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Clin Colon Rectal Surg 2007; 20(4): 269-281
DOI: 10.1055/s-2007-991026
© Thieme Medical Publishers

Medical Management of Crohn's Disease

Paul A. Feldman1 , Daniel Wolfson1 , Jamie S. Barkin1
  • 1Division of Gastroenterology, Leonard Miller School of Medicine/University of Miami, Mount Sinai Medical Center, Miami Florida
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Publication History

Publication Date:
16 October 2007 (online)

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ABSTRACT

The clinical course of Crohn's disease (CD) is characterized by unpredictable phases of disease activity and quiescence. The majority of CD patients experience mild to moderate disease or are in clinical remission over significant periods during the course of their disease. These patients can be treated conservatively with 5-aminosalicylates or budesonide depending on the disease location. Those patients with more severe forms of the disease who require corticosteroids should be treated more aggressively with early introduction of immunomodulator and/or biologic therapy, which may help to prevent the complications associated with CD. It has been suggested that therapies directed at mucosal healing may favorably modify the natural history of CD. As newer, more effective medications become available and new therapeutic approaches are introduced (top-down therapy), mucosal healing, and not solely clinical remission, may well become the preferred treatment objective.

KEYWORDS

Crohn's disease - medical management

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Jamie S BarkinM.D. 

Division of Gastroenterology, Mount Sinai Medical Center

4300 Alton Rd., Ste. 2522, Miami Beach, FL 33140

Email: jamiebarkin@msmc.com

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