An update on the medical treatment of Crohn's disease.
Crohn's disease (CD) is a chronic transmural inflammation that may involve any part of the alimentary tract. The affected patients show peculiar metabolic characteristics; they often have a reduced body weight, due to reduction of lipid stores (in spite of lean mass depletion) and an increased utilization of lipids as fuel substrate. An alteration of nutritional status, up to real malnutrition, is common in CD and malnutrition's effects influence the course of disease, acting as independent factors. We will give a description of the main pharmacological approaches in CD management; the first line therapy for CD patients remains the combinations of aminosalicylates, antibiotics, corticosteroids and immunomodulatory agents. The development of new biological agents for the treatment of inflammatory bowel diseases has added to the growing armamentarium of available therapy. We also will explain the importance of enteral nutrition, whose importance goes over the simple amelioration of nutritional status, especially in childhood CD, where it has shown to be as effective as traditional therapy.
Valentini
G
G
Institute of Internal Medicine and Geriatrics, Catholic University of The Sacred Heart, Roma, Italy. Giovanni_Valentini@hotmail.com
Guidi
L
L
Costanzo
M
M
Ciarniello
M
M
De Vitis
I
I
Capristo
E
E
Fedeli
G
G
D000276:Adjuvants, Immunologic / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000636:Aminosalicylic Acids / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001688:Biological Products / Q000627:therapeutic use; D003424:Crohn Disease / Q000188:drug therapy / Q000628:therapy*; D004750:Enteral Nutrition; D006801:Humans
D000276:Adjuvants, Immunologic; D000305:Adrenal Cortex Hormones; D000636:Aminosalicylic Acids; D000900:Anti-Bacterial Agents; D001688:Biological Products