Crohn's disease: Rational management

Michael F. Picco

Research output: Contribution to journalArticle

Abstract

Crohn's 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's 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; use azathioprine or 6-mercapfopurine to maintain remission in this setting.

Original languageEnglish (US)
Pages (from-to)185-197
Number of pages13
JournalConsultant
Volume42
Issue number2
StatePublished - 2002

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Disease Management
Crohn Disease
Mesalamine
Azathioprine
Fistula
Adrenal Cortex Hormones
Anti-Bacterial Agents
Metronidazole
Immunosuppressive Agents
Ciprofloxacin
Abscess
Abdominal Pain
Gastrointestinal Tract
Diarrhea
Fever
Therapeutics
Infliximab

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Picco, M. F. (2002). Crohn's disease: Rational management. Consultant, 42(2), 185-197.

Crohn's disease : Rational management. / Picco, Michael F.

In: Consultant, Vol. 42, No. 2, 2002, p. 185-197.

Research output: Contribution to journalArticle

Picco, MF 2002, 'Crohn's disease: Rational management', Consultant, vol. 42, no. 2, pp. 185-197.
Picco MF. Crohn's disease: Rational management. Consultant. 2002;42(2):185-197.
Picco, Michael F. / Crohn's disease : Rational management. In: Consultant. 2002 ; Vol. 42, No. 2. pp. 185-197.
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