Medical Management 2: Conventional

  • Torsten KucharzikEmail author
  • Anil Kumar Asthana


Treatment algorithms of Crohn’s disease (CD) and ulcerative colitis (UC) share a lot of similarities. However, despite a variety of common therapeutic pathways, there are a few differences between both diseases that require different treatment approaches. There is no standardized definition on conventional therapy in IBD. In the following chapter steroids and mesalamine are defined as conventional therapy in IBD. The gold standard in the treatment of mild to moderate active ulcerative colitis is mesalamine. Mesalamine also plays an important role in maintenance treatment of UC. Topical application should always be considered as with topical application, much higher concentration of mesalamine could be obtained within the mucosa compared to the oral application. Mesalamine is less frequently used in patients with Crohn’s disease. Budesonide is used as standard treatment for mild to moderate Crohn’s disease with ileocecal involvement. Budesonide MMX exerts a continuous release within the whole colon and can be used in UC patients refractory to mesalamine. Conventional steroids are the method of choice in severe UC and CD. Long term steroid use should be avoided in patients with IBD. Mesalamine and steroids have no role in maintenance therapy of CD. If maintenance therapy appears to be useful in CD patients, immunosuppressive drugs or biologicals should be used. In the following chapter, we will present a therapeutic algorithm on how to use conventional drugs in patients with ulcerative colitis and Crohn’s disease.


Conventional therapy Corticosteroids Glucocorticosteroids Mesalamine Budesonide IBD Ulcerative colitis Crohn’s disease 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of GastroenterologyUniversity of Hamburg, Lüneburg HospitalLüneburgGermany
  2. 2.Department of Gastroenterology and HepatologyThe Royal Melbourne HospitalMelbourneAustralia

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