BMJ  2008;336:1062-1066 (10 May), doi:10.1136/bmj.39547.603218.AE

Clinical Review

Medical management of Crohn’s disease

J R Fraser Cummings, specialist registrar, Satish Keshav, consultant gastroenterologist, Simon P L Travis, consultant gastroenterologist

1 Gastroenterology Unit, John Radcliffe Hospital, Oxford OX3 9DU

Correspondence to: S P L Travis simon.travis@ndm.ox.ac.uk

The first 150 words of the full text of this article appear below.


Biological therapies have radically changed the management of Crohn’s disease but must be used judiciously with great awareness of possible adverse events
Treatment strategies for the disease are rapidly evolving, with immunomodulator and biological therapy being considered in patients who have indicators for developing early severe disease
Clinical indicators of a poor prognosis (at diagnosis) include perianal or stricturing disease, weight loss >5 kg, or the need for steroids
Treatment of active disease with mesalazine is little better than placebo; mesalazine is used mainly to reduce the risk of relapse after small intestinal resection
Access to specialist services, parallel medical and surgical clinics, nurse specialists, dietitians, pharmacists, and other allied professionals is as important as the medication
Publication of standards of care should drive improvement in the care and provision of resources for patients with Crohn’s disease


Crohn’s disease is a chronic, relapsing and remitting inflammatory condition of the gastrointestinal . . . [Full text of this article]


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