Endoscopy with biopsy usually clinches the diagnosis. Diagnosis of CD, although not absolute, may sometimes be made by the typical changes the small bowel seen on barium xrays. Sulfasalazine is the prototype aminosalicylate and newer 5-ASA preparations like Asacol, Pentasa, Dipentum are available. In addition, ASA may be administered as rectal suppositories and enemas. Corticosteroids may be given as intravenously, by mouth or as rectal enemas.
Corticosteroids have substantial long-term toxicity.
6-MP are helpful in reducing the required dose of steroids. However, these drugs may take several months to manifest their action. Several other drugs are used on occasion. Cyclosporine is useful in acutely severe situations. Nicotine is helpful in acute ulcerative colitis.