Inflammatory bowel disease

The etiology of inflammatory bowel diseases is still unknown. However, there seems to be a primary defect in mucosal barrier function resulting in a chronic inflammatory process. Both entities, Crohn's disease and ulcerative colitis show characteristic differences in clinical presentation and laboratory, radiological as well as endoscopical criteria. In some cases of the so called indeterminate colitis a clear distinction may not be possible. Therapy of inflammatory bowel disease aims for a suppression of the mucosal inflammation. Site, extent and especially the course of disease are crucial for the decision when and how to treat the patient. According to the patient's symptoms and disease history topical or systemic application of mesalazine or corticosteroids are used. In case of an intermittent course of disease treatment of the single flare should be started whereas in chronic active disease an immunosuppression with azathioprine, methotrexate or in therapy refractory cases infliximab is warranted.