Inflammatory bowel disease.
BACKGROUND
Inflammatory bowel disease (IBD) is increasing in frequency in Australia. General practitioners play an important role in early diagnosis and in a multidisciplinary approach to managing such patients. Keeping abreast of evolving concepts, particularly in treatment, is challenging.


OBJECTIVE
This article aims to address key issues in diagnosis and management to better equip general practitioners for their role in multidisciplinary management of patients with IBD.


CONCLUSIONS
Making the diagnosis can be difficult, but is facilitated by appropriate clinical suspicion and sensible judgment as to who undergoes diagnostic tests such as colonoscopy. Treatment of ulcerative colitis has changed little in recent years, except for our improved ability to deliver mesalazine to the large bowel via the recent availability of several oral and rectal preparations. Prevention of relapse using these is an important strategy in the majority of patients. Treatment of Crohn disease is changing due to more realistic concepts of the natural history of the disease and the development of new, powerful anti-inflammatory therapies. Attention to issues other than intestinal inflammation such as nutrition, education and counselling, remain important in achieving optimal management.
Gibson
Peter R
PR
Monash University. gibson@med.monash.edu.au
Iser
John
J
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000628:therapy; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000209:etiology; D003424:Crohn Disease / Q000175:diagnosis / Q000628:therapy; D003967:Diarrhea / Q000209:etiology; D013505:Digestive System Surgical Procedures; D005194:Family Practice / Q000379:methods* / Q000592:standards; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D019804:Mesalamine / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine