Copyright
©The Author(s) 2000.
World J Gastroenterol. Jun 15, 2000; 6(3): 315-323
Published online Jun 15, 2000. doi: 10.3748/wjg.v6.i3.315
Published online Jun 15, 2000. doi: 10.3748/wjg.v6.i3.315
Table 2 Management of active ileocaecal Crohn's disease. General measures, monitoring progress and supportive treatment are essentially as for ulcerative colitis
ESTABLISHING THE DIAGNOSIS, EXTENT/SITE AND SEVERITY |
- clinical evaluation |
- FBC, ESR, C-reactive protein, ferritin, folate, B12, albumin, LFTs, Ca, Mg, Zn |
- stool microscopy, culture, C difficile toxin |
- plain abdominal X-ray |
- consider colonoscopy and biopsy, small bowel barium radiology, ultrasound, CT, MRI, leucocyte scan |
SPECIFIC TREATMENT (separately or in combination) |
Medical - corticosteroids i.v. (hydrocortisone or methyl prednisolone) then p.o. (prednisolone or budesonide CR) |
- continue high dose mesalazine (Pentasa or Asacol) in patients already taking it; otherwise start when improvement begins |
- consider metronidazole, ciprofloxacin; also broad spectrum antibiotics for very sick febrile patients, or when infection/collection suspected |
- consider azathioprine/6-mercaptopurine (slow response) or anti TNF antibodies (infliximab) for steroid non-responders |
Nutritional - liquid formula diet |
Endoscopic - balloon dilatation |
Surgical - resection or stricturoplasty |
- Citation: Rampton DS. Management of difficult inflammatory bowel disease: where are we now? World J Gastroenterol 2000; 6(3): 315-323
- URL: https://www.wjgnet.com/1007-9327/full/v6/i3/315.htm
- DOI: https://dx.doi.org/10.3748/wjg.v6.i3.315