Are biologics better than steroids for Crohn’s disease?

Hi,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Your cousin’s reports suggest active Crohn’s disease (a chronic inflammatory bowel disease that affects the digestive tract) with weight loss, low albumin, and raised erythrocyte sedimentation rate (ESR), indicating significant inflammation and mild malnutrition.

This requires prompt and structured management. Your concerns about steroid and immunosuppressive side effects are understandable. In moderate to severe disease, the treatment plan is usually stepwise.

The treatment approach you needed is:

• Steroids are started first to control inflammation quickly.

• Once symptoms improve, Azathioprine or similar immunomodulators are introduced to maintain remission and reduce flare-ups.

• Biologic therapy, such as Infliximab or Adalimumab, may be considered earlier if:

  • The disease is severe at presentation.

  • There is a poor response to steroids or Azathioprine.

  • There are side effects or intolerance to standard therapy.

  • Complications such as fistulas or deep ulcers are present.

The choice between Azathioprine and biologics depends on the severity, response to treatment, cost, and overall health status. The gastroenterologist will guide the best option after reviewing reports and progress.

In addition, nutritional monitoring is also essential. So kindly follow the instructions mentioned below:

• Regular testing for vitamin D and vitamin B12 is important because Crohn’s disease, especially when the ileum is affected, can cause malabsorption.

• Supplementation, either oral or injectable, may be required based on results.

• Monitoring iron, folate, and protein intake is also advisable.

Surgery is not a cure for Crohn’s disease. It is used mainly when complications such as obstruction, abscess, or fistula occur, or when medicines fail to control symptoms.

Surgery helps relieve symptoms but cannot prevent recurrence in other bowel areas, so continued medical therapy is still needed.

• Follow up and self-care: kindly maintain a symptom diary noting weight, diet, pain, and bowel pattern.

• Avoid smoking and stay hydrated.

• Regular follow-up every few months helps adjust treatment promptly.

With proper medical care, nutritional support, and early intervention, most patients achieve good disease control and maintain a normal lifestyle.

I hope this helps you.

Please contact us for further queries.

Thank you.