So it’s been a few months and I am still having my issues with the Crohns. I keep getting asked why I am not taking certain medications or going ahead and having surgery. The best answer I can come up with is think of it like cancer. You don’t cure it you put it in remission. And like cancer you don’t go with the strongest treatment first.
Here is an article I found from the FDA.
Treating the Symptoms
Since there is no cure for Crohn’s disease, the goals of treatment are to control inflammation, relieve symptoms, and correct nutritional deficiencies. Treatment depends on which part and how much of the intestine is affected.
Most people with Crohn’s disease are first treated with drugs containing 5-aminosalicylates (5-ASA), which help control inflammation. Sulfasalazine (azulfidine) was traditionally the drug of choice until later evidence showed that newer ASA-containing medications were more effective at higher doses and presented fewer side effects.
Corticosteroids such as prednisone* can control inflammation as well. These drugs are the most effective for active Crohn’s disease, rather than for remission maintenance, but they can cause serious side effects, including greater susceptibility to infection, weight gain, increased blood sugar levels, thinning of the bones, elevated blood pressure, and personality disorder. Both corticosteroids and 5-ASAs are not approved specifically for Crohn’s disease. Use of approved drugs for unapproved indications is commonly referred to as “off-label.”
Drugs that suppress the immune system are reserved for patients who do not respond to less toxic forms of therapy because “they carry an increased chance of infection,” says Kaminstein. The most commonly prescribed, Purinethol (mercaptopurine) and Imuran (azathioprine)*, also not specifically FDA-approved for this indication, work by blocking the immune reaction that contributes to inflammation, and are particularly effective for maintaining long periods of remission.
Antibiotics such as Flagyl (metronidazole), which are effective against many types of bacteria, are often prescribed “off-label” to help relieve symptoms of Crohn’s disease, especially when it affects the large intestine or causes abscesses and fistulas around the anus. Other “off-label” medication use includes antidiarrheal drugs such as Lomotil (diphenoxylate) and Imodium (loperamide), which may relieve cramps and diarrhea.
Many Crohn’s disease patients require surgery to relieve chronic symptoms that do not respond to drug treatment or, like Gray, to correct complications such as an abscess that has begun to perforate. The bowel is cut above and below the diseased area and reconnected. But since Crohn’s disease often recurs after surgery, it is very important, according to Kaminstein, for the individual and doctor to consider carefully the benefits, risks and costs of surgery compared with other treatments. He says surgery should be used only after attempts at other forms of therapy have failed.
I am just ready to feel better. This flareup has taken alot out of me.