Treating and Managing IBD

Inflammatory bowel disease (IBD) is a chronic condition in which long-term inflammation can cause symptoms and complications affecting the digestive tract. The two major forms of IBD are Crohn's disease and ulcerative colitis. IBD is a complicated autoimmune condition that affects every person in a unique way.

This means that finding the best way to treat it can also be a complex process that involves trying a range of different strategies in order to find the most effective one. IBD is also a disease that changes over time, so a treatment strategy that works for a person at one stage may not work as well (or at all) at a different time.

What kind of treatments are there for IBD?

• Several healthcare providers
• Medications
• Surgery
• Symptom management
• Complementary/alternative medicine

Which healthcare providers treat inflammatory bowel disease?

Many different types of healthcare providers may be involved in creating, maintaining, and adjusting a patient’s IBD treatment plan.¹ Some of those may include:

• Primary care providers, who focus on providing preventative, non-emergency healthcare to patients on an ongoing basis
• Gastroenterologists, who have extensive training in diagnosing and treating conditions related to the digestive tract
• Rheumatologists, who specialize in the diagnosis and treatment of diseases that affect the body’s connective tissue
• Colorectal surgeons, who specialize in surgically treating conditions that affect the lower part of the digestive tract, including the large intestine (colon), rectum, and anus

What medications are used to treat inflammatory bowel disease?

A primary part of any person's IBD treatment plan is medications that are used to directly treat the disease as well as the inflammation that it causes.² Patients may need to try different types of medicines or combinations of medicines to find the regimen that works most effectively to treat their disease and manage their symptoms. The goals of treatment with IBD medications are:

• To treat and manage the symptoms of active IBD during flare-ups
• To help keep IBD in remission
• To increase the time between flare-ups

Five categories of medications are most commonly used to treat IBD. These are:

• Aminosalicylates are anti-inflammatory medicines generally used for longer-term treatment of people with mild-to-moderate IBD
• Corticosteroids are very strong anti-inflammatory medicines generally used for shorter-term treatment of moderate-to-severe active disease
• Antibiotics can be used as short-term therapy to treat complications of IBD, such as abscesses or wound infections, or as longer-term therapy for people with mild or moderate IBD
• Immunomodulators are drugs that work by changing a person’s immune system response in order to reduce inflammation and improve symptoms, mainly for patients with moderate-to-severe IBD
• Biologic therapies contain antibodies that target the disease at its source; they are generally used by people for whom treatment with other types of medications has not been effective
• JAK inhibitors are drugs that are broken down in the GI tract and then carried through the bloodstream to block inflammation reactions and pathways

What types of surgery are there for IBD?

Research shows that around three-quarters of people with IBD will eventually need to have one or more surgeries to treat the disease.³ The most common types of surgeries include:

• Bowel resection
• Strictureplasty
• Colectomy
• Proctocolectomy with ostomy
• Surgery for fistulas
• Procedures to drain abscesses

How are IBD symptoms managed?

Some people with IBD may use other types of over-the-counter medicines or supplements to help with symptom relief, such as:

• Anti-diarrheals
• Pain relievers
• Iron supplements
• Vitamin B12
• Calcium and vitamin D supplements

However, these forms of symptom management should never be used instead of the patient’s primary IBD medications. Medication is needed to treat the underlying cause of symptoms, which is inflammation due to IBD.

What complementary or alternative therapies exist for IBD?

Complementary and alternative therapies are healthcare practices and products that are not presently considered part of conventional medicine in the Western world. Generally, they are not yet supported by scientific research. However, some people with IBD may choose to supplement their medication with these types of therapies under the supervision of their healthcare providers.

Because these therapies have not been proven to treat the underlying inflammation of IBD, it is generally not recommended that these practices are used instead of medications, but rather in addition to traditional medications. Common forms of complementary or alternative therapies include:

• Herbal supplements
• Probiotics and prebiotics
• Fish oil
• Acupuncture
• CBD oil/medical marijuana