Management of Low Risk (Mild Severity) Crohns Disease Asymptomatic or Incidentally Discovered on Endoscopy • Any high-risk features? If none continue periodic surveillance • Fecal calprotectin, CRP every 6 months for 1 year, periodically thereafter • Repeat colonoscopy in 6 —12 months, periodically thereafter Mild Disease Activity • Budesonide 9mg/d induction for 8 weeks • 5 ASA (sulfasalazine) for isolated colonic disease • Short course of prednisone • Maintenance options: observation alone, immunomodulators, 5 ASA, repeat course of budesonide • Limited data on safety/efficacy on low dose (3-6mg) budesonide maintenance • If budesonide needed 2x in one year: treat as high risk disease Gregory Brennan MD @GregoryTBrennan #Crohns #Disease #Management #LowRisk #Mild #Gastroenterology
