| [ Summary ] |
Over the past 30 years, there has been considerable progress in the management of inflammatory bowel disease (IBD); however, the number of patients with IBD has increased. While the disease was predominantly treated with steroids 30 years ago, recently, various medications are available：these include 5‒aminosalicylates ; strong medications, such as biologics and tacrolimus ; and immunomodulators. Previously, the target of IBD treatment was a reduction in symptoms. However, with the advent of new therapies, the target of treatment is now mucosal healing. The assessment of IBD has also changed. In the past, clinical symptoms were the focus of disease assessment. With advances in investigative modalities, such as computerized tomography, magnetic resonance imaging, and endoscopy, more objective indexes have been developed. There have also been advances in elucidating the pathophysiology of IBD. Many IBD‒associated genes have been identified, and the roles of abnormal immune response and intestinal bacterial flora have been determined. The Research Group of Intractable Inflammatory Bowel Disease subsidized by the Ministry of Health, Labour and Welfare of Japan has played an important role in promoting better management of IBD by making guidelines and providing platforms for improvements in diagnosis and treatments. In future, the spread of better diagnosis and therapeutics is expected along with the developments of novel therapy based on basic research and the application of the same to clinics. |