Inflammatory bowel disease (IBD) is a chronic condition that requires long-term treatment. There are a number of different medications that help treat the symptoms of IBD and keep the disease in remission. These include:

• Aminosalicylates. Reduce inflammation in the intestinal wall. The active component of these drugs is a compound called 5-aminosalicylic acid (5-ASA) – the most common treatment choice for IBD. According to the American College of Gastroenterology (ACG), 5-ASA has been used to treat IBD for over 50 years. Aminosalicylates can be taken orally or rectally (in enema or suppository form). Side effects may include nausea, indigestion and/or headaches.
  
  
• Corticosteroids. Used to control the inflammation of IBD when 5-ASA drugs do not work. This medication can be taken orally, rectally (e.g., as a suppository, enema) or intravenously (injected into a vein). Long-term use of corticosteroids can increase a patient’s risk of serious side effects, including high blood pressure, osteoporosis (a disorder in which the bones lose mass and density) and diabetes. Fluid retention and a rounded/swollen appearance of the face may also occur. However, side effects vary depending on the type of corticosteroid used.
  
  
• Immunosuppressants. Suppresses the body’s ability to create the disease-fighting substances (antibodies) that attack the normal intestinal lining in IBD patients, causing inflammation. This decreases immune system activity in patients with IBD. Taken orally, these drugs may not take effect for weeks or months. Possible side effects include allergic reactions, pancreatitis, abnormal liver tests and an increased risk of infections. Newer medications are available in intravenous form.

Other medications can be used to help alleviate the symptoms of IBD, such as antidiarrheals, laxatives (in cases where intestinal obstruction or stricture leads to constipation), acetaminophen pain relievers, iron supplements and vitamin B12 injections (to help prevent anemia). Antibiotics  may also be recommended to help kill harmful microorganisms in the intestines. Nonsteroidal anti-inflammatory drugs (e.g., aspirin, ibuprofen) should not be used as they may intensify the symptoms of IBD.

Hospitalization may be necessary to treat patients with IBD when they are malnourished, or have experienced severe diarrhea and blood loss. A special diet may be required, along with intravenous feeding. Treatment will focus on avoiding further aggravation of the digestive tract.

Surgery may be required in cases of long-lasting illness, cancerous changes in the colon, intestinal obstruction or perforation, or when drug therapy is not working.

Up to 70 percent of IBD patients with Crohn's disease (CD) require surgery at some point in their lives, according to the (ACG). Many patients with CD experience inflammation that goes deep into the intestinal tissue – increasing their risk of fistulae, abscesses and intestinal strictures that can require surgery. However, surgery is not a cure for patients with CD. According to the ACG, the disease returns in 70 to 85 percent of patients with CD, even after surgery.

IBD patients with ulcerative colitis (UC), on the other hand, can cure the condition with surgery that removes the entire colon. When the large intestine is removed, the lower part of the small intestine (ileum) is connected directly to the anal region. In what is known as a pouch procedure, an internal pouch is created out of the ileum, eliminating the need for a permanent ostomy pouch (bag worn outside the body into which stool can drain).  

For patients with CD, cigarette smoking can increase the number and severity of symptom flare-ups. Choosing not to smoke can decrease the severity of symptoms in patients with CD.

Proper nutrition is an important aspect of preventing or reducing the severity of IBD symptoms. A healthy diet for patients with IBD includes soft, bland foods that are low in fiber, as well as adequate amounts of proteins, calories and vitamins. Avoiding high-fiber foods (e.g., bran, beans, fresh fruits and vegetables), dairy products, caffeine and alcohol can help alleviate symptoms of IBD.

Chronic diarrhea may include a loss of control (fecal incontinence), which can be embarrassing and limit outdoor activities. Patients with IBD can be prepared for the sudden onset of symptoms by knowing the location of available restrooms when traveling, and by keeping extra toilet paper and clothing handy.  

Managing stress levels may also help. Although there is little evidence to support stress as a cause of IBD, emotional stress may aggravate IBD symptoms.

Patients with IBD may experience isolation, anxiety and embarrassment as a result of their recurring symptoms. Because of this, attending IBD support groups can provide emotional support from others also living with the disease. If patients become depressed as a result of their IBD, they may want to seek the help of a mental health professional.