Crohns Disease Treatment Anti Inflammatory

Drugs used to treat inflammation (anti-inflammatory drugs) are often the first drugs to be prescribed for Crohn’s disease. Other than sulfasalazine and corticosteroids, most of the anti-inflammatory drugs used to treat Crohn’s belong to the same family of medications: the 5-ASA drug group. All members of this group contain mesalamine, and are related to the salicylates, a group of drugs of which aspirin is a member.

Before anti-inflammatory drugs are prescribed, inform your doctor if

  • you have allergies to sulfa drugs, mesalamine, aspirin or other salicylates
  • you are, or plan to become, pregnant
  • you have a history of asthma, blood problems, liver disease, kidney problems, or intestinal blockage
  • you are taking any prescription or nonprescription drugs or supplements.

Sulfasalazine

Sulfasalazine is likely to be the first of the drugs prescribed to treat your intestinal inflammation. People with sensitivity to it may find that one of the other mesalamine-based medications works better. Sulfasalazine comes in both regular and time-released tablets, and is best taken with meals. Drink plenty of liquids while taking sulfasalazine.

Common sulfasalzine side effects include:

  • nausea
  • diarrhea
  • heartburn
  • vomiting
  • headaches.

Consult your doctor immediately if the following side effects occur:

  • skin rashes or other skin problems
  • a sore throat and/or fever
  • abnormal bleeding or bruising
  • joint pain
  • swallowing difficulties
  • yellow or pale skin.

Anti-Inflammatory 5-ASA Drugs

If sulfasalazine is not tolerated well, or if the drug proves ineffective, Asacol® or Pentasa®, two common 5-ASA drugs may be prescribed. Asacol, Pentasa and the other 5-ASA drugs come in several different forms: oral tablets, rectal suppositories, or enemas. While taking a 5-ASA drug, periodic kidney function testing may be advised.

Common 5-ASA drug side effects include:

  • nausea
  • diarrhea
  • stomach pain
  • vomiting
  • skin reactions.

Consult your doctor immediately if the following side effects occur:

  • rectal bleeding
  • joint pain
  • fatigue
  • fever
  • breathing problems
  • difficulty swallowing.

Corticosteroids: Prednisone and Prednisolone

Corticosteroids are powerful anti-inflammatory drugs. When other anti-inflammatory drugs prove ineffective or cannot be tolerated, synthetic corticosteroids, such as prednisone or prednisolone, may be prescribed.

Corticosteroids offer very real pain relief, but their effectiveness must be balanced against a long list of possible side effects, some of which are very serious. Generally, the short-term use of steroidal anti-inflammatory drugs is fairly safe; but the longer the period of medication, the more likely it is that serious side effects will develop.

The Immune System

People taking corticosteroids are generally more susceptible to infections than other people. The steroid disguises many of the symptoms of infection, and impairs the immune system’s ability to fight infection. As a result, even “normal” infections may develop into serious illness. When the immune system is suppressed, diseases that can lie dormant and contained in the body for years may flare up (tuberculosis is an example). Even the viruses found in vaccines may develop into full-fledged infections. If you’re taking corticosteroids, consult your doctor before scheduling any vaccinations.

Drug Interactions

Prednisone has been known to react with estrogens and the antiepileptic/anticonvulsant drug phenytoin. You must inform your doctor of any prescription or nonprescription medicine, vitamin, or dietary supplement that you are taking before you start a corticosteroid prescription.

Both prednisone and prednisolone depress the body’s ability to absorb calcium, a condition that can lead to osteoporosis. Vitamin D and calcium supplements may be necessary in long-term use.

Easing Off Steroidal Anti-Inflammatory Drugs

When the time comes to stop taking a steroidal anti-inflammatory, the drug dosage should be tapered off slowly. When the time comes to stop taking a steroidal anti-inflammatory, the drug dosage should be tapered off slowly. Synthetic steroids suppress the body’s ability to produce its own corticosteroids. Suddenly ceasing to take a prescription can result in nausea, vomiting or even shock, if the level of steroid in the body plummets and the body is not able to produce an adequate supply on its own.

Side Effects of Corticosteroids

Corticosteroids have a long list of potential side effects, both physical and mental. Here are some of the potential complications. This is by no means an exhaustive list, but gives some idea of the range of side effects that can occur.

Physical side effects include:

  • fluid retention
  • weight gain
  • high blood pressure
  • headaches
  • muscle weakness
  • glaucoma
  • cataracts
  • puffy (moon) face
  • facial hair
  • ulcers
  • convulsions.

Mental side effects include:

  • depression
  • personality changes
  • insomnia
  • mood swings
  • euphoria
  • psychotic behavior (rare).

Resources

Centocor, Inc. (nd). Treatment for Crohn’s disease.

MedicineNet.com. (nd). Prednisolone.

National Digestive Diseases Information Clearinghouse. (2003, January). Crohn’s disease [NIH Publication No. 03-3410].

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