Inflammatory bowel disease: Keys to diagnosis and treatment

Darrell S. Pardi, William J. Tremaine

Research output: Contribution to journalArticle

Abstract

Most patients with ulcerative colitis present with mild or moderate disease characterized by bloody diarrhea; one third or fewer present with severe disease. About 10% of patients have extraintestinal manifestations, including arthralgias, back pain, and skin or eye disorders at initial diagnosis. In Crohn's disease, abdominal pain, diarrhea, and weight loss are common. Postprandial pain with distention, nausea, and vomiting may indicate small-bowel obstruction. Abdominal films are indicated if bowel obstruction, toxic megacolon, or perforation is suspected. Mesalamine or hydrocortisone enemas may be sufficient to control mild ulcerative colitis, while oral aminosalicylates or corticosteroids may be required for more severe disease. Metronidazole may be effective in patients with mild Crohn's disease who do not respond to sulfasalazine or mesalamine; moderate to severe disease is best treated with prednisone, with the addition of sulfasalazine or mesalamine - or an immune modifier, such as azathioprine, 6-mercaptopurine, or methotrexate - to maintain remission.

Original languageEnglish (US)
Pages (from-to)87-98
Number of pages12
JournalConsultant
Volume38
Issue number1
StatePublished - Jan 1998

Fingerprint

Inflammatory Bowel Diseases
Mesalamine
Sulfasalazine
Ulcerative Colitis
Crohn Disease
Diarrhea
Toxic Megacolon
6-Mercaptopurine
Enema
Metronidazole
Azathioprine
Arthralgia
Therapeutics
Motion Pictures
Back Pain
Prednisone
Methotrexate
Nausea
Abdominal Pain
Vomiting

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pardi, D. S., & Tremaine, W. J. (1998). Inflammatory bowel disease: Keys to diagnosis and treatment. Consultant, 38(1), 87-98.

Inflammatory bowel disease : Keys to diagnosis and treatment. / Pardi, Darrell S.; Tremaine, William J.

In: Consultant, Vol. 38, No. 1, 01.1998, p. 87-98.

Research output: Contribution to journalArticle

Pardi, DS & Tremaine, WJ 1998, 'Inflammatory bowel disease: Keys to diagnosis and treatment', Consultant, vol. 38, no. 1, pp. 87-98.
Pardi DS, Tremaine WJ. Inflammatory bowel disease: Keys to diagnosis and treatment. Consultant. 1998 Jan;38(1):87-98.
Pardi, Darrell S. ; Tremaine, William J. / Inflammatory bowel disease : Keys to diagnosis and treatment. In: Consultant. 1998 ; Vol. 38, No. 1. pp. 87-98.
@article{a220fc20be7b4fe08f941d8a9b67aaaf,
title = "Inflammatory bowel disease: Keys to diagnosis and treatment",
abstract = "Most patients with ulcerative colitis present with mild or moderate disease characterized by bloody diarrhea; one third or fewer present with severe disease. About 10{\%} of patients have extraintestinal manifestations, including arthralgias, back pain, and skin or eye disorders at initial diagnosis. In Crohn's disease, abdominal pain, diarrhea, and weight loss are common. Postprandial pain with distention, nausea, and vomiting may indicate small-bowel obstruction. Abdominal films are indicated if bowel obstruction, toxic megacolon, or perforation is suspected. Mesalamine or hydrocortisone enemas may be sufficient to control mild ulcerative colitis, while oral aminosalicylates or corticosteroids may be required for more severe disease. Metronidazole may be effective in patients with mild Crohn's disease who do not respond to sulfasalazine or mesalamine; moderate to severe disease is best treated with prednisone, with the addition of sulfasalazine or mesalamine - or an immune modifier, such as azathioprine, 6-mercaptopurine, or methotrexate - to maintain remission.",
author = "Pardi, {Darrell S.} and Tremaine, {William J.}",
year = "1998",
month = "1",
language = "English (US)",
volume = "38",
pages = "87--98",
journal = "Consultant",
issn = "0010-7069",
publisher = "Cliggott Publishing Co.",
number = "1",

}

TY - JOUR

T1 - Inflammatory bowel disease

T2 - Keys to diagnosis and treatment

AU - Pardi, Darrell S.

AU - Tremaine, William J.

PY - 1998/1

Y1 - 1998/1

N2 - Most patients with ulcerative colitis present with mild or moderate disease characterized by bloody diarrhea; one third or fewer present with severe disease. About 10% of patients have extraintestinal manifestations, including arthralgias, back pain, and skin or eye disorders at initial diagnosis. In Crohn's disease, abdominal pain, diarrhea, and weight loss are common. Postprandial pain with distention, nausea, and vomiting may indicate small-bowel obstruction. Abdominal films are indicated if bowel obstruction, toxic megacolon, or perforation is suspected. Mesalamine or hydrocortisone enemas may be sufficient to control mild ulcerative colitis, while oral aminosalicylates or corticosteroids may be required for more severe disease. Metronidazole may be effective in patients with mild Crohn's disease who do not respond to sulfasalazine or mesalamine; moderate to severe disease is best treated with prednisone, with the addition of sulfasalazine or mesalamine - or an immune modifier, such as azathioprine, 6-mercaptopurine, or methotrexate - to maintain remission.

AB - Most patients with ulcerative colitis present with mild or moderate disease characterized by bloody diarrhea; one third or fewer present with severe disease. About 10% of patients have extraintestinal manifestations, including arthralgias, back pain, and skin or eye disorders at initial diagnosis. In Crohn's disease, abdominal pain, diarrhea, and weight loss are common. Postprandial pain with distention, nausea, and vomiting may indicate small-bowel obstruction. Abdominal films are indicated if bowel obstruction, toxic megacolon, or perforation is suspected. Mesalamine or hydrocortisone enemas may be sufficient to control mild ulcerative colitis, while oral aminosalicylates or corticosteroids may be required for more severe disease. Metronidazole may be effective in patients with mild Crohn's disease who do not respond to sulfasalazine or mesalamine; moderate to severe disease is best treated with prednisone, with the addition of sulfasalazine or mesalamine - or an immune modifier, such as azathioprine, 6-mercaptopurine, or methotrexate - to maintain remission.

UR - http://www.scopus.com/inward/record.url?scp=0032324311&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032324311&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:0032324311

VL - 38

SP - 87

EP - 98

JO - Consultant

JF - Consultant

SN - 0010-7069

IS - 1

ER -