Overview of the medical management of mild to moderate Crohn disease in adults
- Richard J Farrell, MD
Richard J Farrell, MD
- Gastroenterology Consultant, Connolly Hospital
- Senior Clinical Lecturer, Royal College of Surgeons in Ireland
- Mark A Peppercorn, MD
Mark A Peppercorn, MD
- Professor of Medicine
- Harvard Medical School
Crohn disease is an inflammatory condition of unknown etiology that can affect any portion of the gastrointestinal tract from the mouth to the perianal area. Its transmural inflammatory nature coupled with the variability of organ distribution gives rise to a spectrum of clinical presentations, each of which has to be considered separately in deciding upon the proper therapeutic approach. (See "Clinical manifestations, diagnosis and prognosis of Crohn disease in adults".)
Numerous therapies are used for the treatment of Crohn disease. The choice of therapy will vary depending upon the anatomic location of disease, the severity of disease, and the goal of therapy (ie, induction or maintenance of remission). Medical therapies that are commonly used for Crohn disease include:
●Oral 5-aminosalicylates (eg, sulfasalazine, mesalamine)
●Antibiotics (eg, ciprofloxacin, metronidazole)
●Conventional glucocorticoids (eg, prednisone)
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- DEFINITIONS OF SEVERITY
- STEP-UP VERSUS TOP-DOWN THERAPY
- TREATMENT OF ACTIVE DISEASE
- Oral lesions
- Gastroduodenal Crohn disease
- Ileitis and colitis
- - 5-ASA drugs
- - Antibiotics
- - Conventional glucocorticoids
- - Non-systemic glucocorticoids
- - Antidiarrheal medications
- - Probiotics
- - Lactose avoidance
- - Other dietary interventions
- Perianal disease
- MAINTENANCE THERAPY
- REFRACTORY CROHN DISEASE
- OTHER MANAGEMENT ISSUES
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS