What You Need To Know First
The bad news: There's no cure for ulcerative colit (aka UC) and Crohn's disease, and no magic pill that will make your illness go away.
The good news: Medication can control the inflammation in your intestinal tract and bring your symptoms under control -- and keep them there. Eventually, they might even disappear...at least for a while. We call that remission and we like it A LOT, especially because it can last for months or even years.
There's more than one type of medication for UC and Crohn's, and not all medication comes in a pill form. You may be taking medication through an enema or suppository, which you insert right into your bottom (usually at bedtime). The type of meds you need totally depends on how severe your disease is, which part of your intestines are affected, and if you have any complications. Different medications reach different parts of your intestinal tract. That's why all those procedures are so important; they help your doctor identify where your inflammation is and which medication will target it best.
It could take a while for your meds to make a difference. It may also take a while for your doctor to figure out exactly which drug or combination of drugs works best for you or which dosage is just right, so hang in there if something doesn't do the trick right away.
A Roll Call of Drug Types and Names
Here's a roll call of drugs you might get to know really, really well:
- 5-ASA. They're also known as aminosalicylates. These are actually related to aspirin and are the most frequently used medications with UC and Crohn's. Generic names include mesalamine (brand names include Asacol®, Canasa®, Pentasa® and Rowasa®); balsalazideolsalazine (brand name Dipentum®); and sulfasalazine (brand name Azulfidine®). These drugs work to reduce the inflammation in your intestines and may be used for maintenance -- in other words, the long-term control of your symptoms. (brand name Colazal®);
- Steroids. These may be called corticosteroids or systemic steroids. Generic names include prednisone and methylprednisone. These act fast and pack a real punch to inflammation, which is why they're often the go-to drugs if you're having a flare-up. These drugs work throughout your body to try and stop your immune system from causing your active disease. The downside: they can weaken your immune system and have some gnarly side effects (see below). Your doctor will aim to get you off steroids as quickly as possible as your inflammation gets under control. Don't confuse these with anabolic steroids, which are used (and abused) by athletes and bodybuilders. Budesonide (brand name Entocort® EC) belongs to a new class of steroids called nonsystemic steroids. Your body metabolizes this type of drug really fast, so you may have a lot fewer unpleasant side effects than with corticosteroids. This is used for Crohn's disease.
- Antibiotics. With big names like metronidazole (brand name Flagyl®) and ciprofloxacin (brand name Cipro®), these drugs work to help maintain a balance between all the intestinal bacteria, both good and bad. These are usually used with Crohn's disease.
- Immunomodulators. (That's pronounced im-you-no-mod-you-late-oars). Generic names include 6-mercaptopurine (6 MP)azathioprine (brand name Imuran ®) as well as methotrexate. These keep your immune system in check and work to keep your symptoms under control long-term. (brand name Purinethol®) and
- Immunosuppressants. These are like immunomodulators, only stronger. Generic names include cyclosporine (brand names Sandimmune® or Neoral®) and tacrolimus or FK506 (brand name Prograf®). These also affect the immune system. They're used for severe cases of UC that haven't responded to corticosteroids and occasionally for Crohn's disease, too.
- Infliximab. (The brand name for this drug is Remicade ®.) This one, an antibody that reduces inflammation, is in a class known as Biologics. It's actually given intravenously (through a vein) on a schedule set by your doctor, and works best for people whose IBD has not improved with other medications.
- Biologics. These are the new kids on the block and are antibodies (a kind of protein) that reduce inflammation. They are given as a shot, either into a vein or just below the skin on a schedule that is determined by your doctor (sometimes only once every 2 months). They work best for those people whose IBD has not improved on other meds. The best known is Infliximab (aka Remicade) but others such as Adalumimab (aka Humira) or Certolizumab pegol (aka Cimzia) may be available by the time you read this.