Abstract
Crohn disease can involve any part of the digestive tract; it can manifest as inflammatory (diarrhea, abdominal pain, and fever), penetrating (abscess or fistula), or stricturing (recurrent bowel obstruction) disease. Treatment is based on the location and activity of the disease. Mesalamine is recommended to induce and maintain remission in patients with mild to moderate nonpenetrating, nonstricturing disease. Antibiotics may be used as an alternative or adjunct to mesalamine; ciprofloxacin and metronidazole are helpful in fistulizing Crohn disease. For patients with moderate to severe disease, corticosteroids are recommended to induce remission; infliximab is an alternative for those with severe or refractory disease. Remission is then maintained with immunosuppressive therapy, not with corticosteroids. Fistulas are difficult to treat but may respond to antibiotics or azathioprine; however, closure rates are low. Infliximab produces higher closure rates; azathioprine or 6-mercaptopurine should be used to maintain remission in this setting.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 25-33 |
| Number of pages | 9 |
| Journal | Drug Benefit Trends |
| Volume | 14 |
| Issue number | SUPPL. A |
| State | Published - 2002 |
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Keywords
- Crohn disease
- Disease management
- Inflammatory bowel disease
- Patient care
ASJC Scopus subject areas
- Leadership and Management
- Pharmaceutical Science
Cite this
Crohn Disease : A rational approach to management. / Picco, Michael F.
In: Drug Benefit Trends, Vol. 14, No. SUPPL. A, 2002, p. 25-33.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Crohn Disease
T2 - A rational approach to management
AU - Picco, Michael F.
PY - 2002
Y1 - 2002
N2 - Crohn disease can involve any part of the digestive tract; it can manifest as inflammatory (diarrhea, abdominal pain, and fever), penetrating (abscess or fistula), or stricturing (recurrent bowel obstruction) disease. Treatment is based on the location and activity of the disease. Mesalamine is recommended to induce and maintain remission in patients with mild to moderate nonpenetrating, nonstricturing disease. Antibiotics may be used as an alternative or adjunct to mesalamine; ciprofloxacin and metronidazole are helpful in fistulizing Crohn disease. For patients with moderate to severe disease, corticosteroids are recommended to induce remission; infliximab is an alternative for those with severe or refractory disease. Remission is then maintained with immunosuppressive therapy, not with corticosteroids. Fistulas are difficult to treat but may respond to antibiotics or azathioprine; however, closure rates are low. Infliximab produces higher closure rates; azathioprine or 6-mercaptopurine should be used to maintain remission in this setting.
AB - Crohn disease can involve any part of the digestive tract; it can manifest as inflammatory (diarrhea, abdominal pain, and fever), penetrating (abscess or fistula), or stricturing (recurrent bowel obstruction) disease. Treatment is based on the location and activity of the disease. Mesalamine is recommended to induce and maintain remission in patients with mild to moderate nonpenetrating, nonstricturing disease. Antibiotics may be used as an alternative or adjunct to mesalamine; ciprofloxacin and metronidazole are helpful in fistulizing Crohn disease. For patients with moderate to severe disease, corticosteroids are recommended to induce remission; infliximab is an alternative for those with severe or refractory disease. Remission is then maintained with immunosuppressive therapy, not with corticosteroids. Fistulas are difficult to treat but may respond to antibiotics or azathioprine; however, closure rates are low. Infliximab produces higher closure rates; azathioprine or 6-mercaptopurine should be used to maintain remission in this setting.
KW - Crohn disease
KW - Disease management
KW - Inflammatory bowel disease
KW - Patient care
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UR - http://www.scopus.com/inward/citedby.url?scp=0036231402&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:0036231402
VL - 14
SP - 25
EP - 33
JO - Drug Benefit Trends
JF - Drug Benefit Trends
SN - 1080-5826
IS - SUPPL. A
ER -