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Crohn’s Disease (Inducing Remission in Mild to Moderate Disease
OPD…
Crohn’s Disease
-
Acute Severe Crohn’s
-
-
No Improvement → rescue therapy
- Discussion between pt, physician and surgeon
- Medical: methotrexate ± infliximab
- Surgical
Elective Surgery
Indications
- Abscess or fistula
- Perianal disease
- Chronic ill health
- Carcinoma
Procedures
- Limited resection: e.g. ileocaecal
- Stricturoplasty
- Defunction distal disease + temporary loop ileostomy
Maintaining Remission
1st line: azathioprine or mercaptopurine
2nd line: methotrexate
3rd line: Infliximab / adalimumab