While talking to your doctor is important, doing your own research on each of the five types of drug therapies available to treat IBD will prepare you to fully discuss each option with your medical provider.
Amino salicylates as the First Line of Treatment
Your doctor is likely to prescribe an amino salicylate medication to control inflammation if your IBD is mild or moderate. The medication can be administered orally, via suppository, or via enema, but some types have unpleasant side effects. The following is a partial list of these medications:
- Sulfasalazine (Azulfidine®) is an effective, inexpensive oral medication for those who can tolerate it.
- Balsalazide (Colazal™), olsalazine (Dipentum®), and mesalamine (Asacol®HD) are all newer oral drugs which deliver the same active components (known as 5-ASAs) as sulfasalazine but produce fewer side effects.
- Mesalamine in suppository form (Canasa®) or delivered via enema (Rowasa®) often provides enhanced relief, especially when taken in conjunction with an oral medication. Long-term use can affect kidney function.
Corticosteroids for Flare-Ups
During times of inflammatory bowel disease flare-ups, corticosteroids delivered orally, rectally, or, in extreme cases, intravenously, are sometimes used to rapidly relieve the inflammation of the digestive tract. They may be used alone or in conjunction with your regular medication.
Because corticosteroids work by suppressing the body’s natural immune response and reduce adrenal function, they are only recommended for short term use. Side effects can include:
- Weakening of bones and muscle wasting
- Increase in blood sugar levels
- Increased risk of infection
- High blood pressure
- Insomnia, mood swings, and other psychological issues
Immunomodulators Lower Immune Response
Like corticosteroids, immunomodulators also reduce the body’s natural immune system response, thereby reducing inflammation. They are useful for patients who do not respond to the other classes of drugs commonly used for inflammatory bowel disease, and/or for those who are experiencing excessive side effects to those drugs. Azathioprine (Imuran®, Azasan®) and 6-mercaptopurine (6-MP, Purinethol®) are two oral forms used in IBD patients.
Antibiotic Therapy may Help Crohn’s Patients
Certain types of IBD disorders, particularly Crohn’s, often respond well to short or long term antibiotic therapy. Oral metronidazole (Flagyl®) or ciprofloxacin (Cipro®) are commonly used.
New advances have helped scientists create medications that use proteins instead of chemical formulations to treat disease. This provides the advantage of being very specific to one location in the body as opposed to affecting your entire system as chemical drug treatments are known to do. The following biologic are approved to treat people with moderate to severe IBD that hasn’t responded to other treatments:
- Infliximab (Remicade®), Natalizumab (Tysabri®), and Vedolizumab (Entyvio™), delivered through an IV (intravenously)
- Adalimumab (Humira®), Certolizumab pegol (Cimzia®), and Golimumab (Simponi®), administered via injection under the skin (subcutaneous)
Side effects of biologics include redness, swelling, pain, or bruising at the injection site, as well as headache, chills, hives, and fever; nausea, stomach and/or back pain, and upper respiratory infections may also occur.
Discuss Your Options with Your Doctor
Work with your doctor to choose the best medication for your IBD. By educating yourself about the different IBD drug classes, as well as their side effects, you’ll be prepared to discuss the details with your health care provider. Finding the best medication that works well with your body chemistry can help with fewer IBD symptoms.