Crohn's Disease: Other Treatment

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Other Treatment

Some people who have Crohn's disease need additional nutrition because severe disease prevents their small intestine from absorbing nutrients. Supplemental liquid feedings may be done through a tube placed in the nose and down into the stomach (enteral nutrition) or through a vein (total parenteral nutrition, or TPN). Supplemental feeding may be needed when:

• Crohn's disease is not controlled with standard treatment.
• Short bowel syndrome occurs. This happens when so much of the small intestine has been surgically removed or is affected by the disease that you cannot properly digest food and absorb enough nutrients.
• Bowel blockage occurs.

Nutritional therapy may restore good nutrition to children who are growing more slowly than normal. It also can build strength if you need surgery or have been weakened because of severe diarrhea and poor nutrition.

Total parenteral nutrition allows the intestines to rest and heal. It may relieve an acute attack and allow surgery to be delayed or avoided. But it is common for symptoms to return when TPN is stopped and you go back to a regular diet. TPN does not change the long-term outcome of Crohn's disease.

Counseling for Crohn's disease

Crohn's disease can affect every aspect of your life. It may make you feel isolated or depressed. But you can take steps to improve your outlook and coping skills. You may want to seek professional counseling and social support from family, friends, or clergy. Research has shown that strong social support can reduce stress and disease activity.⁴

Other Treatment Choices

Nutritional supplements

• Enteral nutrition or total parenteral nutrition (TPN) provides liquid nutrition, which is more easily digested, through either a tube inserted through the nose and into the stomach or a needle inserted into a vein.

Complementary medicine

Many people with inflammatory bowel disease consider nontraditional or complementary medicine in addition to prescription medicines. They may turn to these alternatives because there is no cure for Crohn's disease. People may also use complementary medicine to help in coping with:

• The difficult side effects from standard medicines.
• The emotional strain of dealing with a chronic illness.
• The negative impact of severe disease on daily life.

These therapies have not been proven effective for Crohn's disease, but they may improve your overall well-being.

The various complementary therapies include:

• Special diets or nutritional supplements, such as probiotics, evening primrose, and fish oils.
• Vitamin supplements, such as vitamins D and B12.
• Herbs, such as aloe and ginseng.
• Massage.
• Stimulation of the feet, hands, and ears to try to affect parts of the body (reflexology).

What To Think About

Nutritional supplements can help people receive enough essential nutrients but they are expensive.

TPN can cause metabolic imbalances. It also can raise the risk of a bloodstream infection from the catheter in the vein, which is needed to give TPN. Long-term use of TPN may raise the risk of liver problems or liver failure.

Last updated:	October 09, 2008
Author:	Monica Rhodes
Reviewed By:	Kathleen Romito, MD - Family Medicine, Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC