Classification and treatment of Crohn's disease

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Abstract

Proper management of Crohn's disease depends upon accurate clinical classification. Primarily inflammatory disease (Vienna classification B1) requires antiinflammatory medication and responds poorly to surgery. By contrast, primarily stricturing (obstructive) disease (Vienna classification B2) mandates surgery - either resection or strictureplasty. The third principal phenotype, penetrating (fistulizing) disease (Vienna classification B3), is the most heterogeneous. 'Innocent' or 'trivial' (asymptomatic) fistulae may require no specific therapy at all, whereas 'nuisance' fistulae may respond adequately to antimetabolites or infliximab. However, 'complicated' fistulae, especially when accompanied by severe or advanced underlying bowel disease, will not be controlled without definitive surgery. (C) 2000 Prous Science.

Original languageEnglish
Pages (from-to)5-8
Number of pages4
JournalDrugs of Today
Volume36
Issue numberSUPPL. G
StatePublished - 2000
Externally publishedYes

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