Medical Management of IBD
Crohn’s disease (CD) and ulcerative colitis (UC), collectively known as inflammatory bowel disease (IBD), often begin in adolescence or early adulthood and have a chronic, episodic course, requiring long-term care.
The goal of treatment for inflammatory bowel diseases is to achieve remission so that symptoms disappear and to maintain remission so flare ups don’t occur, improving quality of life. Remission leads to healing of the lining of the gastrointestinal tract.
The Risks of Not Treating IBD
Active disease symptoms of IBD are challenging to live with. One risk of not treating IBD is a higher frequency of flare ups (of inflammation and symptoms) and progression of the inflammation to irreversible bowel damage. Left untreated, complications of IBD can include:
Leading-Edge Care For Ulcerative Colitis
- Skin conditions
- Inflammation of the eyes
- Liver disorders
- Kidney disorders
- Bone loss
- Increased risk of intestinal cancer
- Intestinal strictures causing bowel obstruction
- Intestinal perforation causing fistulas and abscesses
Go to the Experts
While there’s no permanent cure for IBD, you can expect the IBD Center to carefully evaluate and determine the best course of treatment for your IBD. Treatment options, including medications and surgery, will depend on the symptoms, prognosis and severity of the disease.
Read about surgery for IBD.
Treating IBD with Medications
Several types of drugs are available to treat IBD. First and foremost, treatment must reduce inflammation so symptoms are relieved and nutrients can be absorbed by the intestines. Secondly, treatment is designed to to maintain remission and control the chronic inflammation so the disease is manageable and complications are prevented.
- Aminosalicylates, or 5-ASA drugs, are anti-inflammatory medicines that can be taken orally or via suppositories or enemas to suppress inflammation in the intestine and relieve painful symptoms.
- UC San Diego researchers helped lead clinical trials that resulted in the approval of Asacol HD and Lialda for ulcerative colitis.
- Corticosteroids, such as prednisone, methylprednisone and hydrocortisone are powerful, fast-acting anti-inflammatory drugs. They are used by people who have moderate to severe IBD who do not respond to 5-ASA drugs. Since these drugs trigger side effects, they’re not feasible for long-term maintenance of IBD.
- Antibiotics can be used to reduce and supress intestinal bacteria, even though there’s no specific infectious agent associated with IBD.
- Immunomodulators help weaken the activity of the immune system, which reduces inflammation. Since they act very slowly, they are often paired with corticosteroids, which act quickly.
- Biologic therapies, a class of medications that includes Remicade, Humira and Cimzia, treat inflammation effectively for many people. These drugs are developed to target specific proteins that cause inflammation and suppress immune response.
- UC San Diego researchers helped lead clinical trials that resulted in the approval of Remicade and Humira for ulcerative colitis.
- UC San Diego researchers helped lead clinical trials resulting in the approval of Humira, Cimzia and Tysabri for Crohn's disease.
Investigational Medications for IBD
Antibody May Help Crohn's Disease
Ustekinumab, an antibody proven to treat the skin condition psoriasis, has now shown positive results in decreasing the debilitating effects of Crohn's disease, according to researchers at UC San Diego.
UC San Diego Health is evaluating a variety of investigational medications for inflammatory bowel disease. These are medications that the FDA has not yet approved for the treatment of ulcerative colitis or Crohn’s disease. Investigational medications may already be approved by the FDA for treatment of another disease, but are under investigational use for ulcerative colitis or Crohn’s disease. Alternatively, investigational medications may have not been approved yet for any disease, but are being studied as potential treatments for ulcerative colitis or Crohn’s disease.
Investigational medications are studied in clinical trials and the information collected in the clinical trials is then evaluated by the FDA to determine whether the medication should be approved for the treatment of ulcerative colitis or Crohn’s disease.
UC San Diego is a leader in studying new treatments for ulcerative colitis and Crohn’s disease.
Surgery for Crohn's Disease and Ulcerative Colitis
UC San Diego Health is a high-volume center for complex surgeries for Crohn's disease and ulcerative colitis. We incorporate the use of single-incision techniques, robot-assisted and transanal approaches when appropriate to provide the best possible outcomes in the treatment of Crohn's disease, ulcerative colitis and their complications. Read more about UC San Diego Health's expertise in surgery for IBD.