If you have Crohn’s disease (which is characterized by a range of digestive symptoms and inflammation throughout the digestive tract), you’re probably wondering about the best way to treat your symptoms and feel better. Crohn’s disease treatment includes dietary and lifestyle changes, medication, and more.
Your Crohn’s disease treatment will depend on you and your individual symptoms. Still, there are a few basic ways anyone with Crohn’s disease can approach treating their condition. Many of these are similar to how other digestive diseases are controlled or treated. In general, you can treat your Crohn’s disease by:
Eating an anti-inflammatory diet
Supporting your digestion and gut health with probiotics and other digestive supplements
Supporting your mental health, especially through mindfulness
Taking other medications, including those prescribed by your doctor
What Is Crohn’s Disease?
Crohn’s disease (CD) is an inflammatory disease of the intestinal tract that affects every layer of the bowel wall. It is usually triggered by an inappropriate response of the immune system. Crohn’s disease can involve the entire gastrointestinal tract (from the mouth to the rectum), but in general, it affects the small intestine and the right side of the large intestine.
People with Crohn’s disease usually experience the disease in flare-ups (or periods of time when they experience symptoms). The more flare-ups you have, the more your disease may progress.
Crohn’s disease can be mild or severe. People with severe Crohn’s disease may have fistulas (abnormal passages between layers of the GI tract filled with cell debris, red blood cells, and inflammatory cells) and/or strictures (abnormally narrow parts of the GI tract created by intestinal thickening) .
Inflammatory bowel disease (IBD) is a general term for inflammatory digestive disorders that include Crohn’s disease and ulcerative colitis [2 Trusted SourcePubMedGo to source]. You can think of Crohn’s disease as a type of IBD.
Crohn’s Disease Symptoms
Common symptoms of Crohn’s disease include:
Abdominal pain, especially in the right lower quadrant of the abdomen (colon pain)
Gas and bloating
Diarrhea that may include mucus and blood
Non-digestive symptoms may include:
Eye inflammation causing redness, swelling, irritation, or blurred vision
Diagnosis of Crohn’s disease involves a number of tests to give your doctor more information and to rule out other diseases (like celiac disease and irritable bowel syndrome, or IBS).
You may have blood tests to check for anemia. You may also give a stool sample, which will then be tested in a lab  for infections, parasites, or other issues.
It is important to distinguish Crohn’s disease from ulcerative colitis and diverticulitis, as the symptoms of these disorders can be similar. Tests that check anti-neutrophils (a type of white blood cell) and other antibodies can do this, as there are specific antibodies and markers associated with the different conditions.
CT scans, MRIs, or X-rays can show fistulas or other bowel damage that is typical of Crohn’s disease .
Causes of Crohn’s Disease
The exact cause of Crohn’s disease is still unknown, but may involve a combination of genetic and environmental factors, as well as imbalances in the gut.
Diet and environmental exposures can affect whether or not someone develops Crohn’s disease [2 Trusted SourcePubMedGo to source]. Some research has shown that taking antibiotics in childhood is associated with a greater risk of developing IBD later in life . Crohn’s is also linked with leaky gut and SIBO [5, 6, 7].
Gut Health Imbalances and Crohn’s Disease
Leaky gut syndrome (more officially known as intestinal permeability) has been linked to Crohn’s disease. This occurs when the tight junctions between the cells that line your small intestine loosen, letting small particles such as undigested food pass into your bloodstream. It is an inflammatory condition that can affect the body in multiple ways. Some research shows that having a leaky gut can be a precursor to developing Crohn’s later in life .
Small intestine bacterial overgrowth (SIBO) can also be a factor in developing Crohn’s disease. In 2019, a systematic review concluded that incidence of SIBO was higher in people with IBD (as compared to controls) .
Diet and Lifestyle Changes for Crohn’s Disease
There are a number of diet and lifestyle changes that can make a huge difference in your Crohn’s symptoms. Let’s take a look at these research-backed approaches:
Eating an anti-inflammatory diet can help reduce inflammation in your digestive system and control your Crohn’s symptoms. Avoiding foods that can irritate or inflame your digestive tract can help you feel better and reduce flare-ups.
Paleo and Autoimmune Paleo Diets
A Paleo diet is an example of an anti-inflammatory diet that can help reduce Crohn’s symptoms. A Paleo diet involves eating foods that would have been available to our Paleolithic ancestors. Objectively inflammatory foods (like sugar and processed foods) are avoided, as well as common triggers of inflammation (including gluten and dairy products).
The Autoimmune Paleo Diet (commonly referred to as AIP or the Autoimmune Protocol) can also be a beneficial diet approach for Crohn’s treatment. This diet is essentially a more restrictive version of the Paleo diet that focuses on eating nutrient-dense foods and avoiding inflammatory foods like grains, gluten, sugar, dairy, eggs, alcohol, and caffeine. Some studies have indicated that an elimination diet like AIP can improve symptoms for people with IBD [13, 14].
If following a Paleo diet doesn’t help to reduce symptoms, a more specialized diet, like the low FODMAP diet, might help.
Low FODMAP Diet
A low FODMAP diet can benefit people with Crohn’s disease. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. These are complex natural sugars and starches that can feed bacterial overgrowths and be hard for some people (especially those with digestive diseases) to digest.
Specifically, some research has shown removing high FODMAP foods can improve symptoms for Crohn’s patients. One randomized controlled trial showed that a low FODMAP diet, compared with a control diet, improved symptoms and reduced the loss of microbes thought to regulate the immune response .
Other research indicates that a low FODMAP diet is generally beneficial for people with inflammatory bowel disease [16, 17].
An elemental diet, a powdered meal replacement formula that is hypoallergenic, anti-bacterial, and anti-inflammatory, can be incredibly effective when it comes to soothing Crohn’s symptoms.
The elemental diet is intended to be used as a short-term meal replacement in order to give your gut a chance to rest and heal while still providing essential nutrients.
The elemental diet has been shown to be an effective treatment for Crohn’s in numerous clinical trials, decreasing inflammation, reducing autoimmunity, and preventing relapses [18, 19,20, 21, 22, 23].
In my clinical experience, this is one of the most beneficial treatments for stubborn symptoms of Crohn’s disease.
Digestive Support Supplements for Crohn’s Disease
Another Crohn’s disease treatment option is digestive support supplementation. Taking digestive support supplements can help support your gut, reduce flare-ups, and improve your overall quality of life.
Some research on probiotics for Crohn’s disease specifically has found benefits to be minimal [28, 29]. However, supporting a healthy gut and reducing inflammation is likely to be valuable for you as a patient with Crohn’s disease. In my practice, I find probiotics to be one of the most helpful treatments for those with digestive disorders.
There is some evidence that supplementing with the amino acid L-glutamine can also help ease Crohn’s disease. A randomized controlled trial found that L-glutamine supplements improved the gut wall integrity (intestinal permeability) in patients with Crohn’s disease .
Other Lifestyle Changes
There are other changes you can make in your life to lessen Crohn’s symptoms.
Avoid taking NSAIDs (such as naproxen and ibuprofen), which can lead to increased inflammation in the long run and may cause flare-ups.
Improve your mental health by practicing mindfulness. Two studies showed improved symptoms and reduced pain of IBD patients who practiced breathing and relaxation techniques [31, 32].
Medication for Crohn’s Symptoms
Medications are a common Crohn’s disease treatment. You may already be taking medication to improve your Crohn’s symptoms. Most often, these medications are prescribed by a gastroenterologist. Medications are typically aimed at reducing inflammation and symptoms but may also come with side effects, and do not generally address the root cause of the problem. Medications are best used alongside diet and lifestyle strategies that work to address the root cause of the inflammation and heal the gut.
The most commonly prescribed medications for people who have mild to moderate Crohn’s disease are:
Corticosteroids (these are only used short-term, ex., during a flare-up). Prednisone is an example of a typical corticosteroid prescribed for Crohn’s disease.
Mesalamine (an anti-inflammatory drug)
Immunomodulators, which are medications that suppress your immune system. These include thiopurines (mercaptopurines, azathioprine), methotrexate, and steroids.
For people who have moderate to severe Crohn’s disease, common medications are:
A combination of immunomodulators and biologics. Biologics are medications made from living organisms.
Remicade (infliximab), a biologic used for patients who don’t respond to conventional therapies
Humira (adalimumab), a biologic used for patients who don’t respond to conventional therapy
Antidiarrheal medications like loperamide are also used by Crohn’s patients, especially during flare-ups.
Antibiotics and Antimicrobials
Antibiotics and natural antimicrobials may also be used as Crohn’s disease treatments.
Antibiotics can help to control infections and may also aid in healing abscesses and fistulas caused by inflammation in the digestive tract [33, 34]. However, there are some concerns with the impact of long term antibiotic use on gut health [35 Trusted SourcePubMedGo to source].
The most commonly prescribed antibiotics for Crohn’s disease are:
Metronidazole has been shown to be more effective when Crohn’s affects the colon, but this antibiotic can also come with side effects like gastric distress and a metallic taste .
Natural antimicrobial medications can also be very helpful in curbing Crohn’s disease. A systematic review of several randomized controlled trials found that two antimicrobial herbs, wormwood and thunder god vine, were better at placebo in preventing recurrence of post-operative Crohn’s (or, Crohn’s that persists after surgery) . Another systematic review found that antimicrobial herbal medicines were just as effective at treating IBD as the medication mesalamine .
Other Crohn’s Disease Treatments
A newer treatment that has shown some promise for inflammatory bowel disease is a fecal microbiota transplantation, sometimes called a fecal transplant. This is when fecal matter from a healthy stool donor is transplanted into the colon. This may happen via a colonoscopy (a tube going into the stomach) or via capsules . More research is necessary when it comes to fecal microbiota transplantation, but some preliminary evidence suggests that it may be helpful for inflammatory bowel disease.
Other interventions include surgery for bowel obstructions, fistulas, or perforated bowels. Draining of abscesses is also used as a Crohn’s disease treatment.
Crohn’s Disease Treatment Plan for Relief
With the right combination of diet, lifestyle, and medical treatment, you can manage your Crohn’s disease successfully. Adopt an anti-inflammatory diet, such as low FODMAP or AIP. Consider using probiotics and other digestive supports to heal your gut.
You can find the treatment that is right for you, reduce your Crohn’s flare-ups, and get back to feeling great.
Yunzhi Zou, Lizhi Wu, Wencai Xu, Xiong Zhou, Kun Ye, Huifang Xiong, Conghua Song & Yong Xie(2020)Correlation between antibiotic use in childhood and subsequent inflammatory bowel disease: a systematic review and meta-analysis,Scandinavian Journal of Gastroenterology,55:3,301-311,DOI: 10.1080/00365521.2020.1737882
Yusuke Honzawa, MD, Hiroshi Nakase, MD, PhD, Minoru Matsuura, MD, PhD, Tsutomu Chiba, MD, PhD, Clinical significance of serum diamine oxidase activity in inflammatory bowel disease: Importance of evaluation of small intestinal permeability, Inflammatory Bowel Diseases, Volume 17, Issue 2, 1 February 2011, Pages E23–E25, https://doi.org/10.1002/ibd.21588
Andrea Michielan, Renata D’Incà, “Intestinal Permeability in Inflammatory Bowel Disease: Pathogenesis, Clinical Evaluation, and Therapy of Leaky Gut“, Mediators of Inflammation, vol. 2015, Article ID 628157, 10 pages, 2015. https://doi.org/10.1155/2015/628157
Shah, A, Morrison, M, Burger, D, et al. Systematic review with meta-analysis: the prevalence of small intestinal bacterial overgrowth in inflammatory bowel disease. Aliment Pharmacol Ther. 2019; 49: 624– 635. https://doi.org/10.1111/apt.15133
DANIEL HOLLANDER, CONSTANCE M. VADHEIM, EDWARD BRETTHOLZ, et al. Increased Intestinal Permeability in Patients with Crohn’s Disease and Their Relatives: A Possible Etiologic Factor. Ann Intern Med.1986;105:883-885. [Epub ahead of print 12 March 2020].doi:10.7326/0003-4819-105-6-883
Lerner A, Matthias T. Changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease. Autoimmun Rev. 2015 Jun;14(6):479-89. doi: 10.1016/j.autrev.2015.01.009. Epub 2015 Feb 9. PMID: 25676324. Trusted SourcePubMedGo to source
Swidsinski A, Ung V, Sydora BC, Loening-Baucke V, Doerffel Y, Verstraelen H, Fedorak RN. Bacterial overgrowth and inflammation of small intestine after carboxymethylcellulose ingestion in genetically susceptible mice. Inflamm Bowel Dis. 2009 Mar;15(3):359-64. doi: 10.1002/ibd.20763. PMID: 18844217. Trusted SourcePubMedGo to source
Zou Y, Wu L, Xu W, Zhou X, Ye K, Xiong H, Song C, Xie Y. Correlation between antibiotic use in childhood and subsequent inflammatory bowel disease: a systematic review and meta-analysis. Scand J Gastroenterol. 2020 Mar;55(3):301-311. doi: 10.1080/00365521.2020.1737882. Epub 2020 Mar 17. PMID: 32180472. Trusted SourcePubMedGo to source
Shaw SY, Blanchard JF, Bernstein CN. Association between the use of antibiotics in the first year of life and pediatric inflammatory bowel disease. Am J Gastroenterol. 2010 Dec;105(12):2687-92. doi: 10.1038/ajg.2010.398. Epub 2010 Oct 12. PMID: 20940708. Trusted SourcePubMedGo to source
Anita Chandrasekaran, MD, MPH, Shauna Groven, BS, James D Lewis, MD, MSCE, Susan S Levy, PhD, Caroline Diamant, MD, Emily Singh, MD, Gauree Gupta Konijeti, MD, MPH, An Autoimmune Protocol Diet Improves Patient-Reported Quality of Life in Inflammatory Bowel Disease, Crohn’s & Colitis 360, Volume 1, Issue 3, October 2019, otz019, https://doi.org/10.1093/crocol/otz019
Gauree G. Konijeti, MD, MPH, NaMee Kim, MD, James D. Lewis, MD, MSCE, Shauna Groven, BS, Anita Chandrasekaran, MD, MPH, Sirisha Grandhe, MD, Caroline Diamant, MD, Emily Singh, MD, Glenn Oliveira, BS, Xiaoyun Wang, MS, Bhuvan Molparia, MS, Ali Torkamani, PhD, Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease, Inflammatory Bowel Diseases, Volume 23, Issue 11, 1 November 2017, Pages 2054–2060, https://doi.org/10.1097/MIB.0000000000001221
Ashley Charlebois, Greg Rosenfeld & Brian Bressler(2016)The Impact of Dietary Interventions on the Symptoms of Inflammatory Bowel Disease: A Systematic Review,Critical Reviews in Food Science and Nutrition,56:8,1370-1378,DOI: 10.1080/10408398.2012.760515
Yong-le Zhan, Yong-an Zhan, Shi-xue Dai. Is a low FODMAP diet beneficial for patients with inflammatory bowel disease? A meta-analysis and systematic review. Clinical Nutrition Open Science. 2017. Volume 37, Issue 1, Pages 123-129. DOI: https://doi.org/10.1016/j.clnu.2017.05.019
S Cox, J Lindsay, S Fromentin, A Stagg, N McCarthy, N Galleron, S Ibraim, H Roume, F Levenez, N Pons, N Maziers, M Lomer, SD Ehrlich, P Irving, K Whelan. Effects of Low FODMAP Diet on Symptoms, Fecal Microbiome, and Markers of Inflammation in Patients With Quiescent Inflammatory Bowel Disease in a Randomized Trial. Gastro Journal. 2019. Volume 158, Issue 1, Pages 176-188. DOI: https://doi.org/10.1053/j.gastro.2019.09.024
O Borrelli, L Cordischi, M Cirulli, M Paganelli, V Labalestra, S Uccini, P Russo, S Cucchiara. Polymeric Diet Alone Versus Corticosteroids in the Treatment of Active Pediatric Crohn’s Disease: A Randomized Controlled Open-Label Trial. American Gastroenterological Association. 2006. Volume 4, Issue 6, Pages 744-753. DOI: https://doi.org/10.1016/j.cgh.2006.03.010
C. Knight, W El-Matary, C Spray, B Sandhu. Long-term outcome of nutritional therapy in paediatric Crohn’s disease. Clinical Nutrition Open Science. 2005. Volume 24, Issue 5, Pages 775-779. DOI: https://doi.org/10.1016/j.clnu.2005.03.005
Heuschkel R: Enteral Nutrition Should Be Used to Induce Remission in Childhood Crohn’s Disease. Dig Dis 2009;27:297-305. doi: 10.1159/000228564
Hiwatashi, Nobuo M.D.1 Enteral nutrition for Crohn’s disease in Japan, Diseases of the Colon & Rectum: October 1997 – Volume 40 – Issue 10 – p S48-S53 doi: 10.1007/BF02062020
Avalueva EB, Uspenskiĭ IuP, Tkachenko EI, Sitkin SI. [Use of Saccharomyces boulardii in treating patients inflammatory bowel diseases (clinical trial)]. Eksp Klin Gastroenterol. 2010;(7):103-11. Russian. PMID: 21033091. Trusted SourcePubMedGo to source
Naidoo K, Gordon M, Fagbemi AO, Thomas AG, Akobeng AK. Probiotics for maintenance of remission in ulcerative colitis. Cochrane Database Syst Rev. 2011 Dec 7;(12):CD007443. doi: 10.1002/14651858.CD007443.pub2. Update in: Cochrane Database Syst Rev. 2020 Mar 4;3:CD007443. PMID: 22161412. Trusted SourcePubMedGo to source
Mazidi M, Rezaie P, Ferns GA, Vatanparast H. Impact of Probiotic Administration on Serum C-Reactive Protein Concentrations: Systematic Review and Meta-Analysis of Randomized Control Trials. Nutrients. 2017 Jan 3;9(1):20. doi: 10.3390/nu9010020. PMID: 28054937; PMCID: PMC5295064. Trusted SourcePubMedGo to source
Zhong C, Qu C, Wang B, Liang S, Zeng B. Probiotics for Preventing and Treating Small Intestinal Bacterial Overgrowth: A Meta-Analysis and Systematic Review of Current Evidence. J Clin Gastroenterol. 2017 Apr;51(4):300-311. doi: 10.1097/MCG.0000000000000814. PMID: 28267052. Trusted SourcePubMedGo to source
Pabón-Carrasco M, Ramirez-Baena L, Vilar-Palomo S, Castro-Méndez A, Martos-García R, Rodríguez-Gallego I. Probiotics as a Coadjuvant Factor in Active or Quiescent Inflammatory Bowel Disease of Adults—A Meta-Analytical Study. Nutrients. 2020; 12(9):2628. https://doi.org/10.3390/nu12092628
Limketkai BN, Akobeng AK, Gordon M, Adepoju AA. Probiotics for induction of remission in Crohn’s disease. Cochrane Database of Systematic Reviews 2020, Issue 7. Art. No.: CD006634. DOI: 10.1002/14651858.CD006634.pub3.
Benjamin, J., Makharia, G., Ahuja, V. et al. Glutamine and Whey Protein Improve Intestinal Permeability and Morphology in Patients with Crohn’s Disease: A Randomized Controlled Trial. Dig Dis Sci57, 1000–1012 (2012). https://doi.org/10.1007/s10620-011-1947-9
Patricia L. Gerbarg, MD, Vinita E. Jacob, MD, Laurie Stevens, MD, Brian P. Bosworth, MD, Fatiha Chabouni, MD, Ersilia M. DeFilippis, MD, Ryan Warren, BA, Myra Trivellas, BS, Priyanka V. Patel, MS, Colleen D. Webb, RD, Michael D. Harbus, BA, Paul J. Christos, DrPH, Richard P. Brown, MD, Ellen J. Scherl, MD, The Effect of Breathing, Movement, and Meditation on Psychological and Physical Symptoms and Inflammatory Biomarkers in Inflammatory Bowel Disease: A Randomized Controlled Trial, Inflammatory Bowel Diseases, Volume 21, Issue 12, 1 December 2015, Pages 2886–2896, https://doi.org/10.1097/MIB.0000000000000568
Kuo B, Bhasin M, Jacquart J, Scult MA, Slipp L, Riklin EIK, et al. (2015) Genomic and Clinical Effects Associated with a Relaxation Response Mind-Body Intervention in Patients with Irritable Bowel Syndrome and Inflammatory Bowel Disease. PLoS ONE 10(4): e0123861. https://doi.org/10.1371/journal.pone.0123861
Khan, Khurram J MD1; Ullman, Thomas A MD, FACG2; Ford, Alexander C MD, MRCP3; Abreu, Maria T MD, FACG4; Abadir, A MD1; Marshall, John K MD, MSc, FRCPC1; Talley, Nicholas J MD, PhD, FACG5; Moayyedi, Paul MB, ChB, BSc, MPH, PhD, FACG1 Antibiotic Therapy in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis, American Journal of Gastroenterology: April 2011 – Volume 106 – Issue 4 – p 661-673 doi: 10.1038/ajg.2011.72
Feng Y, Huang Y, Wang Y, Wang P, Song H, Wang F. Antibiotics induced intestinal tight junction barrier dysfunction is associated with microbiota dysbiosis, activated NLRP3 inflammasome and autophagy. PLoS One. 2019 Jun 18;14(6):e0218384. doi: 10.1371/journal.pone.0218384. PMID: 31211803; PMCID: PMC6581431. Trusted SourcePubMedGo to source
Nitzan O, Elias M, Peretz A, Saliba W. Role of antibiotics for treatment of inflammatory bowel disease. World J Gastroenterol. 2016 Jan 21;22(3):1078-87. doi: 10.3748/wjg.v22.i3.1078. PMID: 26811648; PMCID: PMC4716021.
Ng, S.C., Lam, Y.T., Tsoi, K.K.F., Chan, F.K.L., Sung, J.J.Y. and Wu, J.C.Y. (2013), Systematic review: the efficacy of herbal therapy in inflammatory bowel disease. Aliment Pharmacol Ther, 38: 854-863. https://doi.org/10.1111/apt.12464
Rahimi R, Nikfar S, Abdollahi M. Induction of clinical response and remission of inflammatory bowel disease by use of herbal medicines: A meta-analysis. World J Gastroenterol 2013; 19(34): 5738-5749. DOI: https://dx.doi.org/10.3748/wjg.v19.i34.5738<br/ ><br/ >Rahimi R, Nikfar S, Abdollahi M. Induction of clinical response and remission of inflammatory bowel disease by use of herbal medicines: A meta-analysis. World J Gastroenterol 2013; 19(34): 5738-5749 [PMID: 24039370 Trusted SourcePubMedGo to source DOI: 10.3748/wjg.v19.i34.5738]
Sudarshan Paramsothy, Ramesh Paramsothy, David T Rubin, Michael A. Kamm, Nadeem O. Kaakoush, Hazel M Mitchell, Natalia Castaño-Rodríguez, Faecal Microbiota Transplantation for Inflammatory Bowel Disease: A Systematic Review and Meta-analysis, Journal of Crohn’s and Colitis, Volume 11, Issue 10, October 2017, Pages 1180–1199, https://doi.org/10.1093/ecco-jcc/jjx063
I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!
Transform your health
Every product is science-based, validated by real-world use, and personally vetted by Dr. Ruscio, DNM, DC.