Navigating Crohn’s Disease and Colitis: Medications, Symptoms, and Lifestyle Tips

Written by, Roisin Cahill M.P.S.I.

Living with inflammatory bowel diseases (IBD) like Crohn’s disease and colitis can be tough, but the right combination of medications, lifestyle adjustments, and medical care can make all the difference. Here’s an easy-to-understand guide to managing these conditions, incorporating the latest insights from the HSE, NHS and other reputable sources. However, always remember that your healthcare team knows your situation best, so their recommendations should take priority over any general advice.

Crohn’s Disease

Symptoms Crohn’s disease can affect any part of the gastrointestinal tract, from your mouth to your anus. Common symptoms include:

When to See a Doctor

If you notice severe abdominal pain, prolonged diarrhoea, unexplained weight loss, or blood in your stool, it’s time to visit your doctor. Early diagnosis and treatment can help manage your symptoms and prevent complications.

Medications for Treatment

Aminosalicylates (5-ASAs): Medications like mesalamine are often used to manage mild to moderate inflammation.

Corticosteroids: Drugs like prednisone and budesonide are typically reserved for severe inflammation and are used short-term to bring symptoms under control.

Immunomodulators: Azathioprine and methotrexate help suppress the immune system and are usually for moderate to severe cases.

Biologics: Medications like infliximab, adalimumab, and ustekinumab target specific parts of the immune response and are used in severe cases.

Antibiotics: Metronidazole or ciprofloxacin may be prescribed if infections occur or to address complications like fistulas. These are generally used for moderate to severe cases depending on the situation.

Probiotics and Prebiotics: Though research is ongoing, certain probiotics (like Lactobacillus and Bifidobacterium) and prebiotics may help with gut health. Their use should be discussed with your healthcare provider for a personalised approach.

Lifestyle and Dietary Tips

Diet: Focus on a balanced diet with plenty of fruits, vegetables, and lean proteins. Avoid foods that seem to trigger your symptoms, such as dairy, spicy foods, or high-fibre items. Further information on diet can be found here

Soluble Fibre: Foods like oats, apples, and carrots contain soluble fibre, which can help with symptom management by aiding stool formation.

Hydration: Drink plenty of water, especially during flare-ups, to stay hydrated.

Stress Management: Techniques like yoga or meditation can help manage stress, which can sometimes worsen symptoms.

Quit Smoking: Smoking can make Crohn’s disease worse, so quitting is highly recommended.

Flare and Maintenance Treatment

Flare Treatment: During a flare, medications like corticosteroids or biologics might be intensified to quickly control symptoms.

Maintenance Treatment: Long-term use of immunomodulators or biologics can help maintain remission and prevent future flares.

Colitis (Ulcerative Colitis)

Symptoms Ulcerative colitis mainly affects the colon and rectum, with symptoms such as:

When to See a Doctor

If you experience persistent diarrhoea, blood in your stool, severe abdominal pain, or unexplained weight loss, it’s crucial to see your doctor promptly. Early treatment is key to managing symptoms effectively.

Medications for Treatment

Aminosalicylates (5-ASAs): Sulfasalazine and mesalamine are commonly used as first-line treatments to reduce inflammation in mild to moderate cases.

Corticosteroids: These are used for short-term management during moderate to severe flares.

Immunomodulators: Azathioprine and 6-mercaptopurine help maintain remission by suppressing the immune system, typically used for moderate to severe cases.

Biologics: Infliximab, vedolizumab, and golimumab are options for moderate to severe cases that don’t respond to other treatments.

Janus kinase inhibitors (JAK inhibitors): Tofacitinib is an option for moderate to severe cases, particularly when other treatments aren’t effective.

Probiotics and Prebiotics: Probiotics like VSL#3 may help maintain remission in ulcerative colitis. Prebiotics, which nourish beneficial gut bacteria, should be used cautiously and under medical guidance.

Lifestyle and Dietary Tips

Diet: During flares, focus on low-residue foods to reduce bowel movements. Probiotics can support gut health. Further Diet information can be found here 

Soluble Fibre: Foods rich in soluble fibre can improve stool consistency and help manage diarrhoea.

Hydration: Keep hydrated, especially if you’re experiencing diarrhoea.

Exercise: Regular, moderate exercise can boost overall health and reduce stress.

Stress Reduction: Consider stress management techniques like mindfulness or therapy.

Flare and Maintenance Treatment

Flare Treatment: Corticosteroids or biologics are often employed to quickly control symptoms during a flare.

Maintenance Treatment: Aminosalicylates, immunomodulators, or biologics can be used long-term to maintain remission and prevent future flares.

Effectively managing Crohn’s disease and colitis involves a well-rounded approach that includes medication, lifestyle changes, and regular medical care. By staying informed and working closely with your healthcare providers, you can live a healthy, fulfilling life despite these conditions. Always consult your doctor before making any changes to your treatment plan or lifestyle.

Feel free to share this guide with anyone who might benefit, but remember: your healthcare team’s advice is always the most important. Stay healthy!