Diagnosis and therapy of inflammatory bowel disease

Crohn's disease and ulcerative colitis are complex, relatively uncommon diseases with a prevalence of be tween 1:700 and 1:1500. Thus, the diagnosis and therapy of inflammatory bowel disease is often problematic. The main diagnostic tools, including the demarcation of bacterial infections, are clinical presentation (including specific antibodies: ASCA and p-ANCA, and inflammatory markers: fecal calprotectin and procalcitonin in the serum) and imaging of the bowel. Endoscopy, but also ultrasound of the abdomen, computed tomography and magnetic resonance imaging are the diagnostic mainstays. Therapy depends on the extent and severity of the inflammation, and also on the course of the disease. Uncomplicated flaring in Crohn's disease should only receive remission inducing therapy, whereas all patients with ulcerative colitis should also receive remission maintenance therapy. Severe flares and/or chronic active disease in both Crohn's disease and ulcerative colitis should be treated with immunosuppressants.