[ Summary ] |
Although several treatment options are available for inflammatory bowel diseases, no treatments are currently available that can achieve complete cure of the diseases. Therefore, physicians have to know the specific characteristics of each treatment option. In particular, 5‒aminosalicylates are a basic treatment option for ulcerative colitis (UC), with two formulations, namely time‒and pH‒dependent release. Corticosteroids should be used exclusively as a remission induction therapy for both UC and Crohn's disease (CD). Anti‒TNF‒α antibodies such as infliximab and adalimumab have potent efficacy for CD, but the effect on UC varies widely among patients. Cytapheresis therapy and calcineurin inhibitors are also effective for UC. On the other hand, nutritional therapy, including parenteral nutrition and elemental diet, still has considerable roles in the treatment of CD. Thiopurines are key drugs for maintenance of both diseases. Surgery has to be considered appropriately when medical treatments are not effective. In the treatment of UC, physicians should note the difference in therapeutic strategy between the remission induction and maintenance phases. Meanwhile, the performance of anti‒TNF‒α antibodies should be optimized in the treatment of CD, with maximum effort to avoid loss of response. |