Crohn's disease treatment takes a step forward: New guidelines issued

Kathleen Blanchard's picture
New Crohn's disease treatment guidelines issued

The American Gastroenterological Society has issued new guidelines for treating Crohn's disease that is based on symptoms and treating inflammation. Past treatment was geared toward relieving symptoms that failed to prevent complications including fistulas, abscess and strictures, the group notes.

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Physicians now have a new tool for treating Crohn's disease. Guidelines released by the American Gastroenterological Society (AGA) are geared toward treating inflammation rather than clinical symptoms.

Goal of Crohn's therapy is now deep remission

The new goal of therapy is "deep remission" of Crohn's disease, meaning physicians should make treatment decisions based on both symptoms and endoscopic remission.

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Based on study reviews, gauging treatment based on patient symptoms fails to prevent complications that include abscesses, fistulas and strictures.

Inflammation is determined by tools that include endoscopy, the blood test C-reactive protein (CRP), MRI, CT scan and by taking tissue samples of the colon.

The AGA notes that treatment of Crohn's disease is "evolving". William J. Sandborn, MD, AGAF who authored of the clinical decision tool said in a press release: "This clinical support tool represents a big step forward for the treatment of Crohn's disease and was created using a rigorous review process."

  • The new Crohn's disease treatment algorithm include budesonide, steroids and azathioprine for low-risk patients, and biologic therapy with tumor necrosis factor (TNF) antagonists, combined with budesonide, steroids and azathioprine for patients at high risk for complications.
  • Drug monitoring is recommended for patients who lose response to biological therapy to help with decision making.

The new guidelines for Crohn's disease treatment is also designed to provide clinicians with a uniform approach for treating the inflammatory bowel disease.

Image credit: Wikimedia Commons

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Comments

A uniformed approach to treating Crohn's disease is a true diservice to the patient and frankly. Insulting.
I couldn't agree more. The "one size fits all" approach to medicine that has become the norm has caused more trouble for me than whatever led me to seek medical treatment to begin with. With my Crohns, I don't even bother going to the doctor unless it's an emergency. Everyone is different, and should be treated as such.
Hi Kathryn. I don't think this moves individualized treatment away from patients. They are guidelines based on good evidence about how to treat IBD to prevent complications. I guess what I'm trying to say is you have to have a starting point once a diagnosis is made. Just like any disease there are standards of care that physicians follow. That protects us as health care consumers too.
Hi Venus. Can you share your thoughts about why that is an insult? It seems you might think this takes away from patient decision making, or treating people as individuals? Not sure, so would love more of your thoughts.
If diet is not part of a crohns or colitis treatment then it's a joke. Meds are clinical tools but ignoring digestive and nutritional facts is underscoring they are missing the point. It's the worst kept secret in CD UC, diet matters.
I totally agree but many people balk if you try to discuss how diet is almost.........everything. :( There are only general guidelines for people and how confusing.