Crohn's disease affects the gastrointestinal tract and is characterized by inflammation of the digestive tract lining. It can result in abdominal pain, diarrhea and malnutrition. Other complications can also occur due to the spreading of inflammation into the deep tissues of the digestive tract. Treatments for Crohn's are varied and can help manage symptoms.
Sulfasalazine
Sulfasalazine is typically used in the treatment of patients with mild to moderate Crohn's disease. It appears to work through many mechanisms that all serve to decrease the inflammation in the digestive tract, according to the textbook, "Sleisenger & Fordtran's Gastrointestinal and Liver Disease." Adverse effects include upset stomach, decreased appetite, decrease in white and red blood cell counts, folate deficiency and nerve damage.
Antibiotics
Antibiotics have been used in eradicating bacteria that often contribute to the complications of Crohn's disease. Most commonly used is metronidazole, which targets anaerobic bacteria often found in the gut that can damage sensitive digestive tissue weakened by chronic inflammation. Side effects of metronidazole include nausea/headache, increased blood pressure with alcohol use and upset stomach. Ciprofloxacin is another antibiotic that is being used as an adjunct to therapy. Side effects can include tendon rupture and bacterial overgrowth of the colon causing watery diarrhea.
Glucocorticoids
Glucocorticoid, or steroid, therapy has been used to treat exacerbations of Crohn's disease due to the anti-inflammatory effects of steroid use. They are not effective as long-term therapy due to the wide array of side effects which include deranged metabolism resulting in fat deposition in the face and trunk, suppressed immune function, acne, mood disturbances, hair loss, hirsutism, high blood sugar, weakening of bone, fragile skin and muscle damage, according to Surgical Clinics of North America. Patients can also develop dependence on steroids after chronic use and must be weaned off after the exacerbation resolves.
Methotrexate
Methotrexate is a drug that modifies immune function to decrease the inflammation found in Crohn's disease. It is beneficial in maintaining disease remission and is given via injection due to increased absorption. Side effects include folate deficiency, diarrhea, nausea, hair loss and mild decrease in white blood cells.
Infliximab
Infliximab is a synthetically derived antibody that works against a chemical known as TNF, an important modulator of inflammation. It binds to TNF and decreases the inflammation process found in many diseases, including Crohn's. It does have a wide array of side effects including increased incidence of infections, increased tuberculosis infection and lupus-like reactions involving muscle and joint pain, sores, rash and sensitivity to light, according to a June 2007 article in Surgical Clinics of North America. It also causes worsening of congestive heart failure.
References
- "Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 8th Edition;" Feldman; 2006
- "Surgical Clinics of North America;" Current Medical Therapy for Chronic Inflammatory Diseases; Tamboli, C. Volume 87, June 2007
