Symptom Management
Reviewed by: HU Medical Review Board | Last reviewed: August 2025 | Last updated: September 2025
In people with inflammatory bowel disease (IBD) like Crohn’s disease (CD) and ulcerative colitis (UC), inflammation in the digestive tract can cause many different types of symptoms and complications.1
The most important part of any patient’s IBD treatment plan is medications that are used to directly treat the underlying disease and its symptoms. These medicines include:2
As a secondary part of the treatment strategy, some patients may also use other types of medicines or supplements for additional symptom relief. Some of the most common types of medicines or supplements for symptom management include:2
- Anti-diarrheals
- Pain relievers
- Iron supplements
- Vitamin B12 supplements
- Calcium and vitamin D supplements
However, it is very important to note that these forms of symptom management should not be used instead of the patient’s primary IBD medicines since they are 2 completely different categories of treatments. Some people with IBD may get quick, short-term symptom relief from over-the-counter (OTC) medicines such as anti-diarrheals. But such drugs are not doing anything to treat the underlying cause of the symptoms, which is inflammation due to IBD. This is why it is so important for people to continue taking their IBD medicines regularly to help treat the cause of symptoms over the long term.2
What are anti-diarrheals?
Diarrhea is one of the most frequent symptoms experienced by people with IBD. Depending upon the type of diarrhea (acute or chronic) and its underlying cause, healthcare providers may advise people to take anti-diarrheal drugs to help treat this symptom.1,2
The most common type of OTC anti-diarrheal drug is called loperamide (Imodium). It works by slowing down the digestive process to decrease the frequency of bowel movements. It is important to treat diarrhea to improve a person’s quality of life and to make sure that their body is absorbing enough nutrients during the process of digestion.2
What are pain relievers?
Many people with IBD have pain caused by their symptoms or complications. Pain related to IBD can have many different sources. It may or may not be caused by inflammation that the disease causes, and it can arise from within or outside of the digestive tract.1
The first step in trying to manage someone’s pain that is due to active IBD is usually to adjust their IBD medicines. Reducing the symptoms can often help reduce the pain. People who continue to have pain despite the adjustment, or who have pain that is not caused by active IBD, may be advised to try pain relievers such as acetaminophen (Tylenol).2
However, many OTC pain relievers, such as ibuprofen and aspirin (also known as non-steroidal anti-inflammatory drugs, or NSAIDS), are generally not recommended for people with IBD because they can potentially cause bleeding and inflammation in the digestive tract, which can be very harmful for people with CD or UC who already have damage in those areas due to inflammation caused by the disease.2
What are iron supplements?
Anemia is a condition in which a person does not have enough iron for the bloodstream to carry oxygen throughout the body. It is a common complication for many people with IBD, caused by inflammation in their digestive tracts. To treat anemia, healthcare providers will often recommend an iron supplement to help boost the levels of iron in the body.3
What are vitamin B12 supplements?
Vitamins are nutrients that are absorbed into the body through the small intestine. In people with CD, inflammation in the small intestine can reduce its ability to absorb these nutrients from food during the process of digestion.4
If blood tests indicate that a patient with CD is not receiving enough B12 from food, then a person may be advised by healthcare providers to start taking a vitamin B12 supplement. Having a deficiency of vitamin B12 is a common complication of CD.4
What are calcium and vitamin D supplements?
Calcium and vitamin D are 2 other important nutrients in which people with CD are often deficient in. Inflammation in the small intestine can affect the body’s ability to absorb vitamin D, and vitamin D is necessary for absorbing calcium. Taking corticosteroids to relieve CD symptoms or flares can also affect the body’s ability to absorb calcium.5
If healthcare providers detect that a person with CD has a calcium and/or vitamin D deficiency, they may recommend increasing the intake of both nutrients through food and/or supplements. It is important to treat calcium and vitamin D deficiencies because they can lead to serious conditions related to bone strength.5