Medical Treatment

The current medical therapy for IC is substantially the same, which is usually utilised for UC and CD. In particular, therapy utilises anti-inflammatories drugs (mostly mesalazine with selective colonic release), steroids and immunosuppressives and varies on the basis of disease activity. Black et al. [26] recently evaluated the effectiveness of infliximab in 20 patients with severe, medically refractory IC. Fourteen patients showed complete response, two partial response and four no response. Non-responders underwent ileal pouch-anal anastomosis, and in all cases, surgical specimen was consistent with UC even if two were subsequently reclassified as having CD. Among the remaining patients, eight were diagnosed as having CD and eight UC after long-term follow-up. No significant differences were reported in terms of response to therapy based on diagnosis. Treatment with infliximab could then represent an effective option for patients with refractory IC who are likely to undergo surgery, offering prolonged follow-up time in order to obtain a more definite diagnosis.

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