricture, fistulas, or earlier surgery.

ANTI-DIARRHEAL AND FLUID REPLACEMENTS (DIPHENOXYLATE, LOPERAMIDE)
Diarrhea, stomach pain and cramping can get better when the inflammation is under control, but other medication may also be needed to keep these symptoms from coming back. 

If you are dehydrated because of diarrhea, you can be treated with fluids and electrolytes.

Nutrition Supplementation 
If your growth or development is slow, your doctor may recommend nutritional supplements. Special high-calorie drinks can sometimes be helpful in this case. 

A small number of children may need to be fed intravenously for a short time through a small tube inserted into the vein of the arm. 

This therapy can help children who need extra nutrition, those whose intestines need to rest, or those whose intestines cannot absorb enough nutrition from food. 

Surgical Therapies
Many patients with Pedi CD have surgery at some point in their lives.  Surgery may be considered by your gastroenterologist if: 

  • your Pedi CD does not respond well to medications 
  • symptoms can not be controlled by medications or nutritional therapies  
  • or to correct complications such as blockage, perforation, abscess, or bleeding in the intestine

Surgery to remove part of the intestine can help children with Pedi CD, but it is not a cure. 

Surgical treatments for Pedi CD can include: 

  • iIleostomy
  • colostomy
  • subtotal colectomy

which remove or shorten very diseased or inflamed parts of the intestine and allow waste products to leave the body.

Because a surgical treatment can affect you and your family’s lifestyle significantly, it is very important to discuss your questions and concerns with your family and medical team before the surgery.