Cortisone therapy

Cortisone is used in Crohn’s disease primarily for the treatment of acute relapses. It can be administered systemically as a tablet or in some cases locally as an enema or klysma. In mild to moderate attacks, cortisone preparations almost always lead to an improvement in symptoms.

Even the most severe relapses can be brought under control in about half of the cases. As soon as the relapse is over, an attempt should be made to discontinue the cortisone and use other drugs that are better suited to long-term therapy instead. Otherwise, cortisone can lead to the side effects typical of glucocorticoids: Weight gain occurs, mainly due to storage of water in the tissue (edema).

In addition, it can lead to bone loss (osteoporosis), weakening of the immune system and the development of diabetes mellitus (steroid diabetes). If applied locally, considerably less cortisone enters the bloodstream, which is why there are fewer side effects. Even in local form, however, cortisone is not suitable for long-term therapy, as the side effects may still occur at some point.

Azathioprine

The active ingredient azathioprine is a so-called immunosuppressant. This means that it reduces the function of the immune system. This effect is used in the therapy of Crohn’s disease, as it also reduces inflammation in the intestine.

This is achieved by stopping the multiplication of certain attack cells of the immune system. Therefore, azathioprine is also classified as a so-called cytostatic drug. The side effects of azathioprine are relatively non-specific, including hair loss, increased risk of infection, nausea, vomiting, diarrhea, weight loss, fever, joint pain and blood count changes. In addition, it can have a fruit-damaging effect, which is why it should not be taken by pregnant women. Because of this multitude of possible side effects, therapy with azathioprine is always carried out under close medical supervision.Nevertheless, it is suitable for long-term therapy of Crohn’s disease, as the risk of side effects is low with good medical supervision.