From the Research
For treating pleurisy in someone with Crohn's disease, acetaminophen (Tylenol) at 650-1000mg every 6 hours (not exceeding 4000mg daily) is recommended to manage pain and inflammation, as it is less likely to trigger Crohn's flares compared to nonsteroidal anti-inflammatory drugs (NSAIDs) 1, 2. When considering treatment options, it's crucial to weigh the potential benefits against the risks of exacerbating Crohn's disease.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, typically used for pleurisy, should be avoided due to their potential to trigger Crohn's flares 2.
- Acetaminophen is a safer alternative for managing pain and inflammation in patients with Crohn's disease, although it may not be as effective for inflammation as NSAIDs.
- If pain is severe, a short course of corticosteroids like prednisone may be appropriate, which can treat both the pleurisy and potentially benefit Crohn's inflammation.
- For infectious pleurisy, antibiotics would be needed based on the causative organism, commonly including azithromycin or amoxicillin-clavulanate.
- The underlying cause of pleurisy must be identified and treated specifically, and any medication regimen should be closely monitored by a healthcare provider familiar with the patient's Crohn's disease history, as treatment needs to balance addressing the pleurisy while avoiding exacerbation of Crohn's symptoms 3, 4. It's also important to note that certain medications used to treat Crohn's disease, such as mesalazine, can rarely cause pleuropericarditis, highlighting the need for careful monitoring and adjustment of treatment plans as necessary 5.