Crohn's disease

Treatment plan for Crohn's disease

What are the treatment options for Crohn's disease?

Crohn's disease can affect you in many different ways, and every person is different. Someone with mild Crohn's disease may get better with little care or without medication, whereas someone else with severe disease may need to have surgery right away to get their symptoms under control. That is why your treatment plan is developed just for you, based on your situation and how your Crohn's disease is affecting you.

Your treatment plan will be based on the following four elements:

• The severity of your Crohn's disease
• Your past health and treatment history
• How your Crohn's disease is expected to progress (called 'prognosis')
• Your personal needs, wishes and expectations

How can treatment help?

Management of Crohn's disease aims to:

• Treat acute attacks (flares) promptly and effectively
• Maintain remission via the appropriate use of drug therapy
• Take into account people who will benefit from surgery
• Ensure appropriate nutritional care and support is provided
• Consider needs of those being treated at home or leaving hospital
• Weigh the benefits and risks for any approach

When you have a flare, the goal of treatment is to relieve symptoms as promptly and effectively as possible - doctors refer to this as 'induction of remission'. Once your symptoms are under control, the next goal is to keep your symptoms under control. That is called 'maintenance'.

Guidelines on severity of Crohn's disease

Your doctor will talk to you about your illness and whether it is considered mild, moderate or severe. The following guidelines are often used:

Mild

• <4 runny stools per day
• Little or no bleeding
• No signs of systemic effects (eg, fever, raised pulse or blood counts)

Moderate

• 4-6 runny stools per day
• Moderate bleeding
• Some signs of systemic effects (eg, fever, raised pulse or blood counts)
• Mild disease that does not respond to treatment

Severe

• >6 runny stools per day (often at night)
• Severe bleeding
• Signs of systemic effects (eg, fever, raised pulse or blood counts)
• Signs of malnutrition
• Weight loss in excess of 10% of your weight when well

Some people with mild Crohn's disease may have a few flares that require treatment in their lifetime, whereas others with more severe illness may find they need care continuously that may include surgery or long term treatment to keep symptoms under control. Based on your situation, you and your doctor will decide which treatment and care will be right for you.