This video is part of our series on IBD. Watch our other videos to learn more:
If you have inflammatory bowel disease often shortened as ibd you might feel a bit overwhelmed about all the treatment options available you have probably heard of the many different medications diets and surgeries in this video i’m going to go over some of the different medications how they work and why they might be prescribed when using medications to treat
Ibd which includes crohn’s disease and ulcerative colitis we focus on two main strategies managing symptoms directly and reducing disease activity in order to limit future symptoms symptoms and their impact on health and well-being are the most distressing component of the disease and direct treatment of these particularly chronic pain and diarrhea will improve
The quality of your life to reduce pain we use analgesic medications acetaminophen also known as tylenol is the ideal over-the-counter choice non-steroidal anti-inflammatory drugs or nsaids such as acetylsalicylic acid ibuprofen and naproxen are effective at relieving pain but can irritate the gut so use these cautiously to manage diarrhea without treating the
Underlying cause you might use anti-diarrheals that slow down the transit time of food in the intestines or anti-spasmodic agents that improve cramping associated with diarrhea fiber supplements can help adjust stool looseness and frequency by binding to water by modifying its consistency it may be easier for you to pass the stool while medications that ease
These symptoms are helpful the primary goal of treatment for ibd is to stop inflammation in the gastrointestinal tract and halt disease activity treating the cause often eliminates the symptoms entirely and is preferred over simply treating the symptoms as they appear remission is when your disease is managed and the goal is to use medications to stay in the
State for as long as possible your physician might prescribe any of the following medications perhaps individually or in combination it could take some time to find the right mix for you as each case of ibd is unique depending on the location of your disease different drug delivery methods such as oral rectal or combination can help to ensure that all areas of
Active disease are treated 5 asa or 5-amino salicylic acid is a medication used to reduce inflammation in mild to moderate ibd it has a long record of success 5asa is generally safe and well tolerated for long-term use the most common forms of these drugs are coded oral tablets and capsules but it is also available for rectal administration in the forms of enemas
Or suppositories sometimes sulfasalazine is used which is a chemical combination of 5 asa and sulfa however it’s not for you if you have a sulfur allergy five asa also known as misalamine helps to settle acute inflammation and when taken on a long-term basis which we call maintenance is effective in keeping inflammation under control it is important to maintain
Your medicine regimen even if you are symptom-free and you feel completely well maintenance therapy can be at the full initial dosage or at a reduced dosage and interval depending on the disease response if you stop taking your medications symptoms can return quickly and it may be more difficult to regain control compared to continued maintenance regimens your
Doctor might prescribe corticosteroids such as prednisone used orally and budesonide available for oral and rectal administration to reduce inflammation in the shorter term another corticosteroid hydrocortisone is available in rectal formulations including enemas foams and suppositories corticosteroids are effective at reducing inflammation but they aren’t great
For long-term use because they can have many unpleasant side effects physicians sometimes prescribe corticosteroids for administration intravenously in hospital for more severe cases or for a faster response corticosteroids should not be used for long term or for maintenance therapy slow tapering off of these medications is necessary after prolonged use of high
Doses most physicians prescribe oral versions of 5 asas or carticle steroids since patients prefer taking pills however if these medications have a specially designed release mechanism they may not reach and treat the area where the disease is most active oral tablets even with the coating to help drug release at the active inflammation site might not be the optimal
Way to reach the end of the colon or stool can interfere with its effectiveness unfortunately this is also the area in the colon where a flare usually starts the best way to reach this area is by delivering the drug into the rectum to get the best coverage of topical rectal therapies it is best to lie down on your left side the human anatomy is not symmetrical and
The way the organs lay when on the left side makes for better passage and flow of medication through the anus rectum and into the colon a suppository will travel into the rectum and usually reach about 15 centimeters inside from the anus an enema in liquid form or foam will reach farther about 60 centimeters it is best to insert these formulations before bedtime
To ensure that the medication is retained for as long as possible stool does not usually interfere with the drug since the bowel area is typically relatively empty right before bed rectal preparations are particularly good at treating urgency and bleeding which are bothersome symptoms a positive response often occurs within days of treatment immunomodulating drugs
Can help prevent flares and reduce dependence on corticosteroids such as azathioprine cyclosporin 6mp methotrexate or a newer medication called tofacetnib depending on specific circumstances these can take up to 12 weeks for therapy to start working and six months to be fully effective while these are used to reduce dependence on steroids recent literature does
Not show effectiveness when used alone with these drugs there can be an increased risk some infections and adverse effects so regular blood tests will be required the newest category of medications to treat ibd are biologics these products are specifically developed proteins created with living cells which selectively block mediators that are involved in the
Inflammatory process gastroenterologists routinely prescribe biologics to induce clinical remission of inflammatory bowel disease biologics are highly effective and they tend to work where other medications fail some are self-administered under the skin every two to twelve weeks and others require a healthcare professional to administer them through intravenous
Infusion approximately every eight weeks initial treatment may require more frequent infusions broad spectrum antibiotics such as metronidazole and ciprofloxacin are important for treating secondary problems of the disease such as perianal abscess and fistula in crohn’s disease even though the treatment goal is to maintain remission sometimes you might experience
A sudden onset of symptoms which is called a flare it is important to discuss with your physician in advance exactly what you should do if the disease flares having this important conversation with your healthcare team means that you can prepare for some immediate self-management when necessary while keeping everyone aware of your condition however if you have
Severe symptoms you should seek help immediately even if that means heading to the hospital emergency room it is necessary to treat a flare early inflammation typically does not resolve without treatment and early intervention results in a better outcome than waiting delaying treatment may limit the options available to your healthcare team and you’ll experience
Symptoms longer before getting relief living with constant or longer periods of inflammation might also increase your risk for future complications as inflammation may cause damage to the gut wall which accumulates in severity with each flare individuals with ibd may be anemic from a combination of factors such as chronic blood loss or malabsorption of certain
Vitamins and minerals iron supplements might help improve this condition but if you don’t respond to pills an injectable iron by infusion is available if signs of ibd occur outside of the gastrointestinal tract such as arthritis or inflamed eyes your physician will address these conditions individually and you might require referrals to other specialists while
There is currently no known cure for ibd it is a highly treatable condition with the right medications working with your healthcare team along with dietary and lifestyle changes you can live a long healthy life i’m dr alan lowe pharmacist and board advisor to the gi society visit badgut.org ibd for more information
Transcribed from video
Medications for IBD (Crohn's and Colitis) Featuring Dr. Alan Low | GI Society By Gastrointestinal Society
