Inflammatory Bowel Disease: Therapy for Active Disease

The optimal therapy for active inflammatory bowel disease (IBD) is individualized according to the severity and the location of the disease and furthermore, the particular needs of each patient. For ulcerative colitis (UC), topical therapy can be useful in distal disease and the higher the dose of 5 ASA the better the response. In Crohn's disease (CD), budesonide is a promising treatment for mild to moderate ileitis and right-sided colitis. The anti-tumor necrosis factor-a (TNF-a) antibody infliximab is an effective therapy for moderate to severe inflammatory and fistulizing Crohn's disease. Recent studies have shown that infliximab is also effective in the treatment of moderate to severe UC. For both UC and CD, corticosteroids still remain the mainstay of treatment in active disease. The therapeutic goals in inflammatory bowel disease (IBD) include induction of remission in patients with active disease and maintenance of remission in those with quiescent disease. Furthermore, therapy should prevent disease complications. This review is focused on the standard therapeutic options for inducing remission in patients with active IBD.