Crohn's and Colitis Ulcerosa

Crohn's Disease: What is it?

Crohn's disease is a chronic inflammation of the digestive tract. This inflammation can occur anywhere: from your mouth to your anus. Usually the small intestine, colon and/or rectum are inflamed. The inflammation can penetrate deep into the intestinal wall, causing pain, diarrhea and fatigue. With a flare-up of the disease, symptoms may suddenly worsen.

Crohn's can develop at any age, but most people are diagnosed between the ages of 15 and 30. The cause of the disease is not entirely known, but heredity, your immune system and lifestyle factors such as smoking and unhealthy diet likely play a role.

Colitis Ulcerosa: What is it?

Colitis ulcerosa is another chronic inflammatory bowel disease, but unlike Crohn's, it is limited to the colon and rectum. The inflammation is only in the mucosal layer of the intestinal wall, which causes superficial ulcers. Symptoms are very similar to those of Crohn's: diarrhea, abdominal pain and fatigue are common.

Colitis ulcerosa is usually detected between the ages of 15 and 30, but can also begin later in life. As with Crohn's, the cause is not yet completely clear. Heredity and an overactive immune system also play a role.

What can we do for you?

Although there is no cure for these diseases, with the right medications, you can reduce inflammation and prevent flare-ups. There are several types of medications you can take, including:

• Immunosuppressants: These medications, such as mesalazine, reduce inflammation in your gut and are often used first.
• Immunosuppressants: These medications suppress your immune system so it doesn't attack your own body. Examples include azathioprine and methotrexate.
• Biologicals: These are newer medications that specifically block part of your immune system. They're often given when anti-inflammatories and immunosuppressants don't work enough.
• Corticosteroids: These powerful anti-inflammatory drugs are used for severe flare-ups, but are not suitable for long-term use because of their side effects.

We'll advise you on the proper use of these medications and how best to combine them with your daily routine. It is important to take your medication exactly as prescribed, even if you feel well, to avoid flare-ups.

What can you do yourself?

In addition to medications, a healthy lifestyle is also important in the treatment of Crohn's and Ulcerative Colitis. For example, quitting smoking is essential, especially with Crohn's, because smoking can make the disease worse. Your diet also plays a role. Although there is no specific diet that can cure the disease, many people find that certain foods make their symptoms worse. Try to figure out which foods work for you and which are better to avoid.

In addition, take good care of yourself by getting plenty of rest and limiting stress. Stress can cause or aggravate flare-ups, so it is important to find relaxation in your daily life.

Medications in Crohn's disease

• Adrenal bark hormones

Adrenal bark hormones, or corticosteroids, inhibit inflammation. As a result, abdominal pain decreases and fewer thickenings or fistulas will develop.

• Adrenal bark hormones in enema:

An enema only qualifies if the condition is limited to the last part of the colon. It then enters only the last part of the colon and hardly any of the rest of the body. This makes you less likely to have side effects. Examples are beclomethasone enema, betamethasone enema and budesonide enema.

• Adrenal cortical hormones to take:

Adrenal cortical hormones to take work throughout your entire body, including the entire colon. This does make you more likely to have side effects than with adrenal bark hormones in an enema. Usually, adrenal cortical hormones to take are only prescribed as a course of treatment if the condition worsens temporarily. Examples include dexamethasone, prednisolone, and prednisone.

• Adrenal cortical hormones by injection:

Your doctor can also inject the adrenal cortical hormone. It then works throughout your body. Example of adrenal cortex hormones as an injection is triamcinolone acetonide.

Adrenal suppressant drugs

These drugs suppress inflammation. They are prescribed only when the other medications in Crohn's disease are not having sufficient effect. It often takes several weeks to months for these medications to start working. Examples include adalimumab, azathioprine, etanercept, infliximab, methotrexate, mercaptopurine, risankizumab, upadacitinib, ustekinumab and vedolizumab.

Medications for Ulcerative Colitis

5-ASA medications

The 5-ASA medications have an anti-inflammatory effect on the intestinal wall. They are used to treat seizures and prevent new ones. It depends on the exact location of the inflammation in the intestines which brand and form of administration the doctor prescribes. This is because each product releases the active ingredient in a different part of the intestines.

For ulcerative proctitis, the doctor usually prescribes suppositories or an enema. In ulcerative colitis, if the inflammation is at the end of the colon, an enema is necessary, as a suppository pill will not reach far enough into the intestine. Inflammation in even higher parts of the intestine requires tablets or granules. These have a special coating that only dissolves in a specific part of the intestine. Examples are mesalazine, olsalazine and sulfasalazine.

Adrenal bark hormones in enema

Adrenal bark hormones, or corticosteroids, inhibit inflammation. This will reduce abdominal pain, diarrhea, blood in the stool and fever. An enema only qualifies if the condition is limited to the last part of the colon. It then enters only the last part of the colon and barely enters the rest of the body. This makes you less likely to have side effects. Examples are beclomethasone enema, betamethasone enema and budesonide enema.

Adrenal bark hormones

Adrenal bark hormones, or corticosteroids, to take inhibit inflammation. This will reduce abdominal pain, diarrhea, blood in the stool and fever. Adrenal bark hormones you need to take work throughout the body, including the entire intestine. This does make you more likely to have side effects than with adrenal bark hormones in an enema. Usually, adrenal cortical hormones to take are only prescribed as a course of treatment if the condition temporarily worsens. Examples include budesonide, dexamethasone, prednisolone and prednisone. Triamcinolone acetonide is given by injection.

Adjuvant drugs

These drugs suppress inflammation. They are prescribed only when other drugs for ulcerative colitis have insufficient effect. It often takes several weeks to months for these drugs to take effect. Examples include azathioprine, ciclosporin, filgotinib, infliximab, ozanimod, tofacitinib, upadacitinib, ustekinumab and vedolizumab.