RECENT ADVANCES IN THE DIAGNOSIS AND MANAGEMENT OF INFLAMMATORY BOWEL DISEASE

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  • HISAMATSU Tadakazu
    Department of Gastroenterology and Hapatology, Kyorin University School of Medicine.

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  • 炎症性腸疾患－診断と治療の最前線－

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Abstract

<p>The number of patients with inflammatory bowel disease (IBD), a chronic inflammatory disease of unknown cause, continues to increase. A new therapeutic strategy aimed at improving long-term prognosis is necessary. The importance of a treatment strategy based on treat to target (T2T), setting a concrete therapeutic goal, has been advocated. Endoscopic remission has been set as a standard treatment target, and further studies are being performed as to whether histological remission should be a treatment target. Appropriate monitoring is also important for T2T treatment strategies. Stool biomarkers such as calprotectin and fecal immunochemical test can be used. Monitoring of small bowel lesions has become possible due to the development of capsule endoscopy and small intestinal balloon endoscopy. In addition, cross-sectional imaging has been developed and used as a diagnostic and monitoring tool in daily practice. In terms of treatment, options such as 5-aminosalicylic acid preparation and budesonide preparation are increasing, and new evidence including NUDT 15 gene polymorphism has been accumulating for thiopurine treatment. Furthermore, with the success of anti-TNFα antibody agents, molecular targeting therapeutic agents against IBD are being developed.</p>

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