Our goals in treating inflammatory bowel disease are suppressing inflammation, healing tissue and relieving the symptoms of IBD. We commonly use the following medications.
5-ASA medications have been used extensively in patients with inflammatory bowel disease. They work locally to decrease inflammation in the bowel. Aminosalicylates are available in both oral and topical form (i.e. applied locally) and have been effective for inducing and maintaining disease remission. Commonly used 5-ASA medications include mesalamine (Asacol, Pentasa, Rowasa), sulfasalazine (Azulfidine), balsalazide (Colazal), and olsalazine (Dipentum).
Corticosteroids (e.g. prednisone) are most commonly prescribed for individuals with moderately to severely active inflammatory bowel disease. Patients are treated with topical forms (i.e. applied locally), oral forms or are given the steroid intravenously. Recently, rapidly metabolized synthetic steroids such as budesonide (Entocort EC) began being used in patients with inflammatory bowel disease.
Immunomodulators are often used to treat patients with inflammatory disease, either alone or in combination with biological agents. These medications directly inhibit the immune system that triggers the intestinal damage of inflammatory bowel disease. Azathioprine (Imuran), 6-mercaptopurine (6-MP), and methotrexate are the commonly used immunomodulatory medications.
Certain antibiotics have been utilized in inflammatory bowel disease for treating intestinal inflammation, healing fistulas and treating infection. Metronidazole (Flagyl) and ciprofloxacin (Cipro) are the most commonly used antibiotics.
Newer biologic agents such as infliximab (Remicade), adalimumab (Humira), certolizumab (Cimzia), and golimumab (Simponi) are used in the treatment of moderate-to-severe active inflammatory bowel disease. These medications target certain substances in the immune system that contribute to the inflammation and symptoms associated with inflammatory bowel disease. They have also been helpful in promoting growth and healing fistulae associated with Crohn’s disease. New biologics are constantly coming down the pipeline; vedolizumab and ustekinumab are expected to be available soon.
A probiotic is an organism that contributes to the health and balance of the intestinal tract. It is often referred to as the "beneficial" or "good" bacteria and, when ingested, it acts to maintain a healthy intestinal tract and help fight illness and disease.
Enteral nutritional therapy is a treatment that can be used for all levels of severity of inflammatory bowel disease. Treatment often requires a nasogastric (NG) tube to provide 80-100 percent of a child’s daily caloric intake. In Crohn’s disease, enteral therapy has been shown to be even more effective than steroids in inducing intestinal healing. Further information can be found within the Department of Nutrition.
Reviewed by: Kelly E Kachelries, RDN
Date: January 2014
Contact the Center for Pediatric Inflammatory Bowel Disease.