Which Crohn’s Disease Treatment Has the Least Side Effects? What to Consider

If you are comparing Crohn’s medications, effectiveness is probably only one part of the question.

You may also be wondering: Which treatment has the least side effects?

It is a reasonable question. Crohn’s treatment can continue for years, and reading a long list of possible side effects can make even an effective medicine feel intimidating.

But there is an important distinction to make from the start.

There is no single Crohn’s medication with the fewest side effects for everyone.

Different treatments have different risks. Your age, other health conditions, infection history, previous medications, pregnancy plans, and the activity of your Crohn’s can all affect which risks matter most.

And there is another side of the equation: leaving Crohn’s inflammation inadequately controlled has risks too.

So instead of asking only, “Which medicine has the shortest side-effect list?”, it can be more useful to ask:

“Which treatment gives me the right balance of effectiveness and safety?”

That is a conversation to have with your healthcare team.

If you are trying to make sense of the options in between appointments, mama health can help you understand prescriptions, labs, and reports, ask questions about Crohn’s treatments, find specialists and care near you, and learn from the experiences of other people living with the same condition.


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What can a colonoscopy show in Crohn’s disease?

A colonoscopy allows a doctor to look directly at the inside of your colon and usually the terminal ileum, the last part of the small intestine.

During the procedure, a flexible tube with a camera is passed through the rectum and around the colon.

The doctor looks at the bowel lining for signs of inflammation and other abnormalities.

In Crohn’s disease, this can include:

• redness and swelling
• ulcers
• patchy areas of inflammation
• changes to the normal surface of the bowel
• narrowing
• bleeding or fragile tissue
• inflammation in the terminal ileum

The doctor can also take biopsies, which are tiny tissue samples examined under a microscope.

This is important because what the bowel looks like through the camera and what the tissue looks like under a microscope provide different information.

What does Crohn’s disease look like on a colonoscopy?

Crohn’s can have several characteristic appearances, but there is no single colonoscopy finding that appears in everyone with the condition.

One feature doctors may see is patchy inflammation.

Unlike inflammation that runs continuously along the bowel, Crohn’s can affect one area while leaving another area relatively normal. These separated areas are sometimes called skip lesions.

Doctors may also see ulcers.

These can range from small superficial ulcers to larger or deeper areas of ulceration.

More pronounced Crohn’s inflammation can sometimes create a cobblestone appearance, where areas of swollen tissue are separated by deeper ulcers.

Inflammation around the terminal ileum is also common in Crohn’s.

These findings can support a diagnosis, but they are not interpreted on their own. Your gastroenterologist will consider the overall pattern and other test results before deciding what the findings mean. [1,2]

What does “ileitis” mean on a colonoscopy report?

Ileitis means inflammation of the ileum, the final part of the small intestine.

The terminal ileum is particularly relevant in Crohn’s because it is a common location for the disease.

If your report says terminal ileitis, it means the doctor saw evidence of inflammation in this area.

It does not, by itself, mean you definitely have Crohn’s disease.

Ileitis can have causes other than Crohn’s, including certain infections and medication-related injury. The appearance of the inflammation, biopsy findings, symptoms, medical history, and other investigations help doctors work out the cause. [1,2]

So if your report says “ileitis,” the useful question for your gastroenterologist is:

“What do you think is causing the inflammation?”

rather than assuming the word itself confirms a diagnosis.

What do ulcers mean on a Crohn’s colonoscopy?

Ulcers are areas where inflammation has damaged the surface of the bowel lining.

They can occur in Crohn’s disease.

Your report may describe them in different ways, including aphthous ulcers, superficial ulcers, or deep ulcers.

Aphthous ulcers are small areas of ulceration. More active or severe inflammation can be associated with larger or deeper ulcers.

The presence, size, depth, and extent of ulcers can contribute to a doctor's assessment of disease activity.

But an ulcer is not a diagnosis by itself.

The pattern matters.

Your gastroenterologist will consider where the ulcers are, what the surrounding bowel looks like, what the biopsies show, and whether the overall picture is consistent with Crohn’s.

What does “cobblestoning” mean in Crohn’s disease?

Cobblestoning describes a particular appearance of the bowel lining that can occur in Crohn’s disease.

Deep ulcers can intersect with areas of swollen or relatively preserved tissue, creating a surface that resembles cobblestones.

It is a classic description associated with Crohn’s.

Seeing the word on a report can sound alarming, but it should not be interpreted in isolation as a prediction of what will happen next.

It describes an appearance.

Your healthcare team still needs to consider how much of the bowel is affected, how active the disease appears overall, whether complications are present, and what other tests show.

What are “skip lesions” on a colonoscopy?

Skip lesions are areas of inflamed bowel separated by areas that appear relatively unaffected.

This patchy pattern is characteristic of Crohn’s disease.

For example, the doctor might see inflammation in the terminal ileum and another section of the colon while the bowel between those areas looks relatively normal.

This is different from the continuous pattern of inflammation more typically associated with ulcerative colitis.

However, real-world appearances are not always textbook-perfect.

That is another reason doctors use colonoscopy alongside biopsies and other information rather than relying on one visual feature to distinguish inflammatory bowel diseases. [1,2]

What does a stricture mean on your colonoscopy report?

A stricture is an area where the bowel has become narrowed.

Crohn’s can lead to narrowing because of active inflammation, longer-term scarring, or a combination of both.

During a colonoscopy, the doctor may see a narrowed area or find that the scope cannot safely pass through part of the bowel.

A stricture can be important because significant narrowing can make it harder for food and bowel contents to pass through.

But a colonoscopy cannot always tell doctors everything they need to know about a stricture.

Imaging such as magnetic resonance enterography (MRE), intestinal ultrasound, or CT enterography may provide more information about the bowel wall and areas beyond the reach of the colonoscope. [2]

If a stricture appears on your report, ask:

“How significant is the narrowing, and do I need another test to assess it?”

If you develop severe abdominal pain, persistent vomiting, a swollen abdomen, or an inability to pass stool or gas, seek urgent medical assessment because these can occur with bowel obstruction.

Why are biopsies taken during a Crohn’s colonoscopy?

Biopsies let a pathologist examine tiny samples of bowel tissue under a microscope.

This can reveal changes that are not obvious from the colonoscopy camera alone.

Biopsies may be taken from inflamed areas and from areas that appear normal.

When Crohn’s is being investigated, the pathology findings can help doctors understand the type and pattern of inflammation and distinguish between possible causes.

You may see terminology such as:

• active inflammation
• chronic inflammation
• chronic active inflammation
• crypt changes
• granulomas
• no significant abnormality

These words need context.

For example, chronic inflammation generally indicates changes associated with inflammation that has been present over time. “Active” refers to features of current inflammatory activity.

Neither phrase, on its own, tells you everything about the severity or future course of your Crohn’s.

What does a granuloma mean on a Crohn’s biopsy?

A granuloma is a particular collection of immune cells that can sometimes be seen under the microscope in Crohn’s disease.

When an appropriate type of granuloma is found in the right clinical context, it can support a Crohn’s diagnosis.

But there are two important things to know.

First, many people with Crohn’s do not have granulomas on their biopsies.

Not finding one does not rule Crohn’s out.

Second, granulomas can have other causes, so the pathologist and gastroenterologist still interpret the finding in the context of the whole investigation.

Do not worry if your biopsy report does not mention granulomas.

They are one possible clue, not a requirement for Crohn’s disease.

Can a colonoscopy confirm a Crohn’s disease diagnosis?

A colonoscopy with biopsies is an important part of diagnosing Crohn’s disease, but there is no single test that confirms every case.

Doctors generally make a Crohn’s diagnosis using a combination of information.

That can include:

• your symptoms and medical history
• physical examination
• blood tests
• stool tests
• ileocolonoscopy and biopsies
• imaging of the small intestine

Current ECCO diagnostic guidance recommends ileocolonoscopy with biopsies together with intestinal imaging as first-line investigations in people with suspected inflammatory bowel disease. [2]

That is because Crohn’s can occur anywhere in the digestive tract and can affect the bowel in ways that colonoscopy alone cannot fully assess.

So you may finish a colonoscopy and still be asked to have another test.

That does not necessarily mean the colonoscopy was inconclusive or unsuccessful.

The tests answer different questions.

Can you have Crohn’s disease if your colonoscopy is normal?

Yes. A normal colonoscopy does not always exclude Crohn’s disease.

A standard colonoscopy examines the colon and usually the terminal ileum.

But Crohn’s can affect other parts of the small intestine that the scope cannot reach.

If your symptoms, blood tests, stool tests, or other information continue to raise concern about Crohn’s despite a normal colonoscopy, your healthcare team may consider additional testing.

This can include MRE, intestinal ultrasound, or capsule endoscopy in selected situations. [2]

Capsule endoscopy involves swallowing a small camera that takes images as it travels through the digestive tract.

It is not appropriate for everyone—for example, suspected narrowing can affect whether capsule endoscopy is suitable—so the choice of test depends on the individual situation.

What does a normal colonoscopy mean if you already have Crohn’s?

If you have established Crohn’s and your colonoscopy shows little or no visible inflammation, that can be encouraging.

It may indicate endoscopic remission or healing, depending on the findings and terminology used.

This matters because modern Crohn’s treatment aims beyond symptom control alone.

You may feel well while inflammation remains. Conversely, you can have some digestive symptoms even when Crohn’s inflammation has improved considerably.

That is why colonoscopy can sometimes be used to assess how well treatment is controlling the disease. [2,3]

A reassuring colonoscopy does not mean Crohn’s has been cured.

Crohn’s is a chronic condition, and maintenance treatment and follow-up may still be needed.

Do not stop medication because a colonoscopy looks good unless your healthcare team has specifically discussed changing your treatment.

What does SES-CD mean on a Crohn’s colonoscopy report?

SES-CD stands for Simple Endoscopic Score for Crohn’s Disease.

It is one system used to describe the amount of Crohn’s activity seen during ileocolonoscopy.

The score considers features including:

• the size of ulcers
• how much of the bowel surface is ulcerated
• how much of the bowel surface is affected
• whether there is narrowing

These features are assessed in different sections of the bowel.

You may see an SES-CD number in your report, particularly in specialist IBD care or when disease activity is being assessed systematically.

The number should not be interpreted as a standalone verdict on how “bad” your Crohn’s is.

Your healthcare team considers it alongside your symptoms, previous colonoscopies, biomarkers, imaging, treatment, and overall clinical situation.

If you see an unfamiliar score in your report, mama health can help you understand what the terminology refers to, while your gastroenterologist can explain what your individual score means medically.

What does “mild,” “moderate,” or “severe” inflammation mean?

These words describe the degree of inflammation seen or reported, but their exact meaning depends on the context in which they are used.

A colonoscopy report may describe a particular section of bowel as mildly, moderately, or severely inflamed.

That is not necessarily identical to describing your overall Crohn’s disease as mild, moderate, or severe.

Your overall situation can depend on much more than the appearance of one area.

Doctors may consider:

• how much bowel is affected
• the depth of ulcers
• symptoms
• blood and stool markers
• strictures, fistulas, or abscesses
• nutritional effects
• previous disease behavior
• imaging findings

So if your report says “mild inflammation,” do not assume that automatically tells you what treatment you need.

And if it says “severe,” do not assume the word predicts your long-term future.

Ask how the finding fits into the bigger picture.

Why might your colonoscopy results and symptoms not match?

Because symptoms and Crohn’s inflammation do not always move together.

You can have substantial symptoms without a large amount of visible inflammation.

You can also feel relatively well despite inflammation still being present.

This is why modern Crohn’s follow-up does not rely only on how you feel. Objective information from biomarkers, imaging, and endoscopy can help healthcare teams assess disease activity and treatment response. [2,3]

If your colonoscopy looks reassuring but you are still having diarrhea, pain, or bloating, that does not mean your symptoms are imaginary.

Your healthcare team may consider other explanations and decide whether further assessment is needed.

Likewise, if you feel well but your colonoscopy still shows inflammation, your doctor may want to discuss whether the current treatment is achieving its intended target.

What happens after a colonoscopy suggests Crohn’s disease?

The next step depends on how complete the diagnostic picture is.

If biopsies were taken, you may need to wait for the pathology report.

Your healthcare team may also want additional blood tests, stool tests, or imaging.

Once the available information has been reviewed, your gastroenterologist can discuss whether the findings support a Crohn’s diagnosis and what they mean for you.

If Crohn’s is diagnosed, the next questions usually become:

Where is the disease?

How active is it?

Are there complications?

What treatment makes sense?

Our guide to what happens after a new Crohn’s diagnosis explains that next stage in more detail.

What happens after a colonoscopy if you already have Crohn’s?

If the colonoscopy was performed to assess established Crohn’s, what happens next depends on what it shows.

If inflammation has improved substantially, your healthcare team may continue the current maintenance strategy.

If significant inflammation remains, they may consider whether the current treatment is achieving its goal.

That does not mean one abnormal colonoscopy result automatically leads to a new medicine.

Your gastroenterologist may consider your symptoms, biomarkers, imaging, how long you have been taking the treatment, previous response, and other factors before deciding what to do.

If treatment changes are being discussed, our guide to Crohn’s disease treatment options explains the main medication groups and the questions worth asking.

What should you ask your doctor about your Crohn’s colonoscopy results?

You do not need to understand every line of the report.

A few questions can make the findings much clearer:

• Which parts of my bowel did you examine?
• Where did you find inflammation?
• Was my terminal ileum affected?
• Were there ulcers?
• Did you see any narrowing?
• Were you able to examine the whole colon and terminal ileum?
• Where were biopsies taken?
• What did the biopsies show?
• Do these results support a Crohn’s diagnosis?
• Do I need imaging of the small intestine?
• If I already have Crohn’s, has the inflammation improved since my previous assessment?
• What happens next?
• Do these findings change my treatment?

If your doctor uses a term you do not understand, ask them to explain it.

Medical reports are written primarily to communicate between healthcare professionals. You are not failing some test by finding them difficult to read.

How can mama health help you understand a colonoscopy report?

A colonoscopy report can arrive long before you have had a chance to discuss every line with your gastroenterologist.

That gap can be uncomfortable.

You might see terminal ileitis and wonder whether it confirms Crohn’s. You might see ulceration and worry about what it means. Or your report might contain an SES-CD score without explaining what the letters stand for.

With mama health, you can:

• Understand your medical reports. Make unfamiliar terms such as ileitis, ulceration, biopsies, strictures, and SES-CD easier to understand.
• Ask questions about Crohn’s. Get clear information about terminology and the tests commonly used when Crohn’s is investigated or followed up.
• Learn from people living with Crohn’s. Explore what other people experienced around colonoscopy preparation, waiting for results, follow-up appointments, and ongoing care.
• Find specialists and care near you. Explore relevant gastroenterology and IBD care when you want to understand what specialist support is available.

mama health does not determine whether a colonoscopy confirms Crohn’s disease, assess how severe your disease is, or decide whether treatment should change.

Those conclusions belong with your healthcare team.

But understanding the words on the page can make the conversation with them much easier.

What should you remember when reading your Crohn’s colonoscopy results?

A colonoscopy report is one part of the story.

Words such as ulcer, ileitis, stricture, or cobblestoning can sound frightening when you see them without context.

Try not to turn one word into a conclusion.

An abnormal finding does not tell you everything about how your Crohn’s will behave.

A normal-looking colonoscopy does not always exclude disease elsewhere in the digestive tract.

And if you already have Crohn’s, a good colonoscopy result does not necessarily mean treatment and follow-up are finished.

Instead, bring the report back to three questions:

What did you find?

How does it fit with my other results?

What happens next?

Those answers are much more useful than trying to interpret the report one unfamiliar word at a time.

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Which Crohn’s treatment has the least side effects?

There is no medically accurate way to name one Crohn’s treatment as having the fewest side effects for every patient.

Part of the problem is what we mean by “side effects.”

A headache after an infusion is very different from a serious infection. A medicine may cause relatively common mild effects but have a low rate of serious complications. Another may have a different set of rare but important risks.

Then there is your own medical history.

A risk that matters a great deal for one person may be much less important for another.

This is why Crohn’s treatment is chosen by looking at both effectiveness and safety in the individual patient, rather than ranking medicines from safest to most dangerous.

Current Crohn’s treatment options include corticosteroids, immunomodulators, biologics targeting different inflammatory pathways, and targeted oral medicines. Which medicine is appropriate depends on your Crohn’s and your individual circumstances. [1–3]

Do steroids have more side effects than other Crohn’s treatments?

Steroids can cause significant side effects when they are used repeatedly or for long periods, which is why they are generally intended for short-term treatment of active Crohn’s rather than long-term maintenance. [1,2]

Corticosteroids include medicines such as prednisolone and budesonide.

They can be very useful. If Crohn’s is active, steroids can bring inflammation down relatively quickly.

The problem comes with continued exposure.

Depending on the medicine, dose, and length of treatment, corticosteroids can contribute to problems such as infections, osteoporosis, changes in blood sugar, weight gain, mood changes, sleep problems, high blood pressure, and eye problems.

This explains something that can otherwise seem confusing.

You may feel much better after starting steroids and still hear your gastroenterologist talking about getting you off them.

That is not because the medicine failed.

The aim is generally to use steroids when appropriate to bring inflammation under control, then use a more suitable strategy for maintaining remission. NIDDK specifically describes corticosteroids as medicines that should only be used short term in Crohn’s disease. [1]

Never stop or reduce a prescribed steroid suddenly without discussing it with your healthcare team.

Which Crohn’s biologics have fewer side effects?

Several biologics used for Crohn’s disease have reassuring safety profiles, but there is not enough evidence to say that one biologic always causes the fewest side effects.

The differences are still worth understanding.

What should you know about vedolizumab?

Vedolizumab works differently from many other Crohn’s treatments because its action is focused on immune-cell movement into the gut.

That gut-selective mechanism is one reason its safety profile often comes up when doctors and patients discuss treatment choices.

In the trials assessed by ECCO, vedolizumab had similar overall rates of adverse events and serious adverse events to placebo. Current ECCO infection guidance also notes low rates of opportunistic infections, although infections can still occur. [2,4]

That does not mean vedolizumab is side-effect free or automatically the safest Crohn’s treatment for you.

Safety is only one consideration. Your healthcare team also needs to consider whether a treatment is likely to control your particular Crohn’s effectively.

What should you know about ustekinumab?

Ustekinumab is another biologic with reassuring safety data.

It targets inflammatory pathways involving interleukin-12 and interleukin-23.

In a head-to-head study of people with moderate-to-severe Crohn’s who had not previously used biologics, ustekinumab and adalimumab had broadly similar overall safety outcomes. Infections were numerically less common with ustekinumab, although serious infection rates were similar. [2]

Longer-term data have also been reassuring regarding opportunistic infections. [4]

Again, this does not establish ustekinumab as the Crohn’s medicine with the “least side effects.” It tells us something more useful: it has an established safety profile that can be considered alongside its effectiveness and your individual risk factors.

What should you know about risankizumab?

Risankizumab targets interleukin-23 and is recommended by ECCO for both bringing moderate-to-severe Crohn’s into remission and maintaining remission. [2]

Its clinical trials have also produced reassuring safety findings.

In the induction studies reviewed by ECCO, serious adverse events and serious infections were not increased compared with placebo. During maintenance, serious adverse events and serious infections were similar across study groups. [2]

Long-term infection data for the wider IL-23 class are also reassuring so far, with low rates of opportunistic infections reported in extension studies. [4]

As with every Crohn’s medication, however, “reassuring safety data” is not the same as “no risk.”

Do anti-TNF medicines have more side effects?

Anti-TNF medicines such as infliximab and adalimumab have been used to treat Crohn’s disease for many years.

Because TNF plays an important role in the immune system, blocking it can increase susceptibility to certain infections. This is one reason people are commonly screened for infections such as tuberculosis and hepatitis B before starting treatment.

Other potential problems can include injection or infusion reactions, and there are additional uncommon risks that your healthcare team can discuss with you based on the particular medicine and your health history.

But it would be misleading to conclude that anti-TNF treatment is simply “worse” because another medicine appears to have a reassuring safety profile.

Anti-TNF medicines are highly established Crohn’s treatments and can be particularly important in certain disease patterns. For example, infliximab remains a major treatment option for fistulizing Crohn’s disease.

A treatment with a theoretically attractive safety profile is not useful if it does not adequately control the disease you actually have.

Does upadacitinib have more side effects?

Upadacitinib has a different safety profile from biologic medicines, which means doctors consider some additional risks when deciding whether it is appropriate.

Upadacitinib is an oral JAK inhibitor used for moderate-to-severe Crohn’s disease. ECCO recommends it as an option for both inducing and maintaining remission. [2]

One notable risk is herpes zoster, or shingles.

In the maintenance trials reviewed by ECCO, herpes zoster occurred in 4.0% of people receiving 15 mg upadacitinib and 7.2% receiving 30 mg, compared with 4.7% in the placebo group. [2]

JAK inhibitors also carry important warnings and precautions around issues such as serious infection, blood clots, cardiovascular events, and malignancy, particularly for some higher-risk groups.

This does not mean upadacitinib is a “bad” treatment.

It can be an effective Crohn’s medicine. The point is that its risks need to be considered in the context of who is taking it.

Your age, smoking history, cardiovascular risk, history of blood clots, infection history, and other factors may influence the conversation.

That is a good example of why there cannot be one universal answer to “Which Crohn’s treatment has the least side effects?”

What about azathioprine and other immunomodulators?

Older immunomodulators such as azathioprine, mercaptopurine, and methotrexate have their own benefits and safety considerations.

Thiopurines such as azathioprine can affect the bone marrow and liver and increase susceptibility to infection. They are also associated with small increases in the risk of certain cancers, including lymphoma and some skin cancers, with risk depending on factors such as age and treatment context.

That does not mean everyone taking a thiopurine will develop these problems. It means the risks need to be weighed against the potential benefits and monitored appropriately.

Blood testing is therefore an important part of treatment when some immunomodulators are used.

The role of these medicines has also changed as more biologic and targeted therapies have become available.

If you are taking an older Crohn’s medication and wondering why you have not been moved to something newer, do not stop it yourself. Ask your gastroenterologist what role the medicine is playing in your current treatment and whether alternatives would make sense for you.

Does the way you take a Crohn’s medicine affect its side effects?

A tablet is not automatically safer than an injection, and an injection is not automatically safer than an infusion.

How a medicine enters your body tells you relatively little about its overall risk.

Some people understandably prefer tablets because they seem less intimidating. Others prefer an infusion because treatment happens less frequently or because they like receiving it in a healthcare setting. Some prefer an injection they can administer at home.

Those preferences matter.

But when comparing safety, focus on the medicine and how it works, rather than assuming its delivery method tells you how strong or risky it is.

Why do Crohn’s medications have such frightening side-effect lists?

Medication information includes possible adverse effects even when they are uncommon or rare.

That can make reading the leaflet for a new Crohn’s treatment alarming.

It is also easy to lose the difference between possible and probable.

A listed side effect does not mean you will experience it.

The questions that often matter more are:

• How common is this side effect?
• How serious is it?
• Do I have factors that increase my risk?
• Can we screen for it beforehand?
• Can it be monitored?
• What should I do if it happens?
• How does this risk compare with leaving my Crohn’s inadequately controlled?

If you have received a new prescription and the terminology is difficult to understand, mama health can help you understand your prescription and medical information in clearer language. Your healthcare team can then explain how those risks apply specifically to you.

Is taking no medication safer than taking Crohn’s medicine?

Not necessarily.

It is understandable to look at a medication's possible side effects and think that taking nothing must be the safer option.

But untreated or inadequately controlled Crohn’s inflammation has risks of its own.

Ongoing inflammation can contribute to bowel damage and complications such as strictures, fistulas, abscesses, and the need for surgery. The purpose of treatment is therefore not simply to control symptoms. It is also to control the underlying inflammatory disease. [1,2]

This is why treatment decisions involve balancing two sets of risks:

the risks associated with the treatment and the risks associated with Crohn’s itself.

That balance will not be identical for everyone.

Does someone else's experience tell you which medicine will have fewer side effects?

Other people's experiences can tell you what taking a treatment felt like for them. They cannot predict exactly what will happen to you.

One person may tell you they had no noticeable side effects from a biologic. Someone else may have stopped the same medicine because of an adverse effect.

Both experiences can be real.

Neither establishes what the medicine will do in your body.

That does not make patient experiences unhelpful.

On mama health, you can learn from other people living with the same condition, including the questions they had when starting treatment and the experiences they had with injections, infusions, tablets, tests, and everyday life on medication.

The important thing is to use those experiences as context rather than medical evidence about what you should take.

If someone's story raises a question or concern, bring it to your healthcare team.

What should you ask your doctor about Crohn’s medication side effects?

Instead of asking only which medicine has the fewest side effects, ask about the risks that actually matter for you.

Useful questions include:

• What are the most common side effects of this treatment?
• Which serious side effects are possible, even if they are rare?
• Are any of those risks higher because of my age or medical history?
• Do I need infection screening before I start?
• Do I need any vaccinations first?
• What blood tests or other monitoring will I need?
• Are there symptoms that mean I should contact you quickly?
• How does the safety of this option compare with the alternatives that could treat my Crohn’s?
• What are the risks if my Crohn’s remains uncontrolled?
• What happens if I cannot tolerate this medicine?

If you receive blood tests or reports during treatment and the terminology is difficult to follow, mama health can help you understand your labs and reports in more accessible language.

And if you want another specialist opinion or need to understand what IBD care is available around you, mama health can help you find specialists and care near you.

So, what is the safest Crohn’s medication?

There is no single Crohn’s medication that can accurately be called the safest for everyone.

Some treatments do have particularly reassuring safety data.

Vedolizumab's gut-selective mechanism and low observed rates of opportunistic infections can make its safety profile attractive in some situations. Ustekinumab and IL-23 treatments such as risankizumab also have reassuring safety evidence. [2,4]

But those facts cannot be separated from effectiveness.

Your healthcare team needs to consider whether a medicine is likely to control your Crohn’s, what risks it carries for you, and what alternatives are available.

The “best” Crohn’s medicine is therefore not necessarily the one with the shortest list of side effects.

It is the treatment that offers an appropriate balance between controlling the disease and minimizing risks for your individual situation.

That gives you three useful questions to take into your next appointment:

• What are the main risks of this treatment for me?
• How do those risks compare with my other options?
• What are the risks if my Crohn’s is not adequately controlled?

Those questions can tell you far more than a side-effect list alone.