In the past 10 years since I was given my IBD diagnosis many new prescription medications have come on the market to treat both Crohn’s and UC. There is new information about possible genes that may be the cause of IBD, and the idea that foods, emotions, and bacteria may exacerbate IBD symptoms are no longer poo-poo’d by the medical community. There is also a debate among gastroenterologist as to whether IBD is actually an auto-immune disorder or rather an immuno-deficiency disorder. Either way, it seems that there is something in an IBDers genetic make-up that causes the immune system in the gut to go hay-wire and disable the body’s inflammation response.

The first line of treatment for both Crohn’s and UC tends to be using prescription medications to get the inflammation under control. Medications used for both Crohn’s disease and Ulcerative Colitis fall into five categories, or classifications:

1. Aminosalicylates or 5-ASA’s – are drugs like sulfasalazine, Asacol®, Pentasa®, Rowasa, Canasa, Colazol™, and Dipentum®. These drugs contain 5-aminosalicylic acid and help to reduce the inflammation in the colon’s lining by interfering with the body’s ability to control inflammation. 5-ASA’s are used to treat mild to moderate cases of UC and Crohn’s and are often used long-term to maintain remission. ng remission. 

2. Antibiotics – the most commonly used ones for IBD include Flagyl® (metronidazole) and Cipro® (ciproflixin) and are theorized to suppress the intestine’s immune system and reducing intestinal bacteria. The best long-term use of antibiotics has been seen in patients with Crohn’s disease who may also suffer from fistulas and/or recurrent abscesses. 
 
3. Steroids such as prednisone, hydrocortisone, methylprednisolone, and budesonide (Entocort) are all used to modulate inflammation and are metabolized in the liver. Steroids were some of the first drugs used to treat IBD, dating back to the 1950s, and continue today to be a first-line drug of choice for treating both Crohn’s and UC. Steroids are used for acute flare-ups and work by suppressing the body’s immune system. While this immune suppression helps to lessen the IBD flare, it also can leave some patients at higher risk of catching infections. Steroids are meant for only short-term use.  

4. Immuno-Modulators are used to weaken the immune system which is believed to decrease the inflammation caused by IBD. The consideration of using immuno-modulators tends to come after patients have failed to respond to the first three classes of IBD drugs – 5-ASA’s, antibiotics, and steroids. The most commonly used immuno-modulators are: azathioprine (Imuran®, Azasan®) and 6-mercaptopurine (6-MP, Purinethol®). However, these drugs act slowly and can take 3 to 6 months for a patient to see them take effect. For this reason, they may be prescribed along with steroids which are faster acting.