Current Treatment Options in Gastroenterology

, Volume 3, Issue 1, pp 59–68

Crohn’s disease of the small intestine

  • Robert Burakoff

DOI: 10.1007/s11938-000-0062-3

Cite this article as:
Burakoff, R. Curr Treat Options Gastro (2000) 3: 59. doi:10.1007/s11938-000-0062-3

Opinion statement

  • Crohn’s disease of the small intestine is a chronic relapsing disease that requires all the knowledge and ingenuity of the gastroenterologist to successfully treat the disease and the patient.

  • For mild to moderate disease, the first line of therapy is to utilize maximum doses of mesalamine to achieve a remission.

  • If the patient relapses, the maximum dose of mesalamine required to achieve remission should be continued.

  • If the disease relapses despite maximum mesalamine, antibiotics should be tried (before prescribing corticosteroids) using ciprofloxacin 500 mg b.i.d., alone or in combination with metronidazole 250 mg q.i.d. for 2 to 3 weeks. If successful, antibiotics can be slowly tapered off.

  • If antibiotics are unsuccessful, one may try elemental diet for 2 weeks before starting corticosteroids.

  • For moderate to severe Crohn’s disease, begin 40 mg of prednisone. After 2 weeks, taper slowly and start 6-MP or azathioprine, which can be used for several years.

  • If the disease recurs on 6-MP or azathioprine, or prior to 6-MP or azathioprine having a chance to be effective, give an IV infusion of Infliximab, which can be repeated at 4 to 8 weeks after the initial infusion.

  • If the patient continues to be unwell, surgery should be contemplated.

Copyright information

© Current Science Inc 2000

Authors and Affiliations

  • Robert Burakoff
    • 1
  1. 1.Section of GastroenterologyWashington Hospital CenterWashingtonUSA

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