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Non-pharmacological choices for those with crohn's disease
Encourage patient to stop smoking advise patients not to cancel all food groups ensure adequate caloric intake nutritional supplements are parenteral nutrition may be necessary and select patients who are malnourished surgery may be necessary. Treat strictures abscesses fistula or four patients refractory to medical management. Psychological and social support is important especially for adolescents.
Pharmacological treatment for Crohn's disease
Prednisone 40 - 60 milligrams per day for 12 - 16 weeks most commonly used for the induction of remission.
Chronic low-dose corticosteroid therapy is ineffective for the maintenance of remission.
chronically active disease may require continuous low-dose prednisone 10 - 50 milligrams per day to suppress symptoms.
Sulfasalazine 6 - 8 grams per day marginally effective.
Use effective contraception with purine metabolites or Methotrexate as they are teratogenic.
Infliximab is effective for patients who are refractory to antimetabolite therapy it's considered to be Primary Therapy for moderate-to-severe disease with fistula.
What is the non-pharmacological treatment for ulcerative colitis?
Well balanced diet with supplements
Total parenteral Nutrition in those with severe disease
Colectomy for those refractory to Medical therapy or have cancerous changes in Colon
Who changes might occur after colectomy symptoms are tenesmus diarrhea and bleeding
What arethe pharmacological choices for ulcerative colitis?
Sulfasalazine
active disease:
>4 grams per day divided
maintenance dose:
2 - 3 grams per day divided
continuous use of corticosteroids, immunosuppressive agents, or infliximab is reserved for patients with refractory disease who declined surgery.
use the lowest possible dose of prednisone to control disease activity.
What is the treatment for ulcerative
5 ASA preparations, suppositories or enemas, give at bedtime, is the initial treatment of choice.
alternatively topical corticosteroids can be used.
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