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Medical Treatment of Inflammatory Bowel Disease

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Coloproctology

Part of the book series: European Manual of Medicine ((EUROMANUAL))

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Abstract

During the past decade, anti–tumor necrosis factor (TNF) agents and the emergence of new therapeutic concepts have dramatically modified inflammatory bowel disease (IBD) management, especially in the early phase. Salicylates remain the therapeutic basis in ulcerative colitis, whereas their efficacy in Crohn’s disease has not been confirmed. A rapid step-up approach is now considered for managing refractory IBD, providing early exposure to immunomodulators (i.e., conventional immunosuppressants and/or biologics in the case of a poor disease course). Some specific situations (severe, extended, or complicated forms) require the most efficient first-line therapy: the combination of anti-TNF agents and immunosuppressants. A close follow-up based not only on clinical symptoms but also on objective inflammatory tools (endoscopy, cross-sectional imaging, biomarkers) is needed to adjust medical therapy rapidly to prevent bowel damage and surgery.

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Authors and Affiliations

  1. Service d’Hépato Gastroentérologie, Hôpital Haut-Lévêque.CHU de Bordeaux, 1 av. de Magellan, 33604, Pessac, France

    Florian Poullenot & David Laharie MD, PhD

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  1. Florian Poullenot
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  2. David Laharie MD, PhD
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Correspondence to Florian Poullenot .

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Editors and Affiliations

  1. End- und Dickdarm-Zentrum Mannheim, Mannheim, Germany

    Alexander Herold

  2. Clinique de chirurgie digestive et endocrinienne, Institut des maladies de l’appareil digestif, Hotel Dieu, Nantes, France

    Paul-Antoine Lehur

  3. Chirurgische Klinik mit Poliklinik, Universitaet Erlangen, Erlangen, Germany

    Klaus E. Matzel

  4. UCD School of Medicine, St Vincent’s University Hospital, Dublin, Ireland

    P. Ronan O'Connell

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Poullenot, F., Laharie, D. (2017). Medical Treatment of Inflammatory Bowel Disease. In: Herold, A., Lehur, PA., Matzel, K., O'Connell, P. (eds) Coloproctology. European Manual of Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53210-2_19

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