Management of inflammatory bowel disease

In considering the optimal medical therapy of IBD, it is important to individualize treatment according to the particular needs of the patients. Improving and maintaining the patient's quality of life is the most important goal. For ulcerative colitis, it is important to remember that topical therapy can be useful in distal disease and that the higher the dose of 5-ASA, the better the response. For Crohn's disease, activity should be treated according to severity. Budesonide is a promising drug for mild-to-moderate ileitis and right-sided colitis, and infliximab is an effective therapy for moderate-to-severe inflammatory and fistulizing Crohn's disease. For both ulcerative colitis and Crohn's disease, corticosteroids are effective in inducing remission but not maintaining it. Newer advances in medical therapy and diligence by physicians and patients alike should make IBD a more tolerable disease.