7 Reasons Why Your Crohn's Treatment Isn't Working

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Crohn’s disease is a chronic inflammatory condition affecting your gastrointestinal tract—with an emphasis on chronic. Crohn’s can be a hard condition to treat, and even if you do find something that works, it might not last as long as you’d like. Watch out for these signs that your treatment is not doing the trick. A trip to the doctor might be the right next step.

1. Your symptoms never fully went away the first time.

If you’re still experiencing some of the following common signs and symptoms of Crohn's disease, your treatment may need a tweak, or you may need a new approach altogether. Talk to your gastroenterologist if any of these symptoms are a problem for you:

Other less common symptoms include:

2. Your diet isn’t cutting it.

Things like diet and stress don’t cause Crohn’s, but they can aggravate your symptoms. Good nutrition is especially important in managing your condition. Your doctor may suggest that you try to:

  • Avoid carbonated drinks

  • Avoid high-fiber foods, such as beans, nuts and certain vegetables

  • Drink more liquids

  • Eat smaller meals more often

  • Keep a food diary to help identify problems

If you’ve tried changing your diet, and your symptoms haven’t improved, it may be time to re-visit your treatment plan with your doctor. He or she may also recommend nutritional supplements and vitamins if you’re not getting enough nutrients through your diet.

3. You’re still smoking.

It’s possible that, if you haven’t quit smoking, your Crohn’s disease is still active and you’re still experiencing symptoms. If you’ve had surgery for Crohn’s and continue to smoke, the illness will recur sooner and possibly more severely. Although there are conflicting studies on the effect of smoking in Crohn’s, seriously consider cutting the habit for your overall health.

4. You need a combination approach.

Sometimes a combination of medicines works better than just one drug alone. Corticosteroids (steroid medication) are often used short-term to reduce inflammation and help with Crohn’s symptoms and remission. Your doctor may also prescribe an accompanying immunosuppressant (immune system suppressor) to help you maintain remission.

If you have severe Crohn’s disease, your doctor may also prescribe biological therapies, a type of powerful immunosuppressant (created using naturally-occurring substances).

With these medications, there could be some side effects, such as fatigue, nausea and weight gain, as well as allergic reactions or increased risk of infections. Be sure to talk to your doctor about all the risks involved in any treatment.

5. You’ve been using the same medication for too long.

There is a chance your medication has lost its effectiveness if you’ve been taking it for a while. If your medication initially alleviated symptoms, but now they seem to be coming back or getting worse, talk to your doctor. Remember to stay in touch with your doctor—he or she needs to monitor your medication for effectiveness over time. It’s also important for you to keep track of side effects. Finding the right medication may take a few tries, so it may be helpful to keep a log of symptoms and side effects as you begin a new medication or notice yours might not be working as well.

6. Your treatment regimen isn’t strong enough.

If you begin to experience complications from Crohn’s, your doctor may want to consider other methods of treatment, such as new dietary changes, a different medication or, potentially, surgery. Possible complications include:

  • Malnutrition: your body doesn’t absorb the nutrients it needs

  • Bowel obstruction:thickening of the intestinal wall, which keeps food or stool from moving through the intestines

  • Fistulas: abnormal passages, or tunnels, between organs

  • Anal fissures: small tears in the anus that may cause itching, pain or bleeding

  • Ulcers: inflammation along the GI tract, which can lead to ulcers or open sores

  • Inflammation: may spread to other areas of the body, such as the joints, eyes or skin

7. Your medication is tucked away in the medicine cabinet.

Your Crohn’s medication won't work if you don't take it. Keep all your medicines out and accessible, or schedule a reminder on your mobile device, to ensure you don’t forget to take them.

Also, keep in mind that Crohn’s is a long-term disease, so you need a long-term plan to keep symptoms at bay. You may have times of flare-ups with one or more symptoms followed by periods of remission with no symptoms at all. But even when you’re feeling better, it’s important to stick to your treatment plan and continue taking your medication unless your doctor has directed otherwise.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Sep 26

  1. Maintenance Therapy. Crohn’s & Colitis Foundation of America. http://www.ccfa.org/resources/maintenance-therapy.html

  2. What is Crohn’s Disease? Crohn’s & Colitis Foundation of America. http://www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/

  3. Crohn’s Disease – Treatment. NHS Choices. http://www.nhs.uk/conditions/Crohns-disease/pages/treatment.aspx

  4. Crohn’s Disease. National Institute of Diabetes and Digestive and Kidney Diseases. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/crohns-disease/Pages/fa...

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