MANAGEMENT OF INFLAMMATORY BOWEL-DISEASE

Patients with an inflammatory bowel disease, such as ulcerative coliti s or Crohn's disease, have recurrent symptoms with considerable morbid ity. Patient involvement and education are necessary components of eff ective management. Mild disease requires only symptomatic relief and d ietary manipulation. Mild to moderate disease can be managed with 5-am inosalicylic acid compounds, Including olsalazine and mesalamine. Mesa lamine enemas and suppositories are useful in treating proctosigmoidit is. Antibiotics such as metronidazole may be required in patients with Crohn's disease. Corticosteroids are beneficial in patients with more severe. symptoms, but side effects limit their use, particularly for chronic therapy. Immunosuppressant therapy may be not amenable to surg ery. Inflammatory bowel disease in pregnant women can be managed with 5-aminosalicylic acid compounds and corticosteroids. Since longstandin g inflammatory bowel disease (especially ulcerative colitis) is associ ated with an increased risk of colon cancer, periodic colonoscopy is w arranted.