When choosing an initial therapy for Crohn disease, need to take into account
🔺disease ACTIVITY
🔻disease SEVERITY
@JillGaidosMD "I want first and foremost for your symptoms to improve. I also want your inflammation to resolve."
Even when inflammatory activity is low, intestinal damage can continue to progress. We should target disease severity early, ideally at time of diagnosis.
Treatment options in Crohn disease.
1. Give treatments enough time 2. Optimize dose
Selecting Crohn disease treatment
Treatment of Crohn disease by patient characteristics
Shared decision making is important in selecting #IBD therapy
Case conclusions
Need to continue long-term monitoring for objective measures of inflammation. This allows for dose optimization or switching therapies, to prevent steroids, hospitalization, surgery, and other complications.
💎s from @JillGaidosMD on selecting therapy for Crohn disease
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LFD studies are not great (small n, high bias, heterogeneity), but all the studies do suggest that the LFD is a good treatment option for #IBS and can improve global symptoms, pain, and bloating
App-based low-FODMAP #diet was found to be more effective (71%) than antispasmodic therapy (61%) in #IBS, even 6 months out