MEDICAL THERAPY FOR INFLAMMATORY BOWEL-DISEASE

In ulcerative colitis the results with a new preparation of budesonide provide a model for development of topically active, orally administe red compounds. This approach is promising for the treatment of intesti nal inflammation by this class of steroids, which are characterized by high potency and low systemic toxicity, Immunosuppressive treatment i n ulcerative colitis remains a form of therapy whose role is uncertain pending large controlled studies that assess both efficacy and safety . For most patients with ulcerative colitis, 5-ASA remains a mainstay of chronic therapy. Although the use of newer mesalamine compounds is widely accepted among gastroenterologists, they appear to have only ma rginal benefits compared with sulphasalazine and are significantly mor e expensive. Economic analysis comparing these interventions is necess ary. For Crohn's disease, oral steroid therapy remains the cornerstone of treatment and is substantially more effective than dietary therapy . The use of antibiotic therapy to induce remission requires further e valuation in large, randomized controlled trials. Immunosuppressive th erapy with the purine antimetabolites or methotrexate is effective and safe for patients who are resistant to, or dependent on, steroid use.