There are 267,000 patients with Crohn's disease in the US and 437,000 worldwide. These figures are increasing at an average annual rate of 1 per cent. All of these suppress a patient's inflammatory and immune responses to prevent further damage to the intestines. Yet many patients fail to achieve control of their disease despite making chronic use of combination regimens involving all of these agents. In ulcerative colitis, the available classes of agents are used in a step-wise fashion to treat a flare of the disease.
Remission is maintained with aminosalicylates or immunomodulators.
Ostomy surgery is performed in patients at high risk of colorectal cancer and those with uncontrolled disease. Ostomy surgery is a procedure in which a portion of the colon is removed and an opening is created on the abdomen to which the remaining portion of intestine is attached, allowing the patient to evacuate into a plastic ostomy appliance. Although this treatment option is curative in ulcerative colitis, it is aesthetically unappealing to the largely young ulcerative colitis population. Ostomy surgery is also an option for Crohn's disease. It is, however, not curative in this condition because the disease is too diffuse.