ECCO Topical Review: Refractory Inflammatory Bowel Disease

J Crohns Colitis. 2021 Oct 7;15(10):1605-1620. doi: 10.1093/ecco-jcc/jjab112.

Abstract

Inflammatory bowel disease is a chronic disease with variable degrees of extent, severity, and activity. A proportion of patients will have disease that is refractory to licensed therapies, resulting in significant impairment in quality of life. The treatment of these patients involves a systematic approach by the entire multidisciplinary team, with particular consideration given to medical options including unlicensed therapies, surgical interventions, and dietetic and psychological support. The purpose of this review is to guide clinicians through this process and provide an accurate summary of the available evidence for different strategies.

Keywords: Crohn’s disease; Inflammatory bowel disease; refractory; ulcerative colitis; unlicensed medication.

Publication types

  • Consensus Development Conference

MeSH terms

  • Biological Factors / therapeutic use
  • Diet
  • Digestive System Surgical Procedures
  • Fecal Microbiota Transplantation
  • Gastrointestinal Agents / therapeutic use
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Inflammatory Bowel Diseases / diagnosis
  • Inflammatory Bowel Diseases / therapy*
  • Medication Adherence
  • Mesenchymal Stem Cell Transplantation
  • Patient Care Team
  • Remission Induction

Substances

  • Biological Factors
  • Gastrointestinal Agents
  • Immunosuppressive Agents

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