The goal of IBD treatment is to obtain rapid control of symptoms in case of inflammatory thrust (thrust treatment) and to obtain remission (maintenance treatment) to reduce the number of thrusts. There is no cure.
For this purpose, there is a small number of therapeutic classes:
- 5-ASA (aminosalicylates),
Surgery should also be considered as a treatment in certain situations.Each case is unique and the treatment is not uniform. The choice of treatment depends on the clinical situation and is discussed on a case by case basis.
The treatment of relapses is based on a method of therapeutic escalation. Depending on the severity of the thrust, we will use:
- 5-ASA (oldest, well-tolerated, first-line treatment in mild-to-moderate flare),
- corticosteroids (shortest duration possible due to side effects),
- enteral nutrition,
- sometimes biotherapies from the outset in cases of severe corticoresistant (anti-TNF alpha).
The maintenance treatment has several therapeutic classes used according to the severity of the disease and also according to prior art treatments. We have several therapeutic classes:
- 5-ASA at a lower dosage than for the treatment of relapses,
- immunosuppressants (purine analogues or methotrexate),
- biotherapies (anti-TNF, anti-integrin, anti-interleukin).
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