Diagnosis and Treatment of Inflammatory Bowel Disease

Hyo Jong Kim

doi:10.5124/jkma.2003.46.7.605

J Korean Med Assoc > Volume 46(7); 2003 > Article

Kim: Diagnosis and Treatment of Inflammatory Bowel Disease

Special Issue

Diseases of the Colo-rectum and Anus

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2003; 46(7): 605-611.

Published online: July 31, 2003

DOI: http://dx.doi.org/10.5124/jkma.2003.46.7.605

Diagnosis and Treatment of Inflammatory Bowel Disease

Hyo Jong Kim, M.D.

Department of Internal Medicine, Kyung Hee University College of Medicine & Hospital, Korea. hjkim@khmc.or.kr

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Inflammatory bowel disease (IBD) comprises a group of idiopathic diseases of the intestine characterized by chronic inflammation of the bowel with periods of exacerbation and remission. The two major categories of IBD are ulcerative colitis and Crohn's disease, and each disease is distinct both clinically and histologically. The exact cause of IBD remains unknown, but several theories have been proposed. Primary care physicians are frequently confronted with the initial diagnosis and management of patients with IBD, and medical treatment options have rapidly expanded in recent years. This article reviews clinical presentations that are essential to establish a diagnosis in this complex disease and the treatment options available.

Inflammatory bowel disease; Ulcerative colitis; Crohns disease; Diagnosis; Treatment

References

1. Podolsky DK. Inflammatory bowel disease. N Engl J Med 2002;347:417-429.

6. Peeters M, Joossens S, Vermeire S, Vlietinck R, Bossuyt X, Rutgeerts P. Diagnostic value of anti-Saccharomyces cerevisiae and antineutrophil cytoplasmic autoantibodies in inflammatory bowel disease. Am J Gastroenterol 2001;96:730-734.

7. Chutkan RK, Scherl E, Waye JD. Colonoscopy in inflammatory bowel disease. Gastrointest Endosc Clin N Am 2002;12:463-483.

9. Cohen R, Woseth DM, Thisted RA, Hanauer SB. A Meta-analysis and overview of the literature on treatment options for left-sided ulcerative colitis and ulcerative proctitis. Am J Gastroenterol 2000;95:1263-1276.

10. Sandborn WJ. Rational selection of oral 5-aminosalicylate formulations and prodrugs for the treatment of ulcerative colitis. Am J Gastroenterol 2002;97:2939-2941.

12. Faubion WA Jr, Loftus EV Jr, Harmsen WS, Zinsmeister AR, Sandborn WJ. The natural history of corticosteroid therapy for inflammatory bowel disease : a population-based study. Gastroenterology 2001;121:255-260.

13. Danielsson A, Lofberg R, Persson T. A steroid enema, budesonide, lacking systemic effects for the treatment of distal ulcerative colitis or proctitis. Scand J Gastroenterol 1992;27:9-12.

14. Greenberg GR, Feagan BG, Martin F, Sutherland LR, Thomson AB, Persson T, et al. Canadian Inflammatory Bowel Disease Study Group. Oral budesonide as maintenance treatment for Crohn's disease : a placebo-controlled, dose-ranging study. Gastroenterology 1996;110:45-51.

17. Fraser AG, Orchard TR, Jewel DP. The efficacy of azathioprine for the treatment of inflammatory bowel disease. Gut 2002;50:485-489.

18. Present DH, Melzer SJ, Krumholz MP, Wolke A, Korelitz BI. 6-Mercaptopurine in the management of inflammatory bowel disease : short and long-term toxicity. Ann Intern Med 1989;111:641-649.

19. Seidman EG. 6-Mercaptopurine in maintaining remission in Crohns disease : An old friend becomes a new hero. Gastroenterology 2000;119:1158-1160.

21. van Dullemen HM, van Deventer SJ, Hommes DW, Bijl HA, Jansen J, Woody J, et al. Treatment of Crohn's disease with anti-tumor necrosis factor chimeric monoclonal antibody (cA2). Gastroenterology 1995;109:129-135.

22. Targan SR, Hanauer SB, van Deventer SJ, Mayer L, Present DH, Rutgeerts PJ, et al. Crohn's Disease cA2 Study Group. A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn's disease. N Engl J Med 1997;337:1029-1023.

23. Present DH, Rutgeerts P, Targan S, Hanauer SB, Mayer L, van Deventer SJ, et al. Infliximab for the treatment of fistulas in patients with Crohn's disease. N Engl J Med 1999;340:1398-1405.

24. Sutherland L, Singleton J, Sessions J, Hanauer S, Krawitt E, Kelly M, et al. Double blind, placebo controlled trial of metronidazole in Crohn's disease. Gut 1991;32:1071-1075.

25. Turunen UM, Farkkila MA, Hakala K, Seppala K, Sivonen A, Miettinen TA. Long-term treatment of ulcerative colitis with ciprofloxacin : a prospective, double-blind, placebo-controlled study. Gastroenterology 1998;115:1072-1078.

26. Gionchetti P, Rizzello F, Venturi A, Brigidi P, Matteuzzi D, Campieri M. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis : a double-blind, placebo-controlled trial. Gastroenterology 2000;119:305-309.