The American College of Gastroenterology (ACG) has updated its clinical guideline for the management of Crohn’s disease in adults. The guidelines represent the official practice recommendations of the ACG and were established for clinical practice with the intent of suggesting preferable approaches to medical problems. The updated guideline includes 60 recommendations along with 53 summary statements. According to the authors, healthcare providers should incorporate this guideline along with patient’s needs, desires, and their values in order to fully and appropriately care for patients with Crohn’s disease. Among the recommendations and observations:
- For diagnosis, ACG now recommends the use of fecal calprotectin as a helpful test that should be considered to help differentiate the presence of IBD from irritable bowel syndrome (IBS).
- Nonsteroidal anti-inflammatory drugs (NSAIDs) may exacerbate disease activity and should be avoided when possible in patients with Crohn’s disease.
- Oral mesalamine is not effective for induction of remission in patients with Crohn’s disease.
- Patients with low risk of progression may manage their disease with non-specific medications and diet.
To view the guideline in its entirety, go to https://www.nature.com/articles/ajg201827.
Lichtenstein GR, Loftus EV, Isaacs KL, Regueiro MD, Gerson LB, Sands BE. ACG clinical guideline: Management of Crohn’s disease in adults. [Published online ahead of print March 27, 2018]. Am J Gastroenterol. doi:10.1038/ajg.2018.27.
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Incidence of Intestinal Infections in IBD, Inflamm Bowel Dis; ePub 2018 May 2; Barber, et al