TREATMENT OF ADULT CROHN DISEASE

Corticosteroids are an efficient treatment for active Crohn's disease. The treatment has to be undertaken with a daily intake equivalent to 1 mg/kg per day of prednisolone for a 3 to 7 weeks period. Immunosuppr essive agents are indicated in case of corticodependency or in case of large intestinal resection. Artificial nutrition (enteral or parenter al) is proposed in corticoresistant forms, and is usually followed by an immunosuppressive therapy. Surgical management is reserved for comp lications, including resistance to all medical therapy. Surgical resec tion has to be limited in order to avoid a short bowel syndrom. Surger y should not be considered as the ideal therapy as it has been demonst rated that recurrence after surgery increases at distance. 5-aminosaly cilates compounds are an alternative therapy in mild attacks. Mesalazi ne may reduce the recurrence and could be considered as a possible mai ntenance treatment.