Gastrointestinal

Question 1

Inducing remission in ulcerative colitis?

Answer 1

If mild/moderate: oral aminosalicylates (rectal if distal disease)
Wait four weeks to decide whether treatment fails, then prescribe oral prednisolone
If severe: IV steroids in hospital
possible surgery

Question 2

Maintaining remission in ulcerative colitis?

Answer 2

Oral aminosalicylate
Or combined with topical if distal disease

Consider azathioprine or mercaptopurine if above not enough
Or if 2x exacerbations in one year requiring steroids

Question 3

Inducing remission in Crohn’s disease?

Answer 3

Glucocorticosteroid (prednisolone, methylprednisolone or hydrocortisone
Budenoside if above inappropriate

Consider adding azathioprine or mercaptopurine if not under control

Biologics (infliximab and adalimumab) are considered if no response to above

Question 4

Maintaining remission in Crohn’s disease?

Answer 4

Azathioprine or mercaptopurine

Methotrexate if needed