Crohn's Disease Treatment

Key points to remember about Crohn's disease treatment

• treatment options depend on how severe your child's Crohn's disease is
• treatment for children with Crohn's disease may include medicines
• talk to your doctor about your child's medicines and make sure you know the names and doses of the medicines, the side effects and why your child is taking them
• with effective treatment, it is possible to manage your child's symptoms and prevent flare-ups

What are the treatment options for my child with Crohn's disease?

The aims of treatment for Crohn's disease are to control inflammation, relieve symptoms, make sure your child is growing well and has the vitamins and minerals they need. Some children may need to see a dietitian as part of their treatment.

Treatment options depend on how severe your child's Crohn's disease is. Your child's paediatrician or other specialist will talk with you and your child about the best treatment.

With effective treatment, it is possible to manage your child's symptoms and prevent flare-ups, though it may take some time to find the best treatment for your child.

Will my child with Crohn's disease need exclusive enteral nutrition?

Exclusive enteral nutrition (EEN) is a treatment for Crohn's disease that involves drinking a formula for a specific period, instead of drinking and eating usual food. EEN uses a specifically balanced formula that will meet all of your child's daily nutritional needs. Using EEN will allow the bowel to heal and return to its healthy normal state, and should help your child regain weight they have lost because of their condition. Often children have EEN when they first receive a Crohn's disease diagnosis. They may also have EEN if they have a relapse.

EEN works as well as medicines but has no side effects.

How long will my child need exclusive enteral nutrition?

Usually, children have EEN for 8 weeks. Some children will continue to drink a small volume of EEN for longer. Your child's dietitian will tell you how much of the formula you will need to give.

How will my child take exclusive enteral nutrition?

EEN comes in several flavours. Your child may have it by mouth (orally) or by a flexible tube through the nose and into the stomach (nasogastric tube). See Tube feeding. Your child should not have any other food or drink when they are taking EEN. They should drink extra water.

Storing EEN

You can safely store EEN at room temperature, but it tastes better when it is cold. You can freeze EEN so the servings are still cold when your child has it at school. Your child can also have EEN half frozen or completely frozen.

When can my child have regular food and drink again?

After 8 weeks, you can start giving normal food and drinks to your child while gradually reducing the EEN. It's a good idea to start with foods that are low in fat, fibre and lactose with the support of a paediatric dietitian.

How can medicines help my child with Crohn's disease?

The aims of treatment with medicines

Treatment for children with Crohn's disease may include medicines to:

• stop or control the inflammation
• stop the disease from getting worse, or keep your child free from symptoms
• prevent the immune system from attacking the body and causing the inflammation - your child may have some of these medicines by injection or infusion in hospital
• control pain
• provide the body with missing vitamins and minerals

Being informed about your child's medicines

It is important to talk to your doctor about your child's medicines. You should know the names and doses of the medicines, the side effects and why your child is taking them.

Alternative medicines

Your friends and family may suggest trying alternative medicines or treatment. Please discuss these with your doctor first, as some therapies can be harmful or may interact with your child's current medicines.

What medicines might my child with Crohn's disease need?

Children with Crohn's disease will often take more than one medicine together. 

Aminosalicylates

These are often a treatment option for children with mild to moderate symptoms. Examples include mesalazine, which your child may take as tablets, capsules or granules.

Steroids

These are for treatment of sudden flare-ups. These are not usually for long-term use. Examples include budesonide, prednisone and methylprednisone which your child may take as tablets, capsules, liquid or receive directly into a vein (IV or intravenous). 

Immunosuppressants

Most children with Crohn's disease will receive azathioprine.

Biologics (TNF inhibitors)

TNF inhibitors are for children with severe Crohn's disease, or for children whose symptoms don't improve when they take other medicines. Children who have a fistula may also need to take TNF inhibitors. Examples include infliximab and adalimumab. Your child will receive TNF inhibitors by injection.

Vitamins and minerals

Crohn's disease can cause problems with absorption of vitamins and minerals so some children will need vitamins and mineral supplements. These are likely to include iron and vitamin D. They might also include vitamin B12, folate, magnesium and calcium.

Can a low FODMAP diet help my child with Crohn's disease?

​A low FODMAP diet (a diet that avoids certain sugars) does not treat Crohn's disease. Studies show that no particular food is useful in treating Crohn's disease. A low FODMAP diet can be useful in treating irritable bowel syndrome (IBS). But, IBS is not the same as Crohn's disease and the treatments are very different. Some children with Crohn's disease may also have IBS. It is important to talk with your child's doctor and dietitian before making any significant changes to your child's diet.

Will my child with Crohn's disease need surgery?

Some children with Crohn's disease may need surgery if medicines don't work well enough. Your child's doctor will talk to you about this, if necessary.