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INFLAMMATORY BOWEL DISEASE
Treatment Guideline Chart
Inflammatory bowel disease consists of ulcerative colitis and Crohn's disease.
Ulcerative colitis is a diffuse mucosal inflammation limited to the colon while Crohn's disease is a patchy, transmural inflammation that occurs in any part of the gastrointestinal tract.
The ileum and colon are the most frequently affected sites.

Inflammatory Bowel Disease References

  1. Carter MJ, Lobo AJ, Travis SPL; IBD Section of the British Society of Gastroenterology. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2004 Sep;53(Suppl 5):v1-16. PMID: 15306569
  2. Dignass A, Eliakim R, Magro F, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1: definitions and diagnosis. J Crohns Colitis. 2012 Dec;6(10):965-990. doi: 10.1016/j.crohns.2012.09.003. PMID: 23040452
  3. Dignass A, Lindsay JO, Sturm A, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 2: current management. J Crohns Colitis. 2012 Dec;6(10):991-1030. http://www.ncbi.nlm.nih.gov. PMID: 23040451
  4. Feldman PA, Wolfson D, Barkin JS. Medical management of Crohn's disease. Clin Colon Rectal Surg. 2007 Nov;20(4):269-281. doi: 10.1055/s-2007-991026. PMID: 20011423
  5. Knutson D, Greenberg G, Cronau H. Management of Crohn's disease - a practical approach. Am Fam Physician. 2003 Aug;68(4):704-714. http://www.ncbi.nlm.nih.gov/pubmed/?term=12952387. PMID: 12952387
  6. Hanauer SB, Sandborn W. Management of Crohn's disease in adults. Am J Gastroenterol. 2001 Mar;96(3):635-643. http://www.ncbi.nlm.nih.gov/pubmed/11280528. PMID: 11280528
  7. Kumar R, Singh J. The emerging therapy with prebiotics in the management of inflammatory bowel disease: current status. Int J Basic Clin Pharmacol. 2013;2(4):360-367. http://www.ijbcp.com/Volume2Issue4/IJBCP20130803.pdf. Accessed 25 Sep 2013
  8. Kornbluth A, Sachar DB, The Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults: American College of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010 Mar;105(3):501-523. http://gi.org/guideline/ulcerative-colitis-in-adults/. PMID: 20068560
  9. Leighton JA, Shen B, Baron TH, et al; Standards of Practice Committee, American Society for Gastrointestinal Endoscopy. ASGE guideline: endoscopy in the diagnosis and treatment of inflammatory bowel disease. Gastrointest Endosc. 2006 Apr;63(4):558-565. PMID: 16564852
  10. Lichtenstein GR, Abreu MT, Cohen R, et al. American Gastroenterological Association Institute technical review on corticosteroids, immunomodulators, and infliximab in inflammatory bowel disease. Gastroenterology. 2006 Mar;130(3):940-987. http://www.ncbi.nlm.nih.gov/pubmed/?term=American++Gastroenterology+Association++Institute++technical+reviw+on+corticosteroids%2C+immunomodulators%2C+and+infliximab+on+inflammatory+bowel+disease. PMID: 16530532
  11. Lichtenstein GR, Hanauer SB, Sandborn WJ; Practice Parameters Committee of American College of Gastroenterology. Management of Crohn's disease in adults. Jan 06, 2009. Am J Gastroenterol. 2009 Feb;104(2):465-483. http://www.ncbi.nlm.nih.gov/pubmed/?term=19174807. PMID: 19174807
  12. Panes J, Bouhnik Y, Reinisch W, et al. Imaging techniques for assessment of inflammatory bowel disease: Joint ECCO and ESGAR evidence-based consensus guidelines. J Crohns Colitis. 2013 Aug;7(7):556-585. doi: 10.1016/j.crohns.2013.02.020. PMID: 23583097
  13. Mowat C, Cole A, Windsor A, et al; IBD Section of the British Society of Gastroenterology. Guidelines for the management of inflammatory bowel disease in adults. Gut. 2011 May;60(5):571-607. doi: 10.1136/gut.2010.224154. PMID: 21464096
  14. Podolsky DK. Inflammatory bowel disease. N Engl J Med. 2002 Aug;347(6):417-429. http://www.ncbi.nlm.nih.gov/pubmed/12167685. PMID: 12167685
  15. Sandborn WJ, Fazio VW, Feagan BG, Hanauer SB; American Gastroenterological Association Clinical Practice Committee. AGA technical review on perianal Crohn's disease. Gastroenterology. 2003 Nov;125(5):1508-1530. http://www.ncbi.nlm.nih.gov/pubmed/?term=14598268. PMID: 14598268
  16. Siegel CA, Sands BE. Review article: practical management of inflammatory bowel disease patients taking immunomodulators. Aliment Pharmacol Ther. 2005 Jul;22(1):001-16. http://www.ncbi.nlm.nih.gov/pubmed/?term=15963074. PMID: 15963074
  17. Strong SA, Koltun WA, Hyman NH, Buie WD; Standards Practice Task Force of The American Society of Colon and Rectal Surgeons. Practice parameters for the surgical management of Crohn's disease. Dis Colon Rectum. 2007 Nov;50(11):1735-1746. https://www.ncbi.nlm.nih.gov/pubmed/17690937. PMID: 17690937
  18. Turner D, Travis SP, Griffiths AM, et al; European Crohn’s and Colitis Organization; Porto IBD Working Group, European Society of Pediatric Gastroenterology, Hepatology, and Nutrition. Consensus for managing acute severe ulcerative colitis in children: a systematic review and joint statement from ECCO, ESPGHAN, and the Porto IBD Working Group of ESPGHAN. Am J Gastroenterol. 2011 Apr;106(4):574-588. doi: 10.1038/ajg.2010.481. PMID: 21224839
  19. MedWormhttp://www.medworm.com/rss/index.php/Gastroenterology/17/http://www.medworm.com/rss/medicalfeeds/specialities/Gastroenterology.xml
  20. MedWormhttp://www.medworm.com/rss/index.php/Pediatrics/33/http://www.medworm.com/rss/medicalfeeds/specialities/Pediatrics.xml
  21. Peppercorn MA. Clinical manifestations, diagnosis and prognosis of Crohn's disease in adults. UpToDate. http://www.uptodate.com/index. Feb 2011. Accessed 03 Jun 2011
  22. Chan J. A review on the management of Crohn's disease. US Pharmacist. http://www.uspharmacist.com. Jan 2007. Accessed 16 Jun 2011.
  23. Peppercorn MA, Odze RD. Colorectal cancer surveillance in inflammatory bowel disease. UpToDate. http://www.uptodate.com/index. Aug 2010. Accessed 28 Jul 2011.
  24. Peppercorn MA. Clinical manifestations, diagnosis and prognosis of ulcerative colitis in adults. UpToDate. http://www.uptodate.com/index. Jan 2011. Accessed 03 Jun 2011
  25. Crohn's disease. http://www.accessmedicine.com. 2004. Accessed 27 Apr 2005.
  26. National Institute for Health and Care Excellence. Crohn's disease: management in adults, children and young people. NICE. http://www.nice.org.uk. 2012. Accessed 10 Jul 2013.
  27. National Institute for Health and Care Excellence. Guidance on the use of infliximab for Crohn's disease. NICE. http://www.nice.org.uk. 2002. Accessed 30 Sep 2005
  28. Rowe WA. Inflammatory bowel disease. eMedicine. http://emedicine.medscape.com. Jun 2011. Accessed 18 Jul 2011
  29. National Guideline Clearinghouse (NGC). Guideline summary: practice parameters for the surgical treatment of ulcerative colitis. Agency for Healthcare, Research and Quality. http://www.guideline.gov. 18 Jul 2011.
  30. World Gastroenterology Organisation Global Guidelines. Inflammatory bowel disease: a global perspective. World Gastroenterology Organisation. http://www.worldgastroenterology.org. Jun 2009.
  31. National Institute for Health and Care Excellence. Infliximab (review) and adalimumab for the treatment of Crohn’s disease. NICE. http://www.nice.org.uk. 2011. Accessed 09 Jul 2013.
  32. Desimone EM, Lanspa SJ, Hogrefe D, et al. Management and treatment of Crohn's disease. US Pharmacist. http://www.uspharmacist.com. 2004. Accessed 27 Apr 2005.
  33. Peppercorn MA, Farrell RJ. Medical management of ulcerative colitis. UpToDate. http://www.uptodate.com/index. Nov 2010. Accessed 03 Jun 2011
  34. Farrell RJ, Peppercorn MA. Overview of the medical management of mild to moderate Crohn's disease in adults. UpToDate. http://www.uptodate.com/index. 27 Apr 2011. Accessed 03 Jun 2011
  35. Centers for Disease Control and Prevention. Inflammatory bowel disease. CDC. http://www.cdc.gov/ibd/. 14 Jan 2014.
  36. MacDermott RP. Management of mild to moderate ulcerative colitis. UpToDate. http://www.uptodate.com. 13 Feb 2013.
  37. Peppercorn MA, Kane SV. Patient information: ulcerative colitis (beyond the basics). UpToDate. http://www.uptodate.com. 18 Dec 2013.
  38. Travis SP, Danese S, Kupcinskas L, et al. Once-daily budesonide MMX in active, mild-to-moderate ulcerative colitis: results from the randomised CORE II study. Gut. 2014 Mar;63(3):433-441. doi: 10.1136/gutjnl-2012-304258. PMID: 23436336
  39. Bernstein C, Eliakim A, Fedail S, et al. Inflammatory bowel disease. World Gastroenterology Organisation. http://www.worldgastroenterology.org. Aug 2015. Accessed 06 May 2016.
  40. Peppercorn MA, Odze RD. Colorectal cancer surveillance in inflammatory bowel disease. UpToDate. http://www.uptodate.com. 18 Feb 2015. Accessed 28 Jun 2016.
  41. Peyrin-Biroulet L, Panes J, Sandborn WJ, et al. Defining disease severity in inflammatory bowel diseases: current and future directions. Clin Gastroenterol Hepatol. 2016 Mar 11;14(3):348-354. http://dx.doi.org/10.1016/j.cgh.2015.06.001. Accessed 28 Jun 2016
  42. Gomollón F, Dignass A, Annese V, et al. 3. European evidence-based consensus on the diagnosis and management of Crohn's disease 2016: part 1: diagnosis and medical management. J Crohns Colitis. 2017 Jan;11(1):3-25. doi: 10.1093/ecco-jcc/jjw168. PMID: 27660341
  43. Gionchetti P, Dignass A, Danese S, et al. 3. European evidence-based consensus on the diagnosis and management of Crohn's disease 2016: part 2: surgical management and special situations. J Crohns Colitis. 2016 Sep 22. doi: 10.1093/ecco-jcc/jjw169. PMID: 27660342
  44. Gastroenterological Society of Australia (GESA). Clinical update for general practitioners and physicians - inflammatory bowel disease. Updated 2018. GESA. http://www.gesa.org.au. 2018.
  45. Harbord M, Eliakim R, Bettenworth D, et al. Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 2: current management. J Crohns Colitis. 2017 Jul;11(7):769-784. doi: 10.1093/ecco-jcc/jjx009. PMID: 28513805
  46. Lamb CA, Kennedy NA, Raine T, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. BSG. https://www.bsg.org.uk. Jun 2019.
  47. Maaser C, Sturm A, Vavricka SR, et al. ECCO-ESGAR guideline for diagnostic assessment in IBD part 1: initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis. 2019 Feb;13(2):144-164. doi: 10.1093/ecco-jcc/jjy113. PMID: 30137275
  48. Magro F, Gionchetti P, Eliakim R, et al. Third European evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders. J Crohns Colitis. 2017 Jun;11(6):649-670. doi: 10.1093/ecco-jcc/jjx008. PMID: 28158501
  49. Matsuoka K, Kobayashi T, Ueno F, et al. Evidence-based clinical practice guidelines for inflammatory bowel disease. J Gastroenterol. 2018 Mar;53(3):305-353. doi: 10.1007/s00535-018-1439-1. Accessed 02 Aug 2019. PMID: 29429045
  50. National Institute for Health and Care Excellence (NICE). Crohn’s disease: management. NICE. https://www.nice.org.uk. 3 May 2019.
  51. National Institute for Health and Care Excellence (NICE). Ustekinumab for moderately to severely active Crohn’s disease after previous treatment. NICE. https://www.nice.org.uk. 12 Jul 2017. Accessed 12 Aug 2019.
  52. National Institute for Health and Care Excellence (NICE). Vedolizumab for treating moderately to severely active Crohn’s disease after prior therapy. NICE. https://www.nice.org.uk. 26 Aug 2015.
  53. Satsangi J, Silverberg MS, Vermeire S, et al. The Montreal classification of inflammatory bowel disease: controversies, consensus and implications. Gut. 2006 Jun;55(6):749-753. doi: 10.1136/gut.2005.082909. Accessed 07 Aug 2019. PMID: 16698746
  54. Sturm A, Maaser C, Calabrese E, et al. ECCO-ESGAR guideline for diagnostic assessment in IBD part 2: IBD scores and general principles and technical aspects. J Crohns Colitis. 2019 Mar;13(3):273-284. doi: 10.1093/ecco-jcc/jjy114. PMID: 30137278
  55. U.S. Food & Drug Administration. Biosimilar product information. US FDA. https://www.fda.gov/. 24 Feb 2020. Accessed 28 Feb 2020.
  56. Feuerstein JD, Isaacs KL, Schneider Y, et al; American Gastroenterological Association Institute Clinical Guidelines Committee. AGA clinical practice guidelines on the management of moderate to severe ulcerative colitis. Gastroenterology. 2020 Jan 13. pii: S0016-5085(20)30018-4. doi: 10.1053/j.gastro.2020.01.006. PMID: 31945371
  57. Lichtenstein GR, Loftus EV, Isaacs KL, et al. ACG clinical guideline: management of Crohn's disease in adults. Am J Gastroenterol. 2018 Apr;113(4):481-517. doi: 10.1038/ajg.2018.27. PMID: 29610508
  58. Singh S, Fumery M, Sandborn WJ, et al. Systematic review and network meta-analysis: first- and second-line biologic therapies for moderate-severe Crohn's disease. Aliment Pharmacol Ther. 2018 Aug;48(4):394-409. doi: 10.1111/apt.14852. Accessed 24 Mar 2020. PMID: 29920733
  59. Torres J, Bonovas S, Doherty G, et al. ECCO guidelines on therapeutics in Crohn's disease: medical treatment. J Crohns Colitis. 2020 Jan 1;14(1):4-22. doi: 10.1093/ecco-jcc/jjz180. PMID: 31711158
  60. Sulz MC, Burri E, Michetti P, et al. Treatment algorithms for Crohn's disease. Digestion. 2020 Mar 13:1-15. doi: 10.1159/000506364. PMID: 32172251
  61. Dassopoulos T, Cohen R, Scherl E, et al. Identification, assessment and initial medical treatment of ulcerative colitis. Clinical care pathway. American Gastroenterological Association (AGA). https://gastro.org.
  62. Sandborn W, Binion D, Persley K, et al. AGA Institute guidelines for the identification, assessment and initial medical treatment in Crohn’s disease. Clinical decision support tool. American Gastroenterological Association (AGA). https://gastro.org. Accessed Accessed 08 Jan 2021.
  63. American Society for Gastrointestinal Endoscopy Standards of Practice Committee; Shergill AK, Lightdale JR, Bruining DH, et al. The role of endoscopy in inflammatory bowel disease. Gastrointest Endosc. 2015 May;81(5):1101-21.e1-13. doi: 10.1016/j.gie.2014.10.030. PMID: 25800660
  64. Clarke WT, Feuerstein JD. Colorectal cancer surveillance in inflammatory bowel disease: practice guidelines and recent developments. World J Gastroenterol. 2019 Aug 14;25(30):4148-4157. doi: 10.3748/wjg.v25.i30.4148. Accessed 24 Nov 2021. PMID: 31435169
  65. Farraye FA, Odze RD, Eaden J, et al. AGA technical review on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology. 2010 Feb;138(2):746-774. doi: 10.1053/j.gastro.2009.12.035. PMID: 20141809
  66. Feuerstein JD, Ho EY, Shmidt E, et al. AGA clinical practice guidelines on the medical management of moderate to severe luminal and perianal fistulizing Crohn's disease. Gastroenterology. 2021 Jun;160(7):2496-2508. doi: 10.1053/j.gastro.2021.04.022. PMID: 34051983
  67. Raine T, Bonovas S, Burisch J, et al. ECCO guidelines on therapeutics in ulcerative colitis: medical treatment. J Crohns Colitis. 2021 Oct 12;jjab178. doi: 10.1093/ecco-jcc/jjab178. PMID: 34635919
  68. Rubin DT, Ananthakrishnan AN, Siegel CA, et al. ACG clinical guideline: ulcerative colitis in adults. Am J Gastroenterol. 2019 Mar;114(3):384-413. doi: 10.14309/ajg.0000000000000152. PMID: 30840605
  69. Sandborn WJ, Feagan BG, D'Haens G, et al. Ozanimod as induction and maintenance therapy for ulcerative colitis. N Engl J Med. 2021 Sep 30;385(14):1280-1291. doi: 10.1056/NEJMoa2033617. PMID: 34587385
  70. Zeposia highlights of prescribing information. U.S. Food & Drug Administration. https://www.accessdata.fda.gov. May 2021.
  71. Adamina M, Bonovas S, Raine T, et al. ECCO guidelines on therapeutics in Crohn’s disease: surgical treatment. J Crohns Colitis. 2020 Feb;14(2):155-168. doi: 10.1093/ecco-jcc/jjz187. Accessed 18 Apr 2022. PMID: 31742338
  72. Bischoff SC, Escher J, Hébuterne X, et al. ESPEN practical guideline: clinical nutrition in inflammatory bowel disease. Clin Nutr. 2020 Mar;39(3):632-653. doi: 10.1016/j.clnu.2019.11.002. PMID: 32029281
  73. De Simone B, Davies J, Chouillard E, et al. WSES-AAST guidelines: management of inflammatory bowel disease in the emergency setting. World J Emerg Surg. 2021 May;16(1):23. doi: 10.1186/s13017-021-00362-3. PMID: 33971899
  74. Holubar SD, Lightner AL, Poylin V, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the surgical management of ulcerative colitis. Dis Colon Rectum. 2021 Jul;64(7):783-804. doi: 10.1097/DCR.0000000000002037. PMID: 33853087
  75. Ko CW, Singh S, Feuerstein JD, et al. AGA clinical practice guidelines on the management of mild-to-moderate ulcerative colitis. Gastroenterology. 2019 Feb;156(3):748-764. doi: 10.1053/j.gastro.2018.12.009. PMID: 30576644
  76. Kucharzik T, Ellul P, Greuter T, et al. ECCO guidelines on the prevention, diagnosis, and management of infections in inflammatory bowel disease. J Crohns Colitis. 2021 Jun;15(6):879-913. doi: 10.1093/ecco-jcc/jjab052. PMID: 33730753
  77. Lightner AL, Vogel JD, Carmichael JC, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the surgical management of Crohn’s disease. Dis Colon Rectum. 2020 Aug;63(8):1028-1052. doi: 10.1097/DCR.0000000000001716. PMID: 32692069
  78. Murthy SK, Feuerstein JD, Nguyen GC, et al. AGA clinical practice update on endoscopic surveillance and management of colorectal dysplasia in inflammatory bowel diseases: expert review. Gastroenterology. 2021 Sep;161(3):1043-1051. doi: 10.1053/j.gastro.2021.05.063. Accessed 18 Apr 2022. PMID: 34416977
  79. Spinelli A, Bonovas S, Burisch J, et al. ECCO guidelines on therapeutics in ulcerative colitis: surgical treatment. J Crohns Colitis. 2022 Feb;16(2):179-189. doi: 10.1093/ecco-jcc/jjab177. PMID: 34635910
  80. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): colorectal cancer screening. Version 1.2022. NCCN. https://www.nccn.org. 04 Mar 2022.
  81. Hibi T. Risankizumab for Crohn's disease. Lancet. 2022 May 28;399(10340):1992-1993. doi: 10.1016/S0140-6736(22)00628-6. PMID: 35644143
  82. U.S. Food & Drug Administration. Abrilada highlights of prescribing information. US FDA. https://www.fda.gov/. Nov 2019.
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