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Medical Management of Inflammatory Bowel Disease

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The ASCRS Textbook of Colon and Rectal Surgery

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Abstract

Crohn’s disease and ulcerative colitis (UC) are chronic inflammatory diseases of the gastrointestinal tract, collectively known as inflammatory bowel disease (IBD). IBD afflicts approximately 1.3 million Americans and seems to be increasing in frequency in many parts of the world, producing chronic relapsing symptoms that are associated with increased morbidity and decreased quality of life. Although its etiopathogenesis is yet to be fully elucidated, it is thought to involve a complex interplay of genetic, environmental, microbial, and immune factors. Since the discovery of sulfasalazine’s unanticipated efficacy in UC, numerous agents have been added to the therapeutic “arsenal.” Recent advances in our knowledge of the immunopathogenesis of IBD have also opened an exciting new door to biologic therapy. Pharmacotherapy remains the cornerstone of IBD management, with most patients requiring lifelong therapy because of the chronicity of the disease and its typical onset before 30 years of age. Surgery is usually reserved for treating medically refractory disease or specific complications. With the exception of curative proctocolectomy in UC, neither medical nor surgical therapy can offer a cure for IBD. Therefore, the aims of therapy are to control symptoms, improve quality of life, and minimize short- and long-term complications of both the disease and its therapy.

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Authors
  1. Stephen B. Hanauer
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  2. Wee‐Chian Lim
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  3. Miles Sparrow
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Editor information

Editors and Affiliations

  1. Professor of Surgery, Mayo Clinic College of Medicine, Chairman, Division of Colon and Rectal Surgery, Mayo Clinic Foundation, Rochester, MN, USA

    Bruce G. Wolff MD, FASCRS (Senior Editors) (Senior Editors)

  2. Professor of Surgery, Chief, Section of Colorectal Surgery, Washington University School of Medicine, St. Louis, MO, USA

    James W. Fleshman MD, FASCRS (Senior Editors) (Senior Editors)

  3. Chairman, Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA

    David E. Beck MD, FASCRS (Senior Editors) (Senior Editors)

  4. Professor of Surgery, Mayo Clinic College of Medicine, Consultant, Colon and Rectal Surgery, Mayo Clinic and Mayo Foundation, Rochester, MN, USA

    John H. Pemberton MD, FASCRS (Senior Editors) (Senior Editors)

  5. Chief of Staff, Cleveland Clinic Florida, Weston, FL, USA

    Steven D. Wexner MD, FASCRS (Senior Editors) (Senior Editors)

  6. Victor W. Fazio Chair of Colorectal Surgery, Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA

    James M. Church BSc, MBChB, MMed Sci, FASCRS (Associate Editors) (Associate Editors)

  7. Professor of Surgery, Chief, Section of Colon and Rectal Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA, USA

    Julio Garcia-Aguilar MD, PhD, FASCRS (Associate Editors) (Associate Editors)

  8. Department of Colon and Rectal Surgery, Lahey Clinic, Burlington, MA, USA

    Patricia L. Roberts MD, FASCRS (Associate Editors) (Associate Editors)

  9. Professor of Surgery, Head, Section of Colon and Rectal Surgery, Rush University Medical Center, Chicago, IL, USA

    Theodore J. Saclarides MD, FASCRS (Associate Editors) (Associate Editors)

  10. Division of Colon and Rectal Surgery, Department of Surgery, University of California, Irvine Medical Center, Orange, CA, USA

    Michael J. Stamos MD, FASCRS (Associate Editors) (Associate Editors)

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Hanauer, S.B., Lim, W., Sparrow, M. (2007). Medical Management of Inflammatory Bowel Disease. In: Wolff, B.G., et al. The ASCRS Textbook of Colon and Rectal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-36374-5_40

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