Definition
Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract: it can affect one or more sections from the mouth to the anus, although the final tract of the small intestine and the colon are the disease's preferred targets.
Causes
The etiological search for Crohn's disease still remains an unknown factor: however, it has been observed that the anomalous and continuous activation of the immune system of the intestinal mucosa is a consequence of alterations caused by Crohn's disease in the digestive tract. Etiological hypothesis: immune alteration, environmental factors, genetic predisposition.
Symptoms
Symptoms vary, but generally include: fatigue, diarrhea, weight loss, abdominal, joint and perianal pain, perianal fistula, fever, stool blood (proctorrhagia), steatorrhea and vomiting.
Diet
Natural Care
Information on Crohn's Disease - Drugs for the Treatment of Crohn's Disease is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Crohn's disease - Crohn's disease treatment drugs.
drugs
Crohn's disease can be treated with drugs, or surgically, when medical therapy is not successful. Unfortunately, there is still no effective and definitive cure; the various treatments available, certainly useful for damping inflammation and reducing related symptoms and disorders, must be customized according to the individual patient, since the response often varies from individual to individual.
Antibiotics
- Metronidazole (eg. Flagyl, Metronidazole SAME): for acute forms, it is recommended to take 250 mg of active ingredient orally every 6 hours. Continue the treatment for a period varying from 4 to 8 weeks; when the drug is not effective, stop therapy and change active ingredient. Consult your doctor.
- Ciprofloxacin (eg. Ciprofloxac, Samper): the drug is a quinolone derivative able to carry out its therapeutic activity with a suppressive - selective effect on the intestinal flora. It is recommended to take the drug in combination with metronidazole (active Crohn's disease). Take 1 gram a day for 3-6 weeks, as prescribed by your doctor.
Corticosteroids
- Cortisone ( prednisone: eg Deltacortene, Lodotra ), for moderate forms. Take 5 to 60 mg per os (divided into 1 to 4 doses per day), for 4 weeks.
- Budesonide (eg Biben, Pulmaxan): it is recommended to administer 9 mg of active ingredient per day (preferably in the morning) for 8 weeks. The dosage can be reduced to 6 mg per day during the two weeks preceding the end of therapy. It is also recommended to take another 6 mg per day of medication for the three months following the first cycle (maintenance therapy). For children 6 years or older, it is recommended to administer 9 mg per day for a period varying from 7 to 8 weeks; at the end of the first cycle, continue with 6 mg / day for 3-4 weeks.
Aminosilicati
- Sulfasalazine (eg Salazopyrin EN): is a drug combined with 5-aminosalicylic acid (5-ASA) and sulphapyridine. For acute care, an initial dose of 500 mg (orally) 2-4 times a day (taking the drug on a full stomach) is recommended. For the maintenance dose, administer 3-4 g of drug divided into several doses per day. The duration of therapy must be established by the doctor.
- Mesalazine or 5-aminosalicylic acid (eg Asacol, Claversal): useful in the treatment and prevention of relapses of Crohn's disease and ulcerative colitis. It acts as an anti-inflammatory against the intestinal mucosa. Oral administration of a 500 mg tablet three times a day, on an empty stomach is recommended; alternatively, a 500 mg suppository is recommended three times a day (for diseases affecting the rectum). It is preferable to take this drug as an alternative to sulfapyridine, to avoid the side effects of the latter molecule (sulfonamide component).
Suppressors of the immune system : patients who do not respond to the therapies listed above will have to use suppressive drugs of the immune system:
- Azathioprine (eg Azatiopirina, Immunoprin): it is recommended to administer 1.5-4 mg / kg per day for a variable period, which must be established by the doctor (in some patients, only 10 days of treatment are required, in others even 52 weeks).
- Ciclosporin A (eg Sandimmun Neoral): take 4mg / kg per day intravenously continuous. The dose should be reduced gradually; the therapy should generally be continued for 7-14 days. Maintenance therapy is also important (3-6 months). Although effective in fistulising Crohn's disease, this drug is generally prescribed for ulcerative colitis.
- Methotrexate (eg Methotrexate) 25 mg of drug is recommended, to be administered once a week, by intramuscular injection.
Latest generation drugs
Recently, some drugs able to block the action of molecules involved in inflammatory processes have been reported in therapy:
- Infliximab (eg Remicade): it is a monoclonal antibody that must be administered via IV to the dosage of 5mg / kg per day for a week; follow with maintenance therapy (5mg / kg every 8 weeks for active or fistulising Crohn's disease). The dosage can be increased up to 10 mg / kg, according to the doctor's indications.
When the patient suffering from Crohn's disease does not benefit from medical treatment alone, it is necessary to resort to surgery, especially in conjunction with complications such as abscesses, fistulas, perforation and stenosis.
Given their malnutrition status, Crohn's disease patients should follow a high-calorie diet, with added vitamins and mineral salts, albeit light, without milk and derivatives, and poor in slag, fatty meats, foods that are difficult to digest or rich in food coloring.
