Irritable bowel disease (IBD) affects between 1-1.3 million Americans.
IBD is a broader term that refers to Crohn’s disease and ulcerative colitis. Both Crohn’s disease and ulcerative cause chronic inflammation in the gastrointestinal (GI) tract.
The side effects of IBD vary from patient to patient. No matter its extent, IBD is not a pleasant disease to live with. Sufferers experience abdominal pain, diarrhea, constipation, bloating, and even weight loss.
There is no cure for either Crohn’s disease or ulcerative colitis. However, IBD medications can help to relieve symptoms and prevent them from recurring.
If you suffer from IBD, you may be wondering which medications are most effective. In this article, we’ll explore different types of IBD medicine.
Understanding Irritable Bowel Disease
It’s important to distinguish the differences between Crohn’s and ulcerative colitis. Although their symptoms are similar, Crohn’s and ulcerative colitis affect different parts of the gut.
Crohn’s causes inflammation in the inner and outer layers of the bowels anywhere in the GI tract. This includes the mouth, stomach, small and large intestines, and anus.
Ulcerative colitis affects the inner lining of the large intestine. Its inflammatory effects can also extend to the colon and rectum.
Ulcerative colitis can cause rectal bleeding and bloody stools. Meanwhile, Crohn’s can also cause complications like anal fissures, ulcers and mouth sores. Both can cause complications in other areas of the body, including the liver and kidneys.
Causes & Prognosis of IBD
IBD typically develops between the ages of 15 and 35. The number of new cases of IBD has increased in recent decades.
The causes of Crohn’s and ulcerative colitis are widely unknown. Some studies suggest that IBD may be genetic or linked to problems with the immune system.
Those with mild IBD can usually manage their symptoms with lifestyle changes. Some patients are able to alleviate their symptoms with natural remedies for inflammation.
For others, the symptoms are so debilitating that lifestyle changes and natural remedies prove insufficient.
That’s where IBD medications come into play.
IBD medicine can’t cure Crohn’s disease or ulcerative colitis alone. They can, however, alleviate symptoms and help patients achieve remission.
Though not easy to attain, remission is possible for the majority of IBD patients.
The first goal of IBD treatment is to achieve clinical remission. Clinical remission not only refers to when patients feel better. It also refers to when symptoms improve or disappear altogether.
The goal of remission is to reduce inflammation in the bowels. Clinical remission then expands into endoscopic, biochemical, or surgical remission. These variations of remission depend on how a doctor tests for IBD post-treatment.
For instance, some patients undergo surgery. Surgery can remove areas of the intestines affected – even damaged – by an IBD. Patients then enter surgical remission if they experience a period of few to no symptoms.
Remission & Flare-Ups
IBD medications can help patients achieve endoscopic or biochemical remission. Remission occurs when a colonoscopy, sigmoidoscopy, or blood test shows no intestinal inflammation. These tests can also show how effective an IBD medication is for individual patients.
Remission can last for months, even years. After remission, patients and doctors work together to prevent future flare-ups.
Flare-ups are common with IBD, and most patients experience them at some point. When they occur, medication alterations are usually necessary.
Prescription IBD Medications
Because every case of IBD is different, there are many variations in IBD treatment. Certain medications work better for some patients and not others. Some medications may only be effective during certain stages of the disease.
Doctors prescribe IBD meds based on a patient’s case, their needs, and the severity of their symptoms. Doctors can prescribe them in a variety of doses and for different lengths of time.
The main focus of IBD prescription medications is to reduce inflammation in the intestines. But each medication works differently to do so.
IBD medicine comes in a variety of forms. They come as pills, creams, enemas, suppositories, and injections.
Next, we’ll explore the different types of IBD medications and how they work.
Aminosalicylates mainly treat ulcerative colitis. They can also treat milder forms of general IBD.
They work to reduce inflammation at the wall of the intestines. They do so by inhibiting the production of inflammatory enzymes, cytokines, and lipid compounds. They also slow down the production of immunoglobulin proteins created by plasma cells.
Aminosalicylates are anti-inflammatory agents. They come in the form of pills, liquids, and suppositories. Some common brands of aminosalicylates include:
- Asacol HD
- Azulfidine EN-tabs
- Canasa Suppositories
- Azulfidine EN-tabs
Unlike other IBD meds, aminosalicylates don’t suppress the immune system. They work in mild to moderate cases of IBD, and they can also help to prevent flare-ups.
Corticosteroids are a class of steroids that regulate inflammation. They resemble cortisol, a hormone produced by the adrenal glands. The adrenal glands produce and release cortisol in response to stress.
In higher doses, corticosteroids not only regulate inflammation. They also suppress the immune system when it attacks its own tissues.
They’re most effective for treating short-term flare-ups. They can treat flare-ups of Crohn’s, ulcerative colitis, and even microscopic colitis.
Corticosteroids can lead to swelling, weight gain, mood swings, and high blood pressure. This is largely why they’re not prescribed for long-term periods of time. Those who benefit from them and need to keep taking them will often take other medications simultaneously.
US Brand Name
- Aristocort C Cream
- Cortone Acetate
- Dexamethasone Intensol
- Entocort EC
- Florinef Acetate
Canadian Brand Name
Types of Corticosteroids
Prednisone, hydrocortisone and methylprednisolone help with moderate to severe Crohn’s disease. They also help with ulcerative colitis.
All three of these corticosteroids are available as pills. But hydrocortisone and methylprednisolone are also available as IV medications.
Budesonide is another type of corticosteroid that treats mild Crohn’s and ulcerative colitis. It’s known to create fewer side effects than prednisone, hydrocortisone, and methylprednisolone. Patients take budesonide rectally as a suppository or as an enema, or intravenously.
Whereas corticosteroids are usually taken short-term, immunomodulators work more long-term.
Immunomodulators are the active agents of immunotherapy. Immunotherapy is a branch of disease prevention and treatment. It specifically works to suppress, enhance, or induce immune responses.
Immunotherapy is mainly used to treat cancer. But in recent years, immunomodulators have also shown to be effective in treating IBD.
How Immunomodulators Treat IBD
In cases of IBD, immunomodulators calm down immune responses. As a result of this suppression, immunomodulators can prevent ongoing inflammation.
Doctors normally prescribe immunomodulators when patients don’t respond to corticosteroids and aminosalicylates. They can also wean patients away from corticosteroids without causing flare-ups.
Immunomodulators can take anywhere from 3 to 6 months to take effect. They’re usually taken as pills, but patients can also take them intravenously. Some well-known immunomodulators include methotrexate, cyclosporine, and azathioprine.
Immunomodulators exemplify the progress medicine has made when it comes to treating IBD.
Then there’s biologic therapy.
Biologic therapy is a new form of IBD treatment that implements genetic engineering.
Biologic medications are basically antibody proteins that target inflammatory molecules. Many of these inflammatory molecules directly affect the immune system.
Types of Biologic Medications
There are different biologic medications that doctors can prescribe. Each biologic medication targets specific inflammatory molecules and proteins.
Biologic therapy is beneficial in treating severe Crohn’s disease and ulcerative colitis. Some forms of IBD are so severe that they’re resistant to traditional treatment. Biologic medications offer a new and hopeful alternative.
Patients who are at higher risk of developing complications also take biologic medications. Additionally, biologic medications are effective in maintaining remission and reducing steroid use.
Patients can receive biologic medications intravenously or by injections. This depends on which biologic medications their doctor sees most fit.
Complications associated with Crohn’s and ulcerative colitis include infections, abscesses, and bowel obstructions.
Fistulas are also common. Fistulas are abnormal intestinal connections to other parts of the body. Nearly one-third of Crohn’s patients experience fistulas at some point.
When patients develop complications, they’ll receive antibiotics more times than not. Antibiotics are also administered after IBD-related surgery.
Prescription medicine is almost always necessary for treating IBD. But sometimes prescription medication can’t help to alleviate all symptoms.
Certain over-the-counter medications can help patients cope with some of their symptoms. In milder cases of IBD, some over-the-counter medications suffice entirely.
Loperamide, more commonly known as Imodium, can relieve diarrhea, for example. Acetaminophen and NSAIDs (ibuprofen, aspirin, and naproxen) can relieve joint pain and inflammation. Anti-gas medications can also help with bloating.
Before taking any over-the-counter medications, be sure to consult with your doctor. Acetaminophen and NSAIDs can irritate and inflame the colon and small intestine.
Living with Irritable Bowel Disease
Although there is not yet a cure for IBD, it is possible to manage your Crohn’s disease or ulcerative colitis.
IBD medications are constantly evolving and improving. Many patients are finding it possible to resume a better quality of life even with their IBD.
As is the case with most medications, IBD medicine can be expensive. That’s why it’s important to compare prices so you’re not overpaying for your medication.
To get the most out of your IBD treatment without overpaying, contact us today!