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Observations on the Medical Treatment of Inflammatory Bowel Disease

Joseph B. Kirsner, MD, PhD
JAMA. 1980;243(6):557-564. doi:10.1001/jama.1980.03300320045027.
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IN THE absence of decisive knowledge of the causes of inflammatory bowel disease (IBD), there continues to be no consistently curative medical treatment for ulcerative colitis and Crohn's disease.1-3 Treatment has included such widely diverse approaches as prefrontal lobotomy,4 hog extract,5 Calmette-Guérin bacillus,6,7 vaccines including Bargen's Streptococcus, irradiation,8 gonadotropins, "regulation of abnormal electrical rhythm of the bowel" with coherin,9 fasting, tranquilizers, phenylbutazone,10 lithium carbonate,11 psychotherapy,12 mineral water,13 immunosuppressive drugs, and empirical measures for which rationale is not apparent.

Many patients with mild ulcerative colitis and with mild regional enteritis respond favorably to simple treatments, including adequate rest, dietary adjustments, sedation, and perhaps sulfasalazine and other antibacterial agents. The emphasis in this article, therefore, is on selected aspects of the medical treatment of the moderately or severely ill IBD patient.

A major flaw in the evaluation of therapeutic agents in IBD is


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