Medical Management of Crohn’s Disease
Despite tremendous progress in the overall understanding of the disease and advancements in the comprehension of the various phenotypical manifestations, the exact etiology of Crohn’s disease remains unknown. Many hypotheses suggest there involves interplay among the genetic makeup of the individual along with environmental, bacteriological, immunological, and epidemiological factors that contribute to its development. While surgery is often geared toward complications of the disease, medical therapy remains the mainstay of treatment. A tiered strategy for medical therapy is often utilized, taking into account the disease activity (flare vs. chronic), pattern (inflammatory vs. fistulizing vs. fibrotic), and location. Combined, the goal is to safely resolve inflammation, lessen symptoms, improve quality of life, and minimize the risk for short- and long-term complications. This chapter focuses specifically on the medical management of Crohn’s disease with a focus on not only the classification of commonly used medications but also the various strategies implemented to induce and maintain remission.