What Medication Calms IBD?: A Guide to Managing Inflammation

October 10, 2025 •

4 min read

In 2015, an estimated 3.1 million U.S. adults (1.3%) reported being diagnosed with Inflammatory Bowel Disease (IBD) [1.10.3]. If you're one of them, you may be asking, what medication calms IBD? A variety of drugs are used to control and prevent flare-ups.

Quick Summary

Several classes of medication are used to calm Inflammatory Bowel Disease (IBD) by targeting inflammation. Treatment depends on disease severity and includes aminosalicylates, corticosteroids, immunomodulators, biologics, and JAK inhibitors.

Key Points

Multiple Medication Classes: There are several classes of drugs to treat IBD, including aminosalicylates, corticosteroids, immunomodulators, biologics, and JAK inhibitors [1.3.3].
Treatment is Individualized: The choice of medication depends on the type of IBD (Crohn's or colitis), its severity, and its location in the GI tract [1.3.1].
Aminosalicylates (5-ASAs): These are often a first-line treatment for mild to moderate ulcerative colitis, working directly on the intestinal lining [1.3.3, 1.4.4].
Corticosteroids: These are powerful, fast-acting drugs for short-term flare control but are not used for long-term maintenance due to significant side effects [1.5.2].
Immunomodulators: These drugs help maintain remission by modifying the immune system and are often used when steroids are needed frequently [1.3.2].
Biologics and Biosimilars: These are targeted therapies for moderate to severe disease that block specific inflammatory proteins; they are given by injection or IV [1.2.1].
JAK Inhibitors: These are newer, oral small-molecule drugs that block inflammatory pathways inside cells for moderate to severe IBD [1.2.3, 1.8.4].
Goal of Therapy: The main goals are to induce and maintain remission, often aiming for mucosal healing to prevent long-term complications [1.3.4].

Understanding IBD and the Goal of Medication

Inflammatory Bowel Disease (IBD) is a term for two conditions, Crohn's disease and ulcerative colitis, that are characterized by chronic inflammation of the gastrointestinal (GI) tract [1.13.2]. The primary goal of medical treatment for IBD is to reduce the inflammation that triggers your symptoms. Achieving and maintaining remission is key [1.3.4]. Medications work in different ways to control the body's inflammatory response, and treatment is tailored to the location and severity of your disease [1.3.1, 1.7.1].

Aminosalicylates (5-ASAs)

Anti-inflammatory drugs called Aminosalicylates, or 5-ASAs, are often the first step in treating mild to moderate ulcerative colitis [1.3.1, 1.3.3]. These drugs, which include mesalamine, balsalazide, and sulfasalazine, work to reduce inflammation directly in the lining of the intestine [1.4.4]. They are available in oral (pill) form, as well as rectal suppositories and enemas for inflammation in the lower colon [1.4.1]. While highly effective for ulcerative colitis, their benefit in treating Crohn's disease is less consistent [1.4.2, 1.4.4]. Patients may see improvement within four weeks of starting a 5-ASA medication [1.4.1].

Corticosteroids

Corticosteroids, such as prednisone and budesonide, are powerful, fast-acting anti-inflammatory drugs used for short-term control of moderate to severe IBD flare-ups [1.3.2, 1.5.4]. They work by suppressing the entire immune system to quickly reduce inflammation [1.5.3]. These medications are not intended for long-term use due to a significant risk of side effects, including osteoporosis, high blood pressure, and increased risk of infection [1.5.2, 1.11.2]. They are often used as a "bridge" to get symptoms under control while a long-term maintenance medication takes effect [1.3.2]. Budesonide is a formulation designed for more targeted release in the ileum and colon, which limits systemic side effects compared to prednisone [1.5.1, 1.5.3].

Immunomodulators

Immunomodulators modify the activity of the immune system to decrease the inflammatory response. These drugs, such as azathioprine, mercaptopurine, and methotrexate, are used for long-term treatment to maintain remission in IBD [1.3.2, 1.6.2]. They are slower to work, sometimes taking two to three months to become fully effective, and are often started while a patient is also taking a corticosteroid [1.3.4]. Immunomodulators are prescribed for patients who don't respond to 5-ASAs or who are dependent on steroids [1.3.4]. Due to their effect on the immune system, they can increase the risk of infection, and regular blood tests are required to monitor for side effects [1.6.2].

Biologic Therapies

Biologics are a class of therapy that targets specific proteins made by the immune system that cause inflammation [1.6.2]. They have become a standard of care for people with moderate to severe IBD who haven't responded to other treatments [1.2.1]. These medications are administered by IV infusion or injection [1.2.1]. There are several types:

Anti-TNF agents: These were the first biologics approved for IBD and work by blocking a protein called Tumor Necrosis Factor-alpha. Examples include infliximab (Remicade) and adalimumab (Humira) [1.2.1].
Integrin blockers: These drugs, like vedolizumab (Entyvio), work by preventing inflammatory white blood cells from entering the GI tract [1.2.1].
Interleukin blockers: Ustekinumab (Stelara) and risankizumab (Skyrizi) are examples that target interleukin-12 and interleukin-23, two proteins involved in the inflammatory process [1.2.1, 1.6.2].

Targeted Synthetic Small Molecules (JAK Inhibitors)

Janus kinase (JAK) inhibitors are a newer class of oral medication for moderate to severe IBD [1.3.3]. Drugs like tofacitinib (Xeljanz) and upadacitinib (Rinvoq) work by blocking specific inflammation signals within the body's cells [1.2.3, 1.8.4]. They offer the convenience of a pill and can act quickly [1.8.4]. However, they also carry risks, and the FDA has issued warnings for some, like tofacitinib, regarding an increased risk of serious heart-related conditions and cancer [1.2.2].

Comparison of IBD Medication Classes


Medication Class	How it Works	Common Uses	Administration	Key Considerations
Aminosalicylates (5-ASA)	Reduces inflammation in the lining of the GI tract [1.4.4].	Mild to moderate ulcerative colitis; maintaining remission [1.3.3].	Oral (pill), rectal suppository, or enema [1.4.1].	Generally well-tolerated; more effective for UC than Crohn's [1.4.4].
Corticosteroids	Broadly suppresses the immune system to reduce inflammation [1.5.3].	Short-term treatment of moderate to severe flares [1.5.4].	Oral, IV, or rectal [1.5.2].	Fast-acting but not for long-term use due to side effects [1.5.2].
Immunomodulators	Suppresses or regulates the immune system to decrease inflammation [1.3.2].	Long-term maintenance of remission; steroid-dependent disease [1.3.4].	Oral or injection [1.3.2].	Slow onset of action; requires monitoring for side effects [1.6.2].
Biologics	Targets specific proteins that cause inflammation [1.7.3].	Moderate to severe IBD, often when other treatments fail [1.2.1].	IV infusion or self-injection [1.2.1].	Highly effective but can increase infection risk [1.7.1].
JAK Inhibitors	Oral small molecules that block inflammation signals within cells [1.2.3].	Moderate to severe UC and Crohn's disease [1.8.4].	Oral (pill) [1.8.4].	Rapid onset, but potential for serious side effects requires careful monitoring [1.2.2, 1.8.4].

Conclusion

The answer to "what medication calms IBD?" is multifaceted and highly individualized. Treatment has evolved significantly, moving from a stepwise approach to earlier use of more targeted therapies like biologics and JAK inhibitors for moderate to severe disease [1.3.4, 1.9.4]. The goal is to achieve not just symptom relief but deep mucosal healing to prevent long-term complications [1.3.4]. Working closely with a gastroenterologist is crucial to find the right medication or combination of therapies that effectively controls inflammation, manages symptoms, and improves your quality of life.

For more information, you can visit the Crohn's & Colitis Foundation [1.13.1, 1.13.3].

Frequently Asked Questions

For mild to moderate ulcerative colitis, aminosalicylates (5-ASA) are often the first-line treatment. For mild Crohn's disease, the approach can vary, but may also involve 5-ASAs or targeted courses of corticosteroids [1.3.3, 1.3.4].

It varies. Corticosteroids can work quickly to relieve flare-ups [1.3.2]. Aminosalicylates may show improvement in a few weeks [1.4.1]. Immunomodulators are slower, potentially taking two to three months to be fully effective, while biologics can start working within days or weeks [1.3.4, 1.7.3].

Biologic medicines are considered very safe and effective for moderate to severe IBD [1.2.1]. However, because they target the immune system, they can increase the risk of certain infections. Your doctor will screen for underlying infections like tuberculosis before starting treatment [1.7.1].

The newest classes of medication for IBD include IL-23 inhibitors like risankizumab and guselkumab, and oral JAK inhibitors like upadacitinib [1.9.1, 1.12.2]. These are advanced therapies for moderate to severe disease.

No. Even when you are in remission and feel well, it is important to continue your maintenance medication as prescribed by your doctor to prevent future flare-ups and asymptomatic inflammation [1.4.4].

Short-term side effects can include mood swings, weight gain, and trouble sleeping. Long-term use is associated with more serious risks like osteoporosis, diabetes, cataracts, and an increased risk of infections [1.5.2, 1.11.2].

Immunomodulators, like azathioprine, broadly suppress or regulate the immune system [1.3.2]. Biologics are more targeted; they are proteins designed to block specific inflammatory pathways or molecules, such as TNF-alpha or integrins [1.2.1, 1.7.3].