title: [Internistic therapy possibilities in therapy-resistant Crohn disease].
abstract: About 20% of patients with active Crohn's disease do not respond to acute-phase-therapy with glucocorticoids at an initial dose of 60 mg prednisolone-equivalent and stepwise dose reduction every week. In case of primary failure of this therapeutic scheme the dose of glucocorticoids has to be enhanced. If necessary a combination with total parenteral nutrition or tube feeding should be used. In case of early recurrence of inflammation during dose reduction or chronic steroid-dependent disease activity a combination of glucocorticoids with Azathioprine will be successful in about 75% of patients. In addition a combination of glucocorticoids with tube feeding (elemental or polymeric diet) will lead to remission of inflammatory activity in about 60 to 70% of these patients. In patients, who are still refractory to these therapeutic procedures, operation should be discussed.
authors.affiliation: Medizinische Klinik, Fachbereich Gastroenterologie Städt. Krankenanstalt Esslingen.
authors.forename: R
authors.initials: R
authors.lastname: Hoffmann
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001379:Azathioprine / Q000008:administration & dosage; D003424:Crohn Disease / Q000188:drug therapy* / Q000503:physiopathology; D003524:Cyclosporins / Q000008:administration & dosage; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D015122:Mercaptopurine / Q000008:administration & dosage; D010288:Parenteral Nutrition
chemical_list: D000900:Anti-Bacterial Agents; D003524:Cyclosporins; D005938:Glucocorticoids; D015122:Mercaptopurine; D001379:Azathioprine
vernacular_title: Internistische Therapiemöglichkeiten bei "therapieresistentem" Morbus Crohn.