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Inflammatory bowel disease

Prevalence
Clinical features
Differential Diagnosis
Investigations
Therapy
Prevention
Prognosis
Prevention

Crohn's disease

Advise patients to stop smoking c  

Give 

  • fish oil a
  • azathioprine (≥ 2.0 mg/kg daily) or weekly methotrexate a to patients with frequent relapses d
Following surgery
  • give mesalamine a  
  • give cimetidine (400 mg four times a day) following extensive ileal resection a  
There is no clear benefit from
  • budesonide  d or other steroids a  
  • cyclosporine b  


Ulcerative colitis

Give 5-aminosalicylates (preferably sulfasalazine) a as tablets and enemas

There is no clear benefit from using

  • fish oil a  
  • azathioprine d  
  • adding allopurinol to 5-ASA d
Consider screening patients with inflammatory bowel disease for cancer by annual assessment with endoscopy (or radiography if not available) c  

Expiry date: July 2003
Levels of Evidence used in grading these guides

Author   CM   Ball
Reviewer   L   Friedman
CAT Writers   D   Ford , CM   Ball