Keywords

There are multiple management decisions we deal with in caring for our IBD patients. The cases in the chapters that follow cover many complicated issues. Topics that are discussed include the following: How best to evaluate the remainder of the small bowel when ileitis is found on colonoscopy? How long should you continue budesonide? The use of agents such as ozanimod, ustekinumab, risankizumab, and vedolizumab in patients who do not want to be on anti-TNFs; the use of anti-TNFs in a patient with a history of MI; the use of JAK inhibitors when patients fail anti-TNFs; whether to anticoagulate a hospitalized patient with IBD and rectal bleeding; the management of C. difficile in a patient with IBD; how to manage severe IBD in a patient not responding to anti-TNFs; managing post-op Crohn’s; managing multiple pseudopolyps and the finding of dysplasia on a random biopsy during surveillance colonoscopy; options in the management of acute severe ulcerative colitis; treating refractory proctitis; how best to administer vedolizumab? Managing functional diarrhea in IBD; when is it best to postpone infusions? How to interpret and manage musculoskeletal complaints in a patient on anti-TNFs for IBD? How to treat pyoderma gangrenosum? How to manage patients who are squeamish about self-injection or taking rectal medications? How to treat a patient with UC who has a colon stricture? How to approach nonspecific ileal ulcers? Whether to prophylax against Pneumocystis jirovecii in patients on several immunosuppressants; management of microscopic colitis; and help with many other long-term decisions that need to be made.