Chronic intestinal diseases

New treatment options for Crohn’s disease

Diarrhea, pain in the lower abdomen, mild fever and nausea are signs of Crohn's disease.

(Bild: stock.adobe.com/yavdat - stock.adobe.com)

Around 80,000 Austrians suffer from chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. The symptoms of these diseases and the promising treatment options that are already available.

In the case of chronic inflammatory bowel disease (IBD), the immune system reacts via: Immune substances in this digestive organ not only fight harmful pathogens, but also turn against the body.

Crohn's disease
In Crohn's disease patients, this results in permanent inflammation and damage to the digestive tract - from the mouth to the anus. The transition from the small to the large intestine is most affected.

Typical symptoms are watery or mushy diarrhea several times a day and over a longer period of time, cramps and/or pain in the lower abdomen, slight fever, fatigue, loss of appetite, nausea and vomiting as well as weight loss.

Ulcerative colitis
Ulcerative colitis (CU) is an inflammation of the large intestine with ulcer formation. Signs may include persistent diarrhea, often mixed with blood or mucus, weight loss, abdominal pain that is cramping or often associated with defecation and a constant urge to defecate.

For both conditions, it can take a long time before a diagnosis is made. However, early clarification by a gastroenterologist and the rapid start of treatment are important to prevent permanent damage. Help is available.

The therapeutic revolution in chronic inflammatory bowel disease began as early as 1955 with the discovery of the effectiveness of corticosteroids in acute severe ulcerative colitis.

DDr. Franziska Baumann-Durchschein, Klinische Abteilung für Gastroenterologie und Hepatologie, Uniklinik für Innere Medizin, MedUni Graz

Bild: Karl Schrotter Photograph

"The therapeutic revolution in chronic inflammatory bowel diseases began as early as 1955 with the discovery of the effectiveness of corticosteroids in acute severe ulcerative colitis, which drastically reduced the mortality of the disease," explains DDr. Franziska Baumann-Durchschein in "Ärzte Krone". Over the decades, many other treatment options have been added, recently at a rapid pace.

Ulcerative colitis (UC) is an inflammation of the large intestine with ulcer formation, while Crohn's disease is a permanent inflammation and damage to the digestive tract - from the mouth to the anus.

(Bild: stock.adobe.com/bilderzwerg - stock.adobe.com)

New treatment options
"The most exciting new treatment option for IBD at the moment is probably JAK1 inhibitors, which broadly block the messenger substances that cause inflammation.

Another option with a completely new mechanism of action is 'sphingosine-1-phosphate receptor modulators', which are designed to prevent lymphocytes [note: responsible for the defense against pathogens] from migrating into the intestine and thus interrupt the inflammatory process," reports Univ.-OA Priv.-Doz. DDr. Andreas Blesl.

The most exciting new treatment option at the moment is probably JAK1 inhibitors, which broadly block inflammation-causing messenger substances.

Univ.-OA Priv.-Doz. DDr. Andreas Blesl, Klinische Abteilung für Gastroenterologie und Hepatologie, Uniklinik für Innere Medizin, MedUni Graz

Bild: Univ.-OA Priv.-Doz. DDr. Andreas Blesl

"New, highly targeted antibodies against the messenger substance interleukin-23 are also available for patients with Crohn's disease and ulcerative colitis, have a very good safety profile and are even effective against the symptom of urge to defecate, which is particularly distressing for CU patients."

The other side of the coin: bureaucratic hurdles in prescribing the new drugs. The experts therefore see an urgent need for action so that all patients can benefit from the developments.