Tratamiento de la enfermedad inflamatoria del tracto intestinal, manejo individualizado. Tratamiento de inducción de la remisión y del mantenimiento

Abstract

Inflammatory bowel disease (IBD) encompasses a group of chronic disorders characterized by immune-mediated inflammation of the gastrointestinal tract. The most notable entities are Crohn's disease and ulcerative colitis. IBD treatment focuses on achieving measurable goals that are agreed upon with the patient that allow for clinical remission, mucosal healing, and improvement in quality of life. The therapeutic approach to IBD is multidisciplinary and individualized according to the patient's characteristics, severity of the flare, extent and phenotype of the disease, treatment response, and cost of treatment.Currently, a wide variety of drugs are available for treating IBD: aminosalicylates, corticosteroids, immunomodulators, biologic drugs, or new small molecule drugs. Surgery is reserved for severe flare-ups that do not respond to medical treatment or complications such as bowel obstruction or perforation. In addition, nutritional support plays an essential role managing this disease. This document lists the different treatments available in the approach to IBD and proposes a treatment sequence based on the available clinical evidence and clinical practice guidelines recommendations.