News and controversy in inflammatory bowel disease treatment

Abstract

Background: The treatment of Inflammatory bowel disease comes from many years of esperience, clinical trials and mistakes.
Discussion: In patients with active Crohn disease steroids are considerated the first choice, but recently, the introduction of anti-TNF alfa agents (infliximab and adalimumab) has changed the protocols. Anti-TNF are also used for closing fistula after surgical curettage. An efficently preventive treatment of Crohn disease still has not been found but hight dose of oral salicylates, azatioprine or 6-MP and antibiotics might be useful. In severe attacks of ulcerative colitis, high dose iv treatment of steroids are required for a few days. Later on, a further treatment with anti- TNF might delay the need of surgery. In patients with mild to moderate attacks of ulcerative colitis, topical treatment is preferred, it consists of enemas, suppositories or foams containing 5-aminosalycilic acid, traditional steroids, topical active steroids. Topical treatment can be associated with oral steroids or oral salicylates. Oral salicylates or azatioprine are used for prevention of relaps.

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Published
2013-04-30
Info
Issue
Section
Chronic Diseases
Keywords:
Inflammatory bowel disease, Crohn disease, Ulcerative colitis, Fistula.
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  • PDF: 828
How to Cite
Straforini, G., Brugnera, R., Tambasco, R., Rizzello, F., Gionchetti, P., & Campieri, M. (2013). News and controversy in inflammatory bowel disease treatment. Italian Journal of Medicine, 3(3), 179-186. https://doi.org/10.4081/itjm.2009.179