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Crohn's disease, an inflammatory bowel disease is a serious, chronic condition of the gastrointestinal tract with unknown cause. However, it does appear have a strong genetic component in some families (CCFA 1999). Crohn's disease causes diarrhea, abdominal cramps, pain, fever, and occasionally rectal bleeding. Subsequently, an individual with Crohn's disease suffers from a loss of appetite and weight loss. The symptoms of the disease usually manifest themselves between the ages of fifteen and thirty (Moser et al., 2000, CCFA 1999). Unlike ulcerative colitis, which affects the mucosal layer of the bowel, Crohn's disease affects all layers (CCFA 1999).

There is consensus that patients with active disease should avoid pregnancy (Moser et al., 2000, Connell and Miller, 1999). The effects of active inflammation are believed to be more harmful to a fetus than the effects of treatment; subsequently disease activity plays a more important role in determining fetal outcome than drug treatment. In order to maintain remission, treatment during pregnancy is justified (Connell and Miller, 1999).

Connell and Sandborn (1999) suggest fertility is relatively normal in patients that are treating their Crohn's disease. However, some data suggest that even in remission, regardless of the type of treatment, Crohn's disease may cause pregnancy complications (Kornfeld et al., 1997). For example, an association between Crohn's disease and poor maternal weight gain, vaginal bleeding, premature rupture of the membrane, miscarriage and low birth weight independent of medication use has been raised (Moser et al., 2000). In fact, the severity of the disease is related to the severity of the complications experienced in pregnancy (Mogadam et al., 1981).

Corticosteroids, aminosalicylic acids, immunosuppressives, methotrexate, and antibacterial medications are used in the treatment of Crohn's disease. These medications are also used to maintain remission. This newsletter will review these medications. (CONTINUE)

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