Medication used in IBD
This information has been provided with kind permission from Crohn’s and Colitis UK - a nationwide charity committed to providing information and support, funding crucial research and working to improve healthcare services for anyone affected by Inflammatory Bowel Disease.
The main types of drugs commonly used in IBD are:
- aminosalicylates (5-ASAs)
- corticosteroids, often just called steroids
- biologics or ‘anti-TNF’ drugs.
Another way of treating Crohn’s is with “enteral nutrition” – a specially formulated liquid diet that can be taken instead of food, usually for up to eight weeks. Exclusive enteral nutrition is commonly used in children. In adults this type of liquid food is more likely to be prescribed as a supplement.
5-ASAs work by damping down the inflammatory process, so allow damaged tissue to heal. They are often used to treat mild to moderate flare-ups of UC. They may then be prescribed to maintain remission and help prevent flare-ups on a longer term basis.
Some 5-ASAs may help to control mild Crohn’s in the ileum and colon. However, there is little evidence that they are effective in maintaining remission, although they may help reduce the chance of Crohn’s reoccurring after surgery. 5-ASAs are not recommended for severe Crohn’s.
Corticosteroids are closely related to cortisol, a hormone produced naturally in the adrenal gland. They act on the immune system (the body’s protection system against harmful substances) and work by blocking the substances that trigger allergic and inflammatory responses. This means that they can reduce the redness, swelling and pain of the type of inflammation found in IBD.
Steroids are generally very effective at bringing symptoms under control – people often notice an improvement in their symptoms within days of starting the drug.
As their name suggests, immunosuppressants suppress (reduce the effectiveness of) the immune system (the body’s protection system against harmful substances). They are helpful in IBD because, in doing so they also reduce levels of inflammation.
Immunosuppressants are mainly used when treatment with steroids and 5-ASAs has failed to control the inflammation, or when steroids cannot be withdrawn without causing a relapse.
BIOLOGICS (ANTI-TNF DRUGS)
Biologics are the newest group of drugs to be used in IBD.
They are sometimes called ‘anti-TNF’ drugs because most of them work by targeting a protein in the body called TNF-alpha. Your body naturally produces TNF-alpha as part of its immune response, but it is thought that over-production of TNF-alpha is partly responsible for the chronic inflammation found in IBD. Anti-TNF drugs bind to TNF-alpha, helping to prevent inflammation and relieve the symptoms of IBD.
In general, biologics are prescribed for severe IBD when standard treatments have not worked. However there is some evidence that earlier use of biologics or combined therapies (biologics plus immunosuppressants) may be helpful, especially in Crohn’s Disease. Research is continuing in these areas, and on the comparative effectiveness of the newer biologics.
© Crohn’s and Colitis UK 2015