Review article: the management of severe Crohn's disease

The treatment of severe and active Crohn's disease is currently based on im munosuppression, but also involves the management of nutrition, appropriate selection of patients for surgery, and maintenance of remission in the lon g term. Corticosteroids remain the drug of the first choice, particularly i n the acute setting. However, there is evolving understanding of the role o f other immunosuppressants and immune modifiers, as major concerns regardin g side-effects and efficacy of steroids in the medium to long-term drive th e search for alternatives.