title: [Intensive care and inflammatory bowel diseases (IBD). The severe and fulminant flare].
abstract: Inflammatory bowel disease (IBD) is a non-curable disease. Although we seem to have a definitive surgical solution for ulcerative colitis, patients are at risk of suffering from acute and chronic pouchitis as well as peri- and postoperative complications. In Crohn's disease medical treatment is able to prolong surgery-free survival, but no definitive healing strategy is as yet at hand. Moreover, effective medication exposes patients to potentially life-threatening complications. The severely compromised patient in particular needs careful surveillance and requires a balanced treatment strategy endorsed by gastroenterologists and surgeons. Treatment is still aimed at suppressing immune mechanisms and is far from being causal. Nevertheless, this approach has resulted in a reduction in surgical procedures and hospitalizations. The following overview covers special issues related to strategies for severe and fulminant flares of inflammatory bowel disease.
authors.affiliation: Bereich Gastroenterologie und Hepatologie, Medizinische Klinik I, Universitätsklinikum Schleswig-Holstein Campus Lübeck , Ratzeburger Allee 160, 23538, Lübeck. juergen.buening@uk-sh.de
authors.forename: J
authors.initials: J
authors.lastname: Büning
authors.forename: K
authors.initials: K
authors.lastname: Fellermann
mesh_terms: D000465:Algorithms; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D003422:Critical Care / Q000379:methods*; D003424:Crohn Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D000069285:Infliximab; D033183:Interdisciplinary Communication; D010348:Patient Care Team; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D016572:Cyclosporine; D000069285:Infliximab; D016559:Tacrolimus