This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.
Medication for inflammation
Key points
- Inflammation is the body’s normal response to an infection. However, in Crohn’s and colitis, inflammation is present in the gastrointestinal tract without an underlying infection.
- Medication can be an effective way to reduce inflammation and improve IBD symptoms.
Why do we need medication to treat inflammation in IBD?
Normally inflammation is the body’s response to an infection. The infected tissues (e.g. skin or lungs or bladder or bowel and so on) send “danger” signals for white blood cells to come to fight the bacterial or viral infection. In the process of evolution, white blood (and other) cells have developed many different ways of eliminating bacteria or viruses (inflammatory pathways). These cause the tissue to become red, hot, swollen, tender and to stop working properly. When the infection is overcome, the inflammatory pathways are switched off and everything settles back to normal.
Every organ system in the body can develop inflammation without any obvious underlying infection. For example, conditions such as rheumatoid arthritis, psoriasis, and nephritis are due to inflammation in the joints, skin and kidneys without any identifiable infective cause. Similarly, Crohn’s disease and ulcerative colitis are due to inflammation anywhere along the gastrointestinal tract or the colon respectively.
These conditions are called “idiopathic” because we don’t know the cause, but we do know a lot about how inflammation works and how to stop it when it gets out of hand.
The drugs that were first used to suppress inflammation were the corticosteroids, or steroids, like prednisone, cortisone and so on. These drugs suppressed many different aspects of inflammation. They were life-saving when first introduced for conditions such as severe ulcerative colitis and are generally used today to bring inflammation under control, that is, to induce remission. However, their long-term use is associated with potentially serious complications, so we don’t use them as maintenance therapy. Other drugs such as the 5-ASA molecules (such as sulfasalazine and mesalazine) are effective in mild forms of disease and are generally safe for long-term use. A third class of drugs called the immunosuppressives (such as azathioprine, 6-mercaptopurine and methotrexate) have very many effects on the white blood cells that cause inflammation but also affect many cells in the body more broadly. These drugs can be used to both induce and maintain remission.
All the drugs described above have widespread effects on inflammation and may have significant side-effects. In contrast, biologics are designed to target a specific inflammatory pathway with precision. Your IBD team will recommend a medication that is best suited for you.