ECCO Topical Review: Refractory Inflammatory Bowel Disease
Tim Raine, Bram Verstockt, Uri Kopylov, Konstantinos Κarmiris, Rimma Goldberg, Raja Atreya, Johan Burisch, John P. Burke, Pierre Ellul, Charlotte Hedin, Stefan D. Holubar, Κωνσταντίνος Κατσάνος, Triana Lobatón, Carsten Schmidt, Garret Cullen
Abstract
Inflammatory bowel disease is a chronic disease with variable degrees of extent, severity, and activity. A proportion of patients will have disease that is refractory to licensed therapies, resulting in significant impairment in quality of life. The treatment of these patients involves a systematic approach by the entire multidisciplinary team, with particular consideration given to medical options including unlicensed therapies, surgical interventions, and dietetic and psychological support. The purpose of this review is to guide clinicians through this process and provide an accurate summary of the available evidence for different strategies.