Inflammatory Bowel Disease

A. Treatment when disease is active:

Patients with IBD get recurrent flares of their condition. Common medicines used during flares include:

• Steroids (e.g. prednisolone, budesonide, hydrocortisone) which are given intravenously, orally or topically (i.e delivered to the site of inflammation).
• High dose 5’aminosalicylic acids (5ASA) are used orally or topically.
• Immune suppressants such as: anti-tumour necrosis factor antibodies (eg infliximab/ Remicade or adalimumab/ Humira) and ciclosporin are used in challenging cases.
• Antibiotics have also been used for special cases (e.g perianal fistula)
• Special diets (e.g. elemental/ polymeric diets) and infusion of nutrition (i.e. total parenteral nutrition) are sometimes used to treat Crohn’s disease patients.
• Patients with refractory disease (IBD not responding to treatment) and patients who develop complications may need surgery.

B. Maintenance treatment to prevent flare:

• Long term 5ASA are used to prevent and decrease the severity of flares and cancer.
• Medicine that suppress the immune system such as azathioprine/6-mercaptopurine, methotrexate and anti-TNF antibodies, are good at preventing and decreasing the severity of flares.
• In a very select group of patients, good bacteria (probiotics) is useful.

IBD is a treatable illness that can be kept in remission.