MAINTENANCE OF SYMPTOMATIC REMISSION IN PATIENTS WITH CROHNS-DISEASE

Crohn's disease is a chronic inflammatory intestinal disorder characte rized in most patients by repeated episodes of diminished and exacerba ted symptoms. Recent controlled trials demonstrated that oral preparat ions of 5-aminosalicylic acid decrease recurrence rates by approximate ly 40% when administered long-term to patients with quiescent Crohn's disease. Orally administered corticosteroids, sulfasalazine, metronida zole, azathioprine, and cyclosporine have not proved of benefit in the prevention of recurrences of Crohn's disease. Nonetheless, corticoste roids, metronidazole, and azathioprine can control chronically active disease. Methotrexate may have some benefit in the treatment of active Crohn's disease, but its role in maintenance of remission has not bee n investigated. Elimination diets seem to prolong periods of symptomat ic remission. Further studies are needed to define subgroups of patien ts who are most likely to benefit from preventive therapy.