Initial treatment is with medication. The most common drugs used are steroids such as prednisolone, and various anti-inflammatory agents. The drugs do not "cure" Crohn's disease (there is no "cure" available yet), but the drugs are used to relieve its symptoms and may help to avoid recurrence.
In more serious cases, stronger drugs such as 6-mercaptopurine and azathioprine, may be used. However, these drugs have more side effects and suppress the immune system, making the patient more prone to infection.
In more advanced or complicated cases of Crohn's disease, surgery may be recommended.
Emergency surgery is performed when complications, such as a perforation of the intestine, obstruction (blockage) of the bowel, or massive bleeding occur with Crohn's disease. Operations may also be needed in patients who do not respond to medication, patients with abscess formation, fistulas (abnormal communication from the intestine), and patients with severe anal disease.
Although drug treatment is used initially, up to three-fourths of patients may eventually require surgery. Surgery is not "curative," although many patients never require additional operations. A conservative approach is frequently taken at surgery, with only the diseased portion of the intestines being removed.
Surgery may provide long-term relief of symptoms, decreasing the need for medications. Surgical therapy is best conducted by a surgeon skilled and experienced in the management of Crohn's disease.