Inflammatory bowel disease comprises a group of chronic idiopathic inflammatory disorders of the intestine, ulcerative colitis and Crohn's disease. These disorders currently afflict over 1 million Americans and have an annual incidence of 70,000 to 100,000 cases in the United States alone. Despite an inability to identify the etiologic agents of ulcerative colitis and Crohn's disease, we are still able to diagnose and treat these disorders effectively. Although Crohn's disease currently has no medical or surgical cure, we are able to effectively alter its natural course and achieve and maintain symptomatic remission pharmacologically. Total proctocolectomy with ileoanal pouch construction is not the panacea it was initially thought to be, because it can be associated with a small perioperative morbidity and subsequent development of pouchitis, a clinical syndrome that has symptoms often indistinguishable from those of ulcerative colitis. Thus, medical therapy remains the mainstay of treatment for ulcerative colitis. Effective treatment of ulcerative colitis and Crohn's disease is dependent on establishing a precise diagnosis and determining the extent and severity of disease. In this paper, the current standard medical therapies available for treatment of patients with inflammatory bowel disease will be reviewed along with their efficacy and side effects, as well as the status of other investigative drugs.
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