Medical Management 1: General
In inflammatory bowel disease (IBD), no single cause initiates or triggers the disease. So far, medical treatment of ulcerative colitis (UC) and Crohn’s disease (CD) has been aimed at decreasing the frequency and intensity of flares and limiting comorbidities and their consequences such as strictures, fistulae or cancer. Life-long therapy is usually required as there is to date no cure for IBD.
The goal in the treatment of IBD is to reach deep remission, meaning long-lasting clinical well-being combined with normal endoscopic (mucosal), biochemical (calprotectin and CRP) and histological findings. This status is currently considered to be necessary to alter disease course in IBD patients. Along with clinical reported outcomes (ClinRO), patient-reported outcome measures (PROMs) are gaining more and more weight in the judgement of remission. PROMs are validated and standardized questionnaires intended for completion by the patient to measure their perceptions of their own health condition or treatment. PROMs are aimed to allow decision-making at the level of individual patients.
As the causes of UC and CD are multifactorial, numerous and varying therapeutic strategies are needed to establish a sufficient treatment regime in IBD. However, as disease and patient expectations change over time, treatment often needs to be modified to meet the treatment goals required to optimize the disease outcome.
KeywordsCrohn’s disease Ulcerative colitis Treatment goals Patient-related outcome Remission Mucosa healing Burden of disease
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