Current position and future trends of therapy for Crohn’s disease

Abstract

Despite significant progress in the therapy of Crohn's disease, many problems and unsolved approaches still remain. In this reviewthe author identifies and discusses some of them. Major consideration is focused on therapy of perianal Crohn's disease, on combination therapy with immunomodulators, and biologic therapy including the advantages and limitations of each. Additionally, the approach to patients after surgery and the choice of prophylactic therapy is discussed. At the end of this paper the position of musosal healing in Crohn's disease patients is discussed. It is recognized that mucosal healing has great importance for patients' prognosis after therapy has started, but an endoscopic evaluation of mucosal healing in Crohn's disease partients is far more problematic in comparision to ulcerative colitis patients. This is one reason why monitoring of mucosal healing is not currently standard clinical practice.