Inflammatory Bowel Disease Treatment

Medical Management of IBD

Crohn’s disease (CD) and ulcerative colitis (UC), collectively known as inflammatory bowel disease (IBD), often begin in adolescence or early adulthood and have a chronic, episodic course, requiring long-term care.

The goal of treatment for inflammatory bowel diseases is to archieve remission so that symptoms disappear and to maintain remission so flare ups don’t occur, improving quality of life. Remission leads to healing of the lining of the gastrointestinal tract.

The Risks of Not Treating IBD

Active disease symptoms of IBD are challenging to live with. One risk of not treating IBD is a higher frequency of flare ups (of inflammation and symptoms) and progression of the inflammation to irreversible bowel damage. Left untreated, complications of IBD can include:

• Arthritis
• Skin conditions
• Inflammation of the eyes
• Liver disorders
• Kidney disorders
• Bone loss
• Increased risk of intestinal cancer
• Intestinal strictures causing bowel obstruction
• Intestinal perforation causing fistulas and abscesses

Go to the Experts

While there’s no permanent cure for IBD, you can expect the IBD Center to carefully evaluate and determine the best course of treatment for your IBD. Treatment options, including medications and surgery, will depend on the symptoms, prognosis and severity of the disease.

Treating IBD with Medications

Several types of drugs are available to treat IBD. First and foremost, treatment must reduce to get the inflammation so symptoms are relieved and nutrients can be absorbed by the intestines. Secondly, treatment is aimed to maintain remission and control the chronic inflammation so that the disease is manageable and complications are prevented.

Medications include:

• Aminosalicylates, or 5-ASA drugs, are anti-inflammatory medicines that can be taken orally or via suppositories or enemas to suppress inflammation in the intestine and relieve painful symptoms.
  • UC San Diego researchers helped lead clinical trials that resulted in the approval of Asacol HD and Lialda for ulcerative colitis.
    • Once-Daily, High-Concentration MMX Mesalamine in Active Ulcerative Colitis
    • Effect of Once- or Twice-Daily MMX Mesalamine (SPD476) for UC
    • Delayed-Release Oral Mesalamine 4.8 g/day (800-mg tablet) is Effective for Patients With Moderately Active Ulcerative Colitis
    • Once-daily MMX Mesalamine for Endoscopic Maintenace of Remission of Ulcerative Colitis
• Corticosteroids, such as prednisone, methylprednisone and hydrocortisone are powerful, fast-acting anti-inflammatory drugs. They are used by people who have moderate to severe IBD who do not respond to 5-ASA drugs. Since these drugs trigger side effects, they’re not feasible for long-term maintenance of IBD.
• Antibiotics can be used to reduce and supress intestinal bacteria and suppress the intestinal bacteria, even though there’s no specific infectious agent associated with IBD.
• Immunomodulators help to weaken the activity of the immune system, which reduces inflammation. Since they act very slowly, they are often paired with corticosteroids, which act quickly.
• Biologic therapies, a class of medications that includes Remicade, Humira and Cimzia, treat inflammation effectively for many people. These drugs are developed to target specific proteins that cause inflammation and suppress immune response.
  • UC San Diego researchers helped lead clinical trials that resulted in the approval of Remicade and Humira for ulcerative colitis.
    • Infliximab for Induction and Maintenance Therapy for Ulcerative Colitis
    • Adalimumab Induces and Maintains Clinical remission in Patients with Moderate-to-Severe Ulcerative Colitis
    • Adalimumab for Induction of Clinical Remission in Moderately to Severely Active Ulcerative Colitis: Results of a Randomised Controlled Trial
  • UC San Diego researchers helped lead clinical trials resulting in the approval of Humira, Cimzia and Tysabri for Crohn's disease.
    • Adalimumab Induction Therapy for Crohn's Disease Previously Treated with Infliximab
    • Human Anti–Tumor Necrosis Factor Monoclonal Antibody (Adalimumab) in Crohn’s Disease: the CLASSIC-I Trial.
    • Adalimumab for Maintenance of Clinical Response and Remission in Patients With Crohn’s Disease: The CHARM Trial
    • Certolizumab Pegol for the Treatment of Crohn's Disease
    • Maintenance Therapy with Certolizumab Pegol for Crohn's Disease
    • Natalizumab Induction and Maintenance Therapy for Crohn's Disease
    • Natalizumab for the Treatment of Active Crohn's Disease: Results of the Encore Trial
•  Read more about IBD Clinical Trials.

Investigational Medications for IBD

UC San Diego Health System is evaluating a variety of investigational medications for inflammatory bowel disease. Investigational medications for inflammatory bowel diseases are medications that the FDA has not yet approved for the treatment of ulcerative colitis or Crohn’s disease. Investigational medications may already be approved by the FDA for treatment of another disease, but are under investigational use for ulcerative colitis or Crohn’s disease. Alternatively, investigational medications may have not been approved yet for any disease, but are being studied as potential treatments for ulcerative colitis or Crohn’s disease.

Investigational medications are studied in clinical trials and the information collected in the clinical trials is then evaluated by the FDA to determine whether the medication should be approved for the treatment of ulcerative colitis or Crohn’s disease. 

UC San Diego is a leader in studying new treatments for ulcerative colitis and Crohn’s disease.

Learn more about IBD Clinical Trials.

 Surgery for Crohn's Disease and Ulcerative Colitis

UC San Diego Health System is a high-volume center for complex surgeries for Crohn's disease and ulcerative colitis. We incorporate the use of single-incision techniques, robot-assisted and transanal approaches when appropriate to provide the best possible outcomes in the treatment of Crohn's disease, ulcerative colitis and their complications. Read more about UC San Diego Health System's expertise in surgery for IBD.