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Antibiotics in Crohns

I have been reading about whether antibiotics can induce and maintain remission in Crohns disease and have found information on trials which suggest rifaximin which is a non absorbable antibiotic with a high safety profile, might be effective and suitable for long term use. This drug is not available in the uk but has been used for travellers D in USA and Europe for many years. Does anyone use this to treat their Crohns and if not why not ? Does anyone have other information about using antibiotics instead of steroids or immuno suppressants please ? It seems research is moving towards an explanation that Crohns symptoms at least for some people are caused by bacteria in the gut ( which would explain why many people find dietary and probiotic therapy works for them ) . If so it makes sense that antibiotics should work too. I am wondering about using antibiotics to treat a flare so that I can then start dietary therapy. Does anyone have useful suggestions please ? Thanks.
I do not know about rifaximin, but I have had a great deal of success with Cipro and Flagyl which are commonly prescribed for abscesses and other intestinal infections. The only problem is that I wasn't able to quit them or the symptoms returned. I agree with you about the whole bacteria thing though. I am not comfortable with long term use of antibiotics (I have done the on again off again thing for a year), but others have used them continuosly at low doses and have had some success. I would talk to your doctor about it and see if he/she feels it is an option.
After 35 or so years with "mild" Crohn's, and very successful remission for the last 10 years with Asacol then Pentasa, for a recent flare-up I have just been prescribed Flagyl for a week followed by 6 months of Creon 25000U.

I was mildly surprised that an antibiotic should be used - I supposed it was to clear out any bacteria before the Creon.

Of course as no-one knows what causes Crohn's these varying prescriptions may simply reflect the latest trends, or even individual specialist's ideas!


Super Moderator
I too have seen various studies about the role of antibiotics in Crohn's.

Like cookie, my son was prescribed Flagyl and Augmentin Duo forte for intestinal infection and an abscess.
Flagyl is commonly used as a first line treatment when flaring due to it's ability to treat both infection and inflammation. My son was also prescribed it for 3 months post operatively as the Crohn's specialist stated that research showed it increased chances of gaining remission and maintaining that remission for a longer period of time. He had surgery last April and has been in remission since then.

I should mention here that my daughter had surgery in July 2006 with no post op Flagyl prescribed and she has also been in remission since her surgery. They are both on Imuran as a maintenance med.

Dusty. xxx
Thanks for those helpful replies .
Frank I am intrigued as to what Creon is as i have never heard of it .
I have been diagnosed 11 years now and have managed so far with intermittent budesonide and pred, liquid diet and cipro. I had a bad reaction to a trial of azathioprine. I also have worries about longer term use of antibiotics, but try and avoid steroids for the same reason. That's partly why rifaximin sounded interesting as it is mostly not absorbed .
I have had grumbling disease throughout and have a lengthy stricture, which I guess is causing problems with bacteria building up etc, and perhaps why antibiotics have helped. (I decided to start cipro again 3 days ago and am feeling much better. ) The stricture has been dilated 3 times, the last time it perforated and now the ileum is attached to the rectum which causes a complication for surgery.
Like most people i am looking for the least damaging medication to help me to continue to live well and avoid surgery a while longer. I am ever hopeful an exclusion diet or diet supplemented by liquids will work but recent illness makes me think I need to move on to more effective treatment. Immuno supressants scare me and that's why I'm interested in antibiotics ( I have even considered worm therapy ! )
I'm finding the decision about what treatment to try and when to have surgery the hardest thing.
Thanks again
Frank I am intrigued as to what Creon is as i have never heard of it .
Neither had I until the other day!

A problem for me with the forum is that although I have had Crohn's for 35 years or so, originally treated with sulfasalazine (useless), then ignored, then with Colifoam (useless), then finally with steroids before Asacol leading on to Pentasa, I have only really had problems of very bad (uncontrollable) diarrhoea, stomach pains, and so on. My case is, fortunately for me, much less serious than a lot of cases I read on the forum.

As a result I am not familiar with the drugs and treatments that are regularly mentioned here.

My French specialist has been quite happy to continue the treatment started 12 years ago in England (Pentasa) with regular colonoscopies, and has just added the Flagyl followed by Creon because of a recent increase in diarrhoea with some blood. Whether this treatment is aimed at the symptoms only, or also an attempt to a new way of controlling the Crohn's I really don't know.

But to answer your question - Creon capsules contain the active ingredient pancreatin, a mixture of digestive enzymes normally released by the pancreas to digest food. It aids digestion of food in conditions where there is reduced or absent production of digestive enzymes by the pancreas.

Again, why the specialist put me on this I don't know, and I didn't know enough to ask him during the consultation (my french would probably not have been good enough to understand properly anyway).

Interestingly though, at the pharmacy they knew straight away that it was for a Crohn's type problem, so it can't be unusual.

I don't usually take anything without careful thought and independent investigation, but I will give this a try - and let you know what happens.
Good luck with the Creon, i would like to hear it works for you . It is interesting how different countries adopt different approaches to treatment. I am told that Japan treat primarily with a liquid diet, exclusively to get remission, in preference to steroids, and then to supplement half a normal diet to maintain remission. I think that is catching on here. I would recommend trying the liquid diet as it has helped me get over minor flares . I can also recommend a book by prof John Hunter " inflammatory bowel disease " which can guide you through an elemental then exclusion diet to see if the crohns can be controlled by diet.


Super Moderator
Enternal Nutrition is used quite widely in the UK, especially in children. It would seem that the US is the main country in which it's use is limited.

There are quite a few members on the forum that use digestive enzymes, not sure how they compare with Creon though.

Dusty. xxx