INFLAMMATORY BOWEL DISEASES - 2 - CURRENT AND FUTURE THERAPEUTIC OPTIONS

The exact source of interference with the normal protective immune res ponse in patients with inflammatory bowel disease remains unclear. Inf ectious causes have been proposed, and the increased incidence among f amily members indicates genetic predisposition. No matter what the pat hogenesis may be, the disease is chronic, recurrent, and destructive i n many cases. Conventional therapy with 5-ASAs, corticosteroids, immun omodulating agents, methotrexate, and antibiotics often offers relief. However, adverse effects accompany long-term use of many of these age nts, so follow-up is important. Much investigation of alternative meth ods is under way, and anecdotal as well as published experience sugges ts benefits in at least some patients. Because of the chronic nature o f their condition, patients with inflammatory bowel disease often beco me quite sophisticated in their understanding of treatment methods. Th erefore, they should be told of updates regarding new options for dise ase control. We recommend that patients be seen periodically by a gast roenterologist who has expertise in inflammatory bowel disease, even w hen the disease is quiescent. Our experience in observing these patien ts over time strongly supports use of some of the agents discussed in this article for prophylaxis against flares and chronic inflammation.