NEWER TREATMENTS FOR INFLAMMATORY BOWEL-DISEASE

inflammatory bowel disease represents chronic idiopathic disorders whi ch involve either the colon exclusively (ulcerative colitis) of any pa rt of the gastrointestinal tract (Crohn's disease). The course of thes e entities is typified by periods of symptomatic exacerbation interspe rsed with clinical remissions. Management is based upon regimens which decrease mucosal inflammation. Colonic disease distal to the splenic flexure may be treated with topical therapy, but other regions general ly necessitate oral therapy. Currently used medications include the am inosalicylates, glucocorticoids, antibiotics and immunomodulators. The immunomodulator class of medications includes azathioprine, 6-mercapt opurine, cyclosporine A and methotrexate. Newer agents include short-c hain fatty acids, omega-3 fatty acids and antibodies directed to tumor necrosis factor. Medical management also occasionally involves optimi zing nutritional status with the addition of elemental diets or total parenteral nutrition. Management of specific clinical presentations is discussed.