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Feature Article

Managing inflammatory bowel disease

Bernard Chin, Michael C Grimm, Susan J Connor, Rupert W Leong

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Abstract

Inflammatory bowel diseases, comprising Crohn’s disease and ulcerative colitis, usually take on a relapsing–remiting course. In most cases, they can be controlled successfully with medical therapy but sometimes surgery is necessary.

Key Points

  • IBD can be difficult to diagnose. The key is to suspect IBD when patients present with chronic gastrointestinal tract (GIT) symptoms that are not easily explained.
  • The aim of management of IBD is to induce and maintain remission and prevent the long term consequences of GIT inflammation. This is usually achieved medically, but surgery can sometimes be the best option. The avoidance of long term corticosteroid treatment is important.
  • The management of patients with severe and refractory IBD is changing with the advent of powerful new drugs such as the anti-tumour necrosis factor agents. Multinational, multicentre clinical trials are enrolling suitable patients in many Australian teaching hospitals to study these agents.
  • IBD is chronic and can be complex. It is best managed in a multidisciplinary way by a gastroenterologist, GP, surgeon and dietitian.

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