Drugs Suppress the Immune System & Antibiotic for Crohn’s Disease

Drugs Suppress the Immune System

Crohn’s Disease and the Immune System

Although the exact cause of the disease is unclear, its origins appear to have something to do with the body’s immune system. Either the immune system reacts too aggressively to an infection, or mistakes the intestinal contents (both food products and naturally-occurring intestinal bacteria) as a threat. The immune system floods the area with white blood cells, resulting in painful inflammation.

Certain drugs suppress the immune system, which in turn reduces inflammation and provides pain relief. While low doses of immunosuppressant are often administered for Crohn’s Disease, some risks are involved. Because the immune system is suppressed, the chances of serious infection are higher than normal. This, and other possible side effects, must be balanced against the pain relief they provide.

What is Immunosuppressant?

An immunosuppressant controls inflammation by blocking the body’s immune system. An immunosuppressant can provide much-needed pain relief, but raises the risk of infections from other sources.

If you are taking an immunosuppressant, consult your doctor immediately if you experience:

•  blood in your urine
•  black “tar-like” stools
•  rapid heartbeat
•  vision problems
•  yellowing of your skin
•  shortness of breath.

Azathioprine and 6MP

Azathioprine and 6MP are two closely related medications. Azathioprine actually breaks down into 6MP in the intestinal tract. Both drugs suppress the immune system and provide pain relief. Seventy percent of patients with moderate to severe Crohn’s symptoms respond to these medications, although it may take up to three months of treatment before symptoms improve.

Although they have fewer side effects than corticosteroids, these medications can also have serious side effects. Those taking 6MP may have an increased risk of cancer, and both medications can cause low white blood cell counts. (Some reduction of white blood cells is necessary for the medication to work, and is to be expected.) Taking either azathioprine or 6MP with bone marrow medications or ACE inhibitors (used to control high blood pressure) can contribute to low white blood cell counts. Inflammation of the liver and the pancreas may also occur.

Both azathioprine and 6MP can produce irregular menstrual cycles and lowered sperm counts. Neither medication should be taken while pregnant or nursing. While taking either medication, regular blood tests will be taken to monitor both white blood cell counts and liver function.

Some of the common side effects of azathioprine and 6MP are nausea, vomiting and loss of appetite.

Methotrexate

An alternative to azathioprine and 6MP, methotrexate is both an immune system suppressor and an anti-inflammatory. It also produces faster results than older immunosuppressant. Methotrexate can be taken in tablet form or through weekly injections. Like azathioprine and 6MP, it can cause low white blood cell counts. Years of use can result in cirrhosis of the liver, lung inflammation, bone marrow damage and an increased risk of cancer. The side effects of methotrexate are, in general, similar to those of 6MP and azathioprine: nausea, vomiting and loss of appetite.

Antibiotics and Crohn’s Disease

Antibiotics

Although a faulty immune system is often blamed for the disease, studies of the role antibiotics play in treating Crohn’s are starting to suggest that the immune system may be doing exactly what it’s supposed to do: fighting infection.

Research has shown the presence of a bacterium called Mycobacterium avium ss paratuberculosis, or M-para, in the intestines of people with Crohn’s. Treating the condition with antibiotics that target M-para has produced encouraging results in clinical trials, with claims of long-term remission of symptoms. Others suggest that M-para may be only one of a number of bacteria that contribute to the disease. In either case, clinical studies are taking the possibility of antibiotic treatments very seriously.Mycobacterium avium subspecies paratuberculosis is a bacterial parasite and the causative agent of paratuberculosis, a disease predominately found in cattle and sheep. Infection with this microorganism results in substantial farming economic losses and animal morbidity

Traditional Antibiotic Treatments for Crohn’s Disease

antibiotics

The viability of using antibiotics to treat the disease directly has yet to be proven. In the meantime, antibiotics continue to be used to treat associated bacterial overgrowth and secondary infections. Antibiotics are also often used to treat intestinal obstructions, fistulas, abscesses and post-surgery infections. Ampicillin, ciprofloxacin, and metronidazole (known under the brand name Flagyl®) are the drugs most often used, but many other antibiotics are available. Below you’ll find brief descriptions of some of the more common Crohn’s-related antibiotics.

Antibiotics	Comments	Side Effects
Ampicillin	Ampicillin is closely related to penicillin, and people with allergies to penicillin should inform their doctor before using ampicillin. Medical professionals should be informed that you take ampicillin if any form of surgery (including dental) is required.	-upset stomach -diarrhea -vomiting -skin rashes. Seek medical attention if you develop: -hives -itching -difficulty swallowing -breathing difficulties -severe rashes -vaginal infections.
Ciprofloxacin	Often used with metronidazole (Flagyl), ciprofloxacin should not be taken while pregnant or nursing. It is not intended for use by children. Inform your doctor of any prescription or non-prescription drugs you may be taking, Ciprofloxacin has a long list of potential drug interactions. If you have diabetes, nervous system diseases, heart disease, tendonitis, liver or kidney disease, inform your doctor before taking ciprofloxacin.	-sun sensitivity -light-headedness -insomnia -dizziness -abdominal pain.
Metronidazole (Flagyl)	Metronidazole is very effective when used to treat colitis and anal fistulas. If you take anticoagulants, disulfiram or lithium, inform your doctor before taking Flagyl. In high doses, metronidazole can cause nerve damage. Conditions such as blood disorder, heart disease, liver disease and central nervous system diseases are often aggravated by metronidazole.	When taken with alcohol: -nausea -headaches -dizziness -lightheadedness -metallic taste in the     mouth -rashes -redness of the face. Check with your health professional for other side effects.
Sulfonamide	One of the sulfa-based antibiotics, sulfonamide is not recommended for use while pregnant or nursing. Inform your health professional of all medications you take and any allergies you have to medications before starting sulfonamide. Let your doctor know if you suffer from anemia or other blood diseases, glucose deficiency, kidney or liver problems. Taking sulfonamide if you have porphyria may bring on an attack.	-sun sensitivity -itching -rashes -skin problems -fever -sore throat -difficulty swallowing.
Tetracycline	Before taking tetracycline, report any allergies to medication to your doctor, especially antibiotic allergies. Report any medication you currently use, including antacids, antibiotics, anticoagulants and vitamin supplements. Do not take while pregnant or nursing. Inform your doctor if you have diabetes, liver disease or kidney disease.	-stomach problems -diarrhoea -rectal or vaginal         itching -skin rashes -sore mouth -yellow eyes -yellow skin.