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March 2008
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Living with Crohn’s Disease
More Options for Treatment

Living with Crohn’s Disease

For the half-million Americans with Crohn’s disease, finding relief from abdominal pain and digestive problems is an ongoing challenge.  Conventional therapies like steroids are often effective, but some patients find that they don’t do enough to calm their troubling symptoms.

Fortunately, in the past few years a wider range of treatments has become available for people with Crohn’s disease.  Other experimental drugs are showing promise in clinical trials.  But even the newest treatments have plusses and minuses.  That’s why NIH researchers are continuing to investigate Crohn’s disease.  They hope to discover who’s at risk so they can block the disease before it appears.  And they’re exploring a variety of new treatments.

Crohn’s disease arises from inflammation, or swelling, of the digestive tract, usually in the small intestines.  Its symptoms include abdominal cramps, diarrhea, weight loss, malnourishment and rectal bleeding.  In some cases, the intestine can become blocked or develop open sores, or ulcers. The ulcers sometimes tunnel through to other tissues.

Most people are diagnosed with Crohn’s disease in their 20s, although it can affect people of any age.  The symptoms often come and go throughout a person’s life.  In many cases, they get worse over time. 

Scientists are not yet certain what causes Crohn’s disease.  Many believe it’s set off when the immune system misidentifies harmless bacteria, foods and other substances in the digestive tract as dangerous invaders.  White blood cells are sent to attack these “invaders” and may build up in the lining of the intestines.  The buildup of cells can cause long-term inflammation and ulcers. 

The current treatments available for Crohn’s disease each come with their own risks and benefits.  NIH-funded research helped lay the groundwork for some of the newest therapies.  One new type of drug blocks an inflammation-causing molecule called tumor necrosis factor (TNF).  So far, the U.S.  Food and Drug Administration (FDA) has approved 2 anti-TNF drugs—Remicade and Humira—for treating Crohn’s disease.  About half of Crohn’s patients find anti-TNF drugs helpful.

In January 2008, the FDA approved another new drug, called Tysabri, that blocks white blood cells from moving to inflamed tissues.  Tysabri seems to help many patients who don’t respond to anti-TNF drugs.  But the new drug can have severe and even deadly side effects, so patients have to be carefully monitored. 

Another promising approach was developed more than a decade ago by NIH researchers.  This experimental treatment blocks immune molecules called interleukins.  In 2004, a clinical trial showed that up to 3 out of every 4 patients with Crohn’s disease responded to an interleukin-blocking drug.  Up to half had long-term freedom from symptoms.  The drugs, which are not available to the public, are now being tested in large clinical trials.

If you have ongoing abdominal pain and digestive problems, don’t suffer in silence.  If you have Crohn’s disease, the symptoms can be treated.  Talk to your doctor about your options.

Definitions iconDefinition

Immune System
The system that protects your body from invading viruses, bacteria and other microscopic threats.

Links iconWeb Sites

Crohn’s Disease

What I Need to Know About Crohn’s Disease

Wise Choices iconWise Choices
Treating Crohn’s Disease

Here are some treatment options you can discuss with your doctor:

  • Conventional medications include corticosteroids, immune system suppressors and anti-inflammation drugs.  
  • Newer medications use genetically engineered antibodies to block molecules that cause inflammation.  These drugs include anti-TNF medications and a drug that blocks the movement of white blood cells.
  • Surgery is sometimes needed to remove diseased parts of the intestine.  Crohn’s disease can return after surgery, so patients and doctors need to carefully weigh the benefits and risks.
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