Novel and future medical management of inflammatory bowel disease

The treatment of inflammatory bowel disease (IBD) is undergoing rapid and profound change. Entirely new approaches are being developed that reflect a greater understanding of how to control the inflammatory process. These began with inflixumab therapy for Crohn's disease. Additional tumor necrosis antibodies will soon be employed, and other biological agents are being investigated. Probiotics, helminth ova therapy, alternative and complementary treatments, leukocytophoresis, and bone-marrow and stem-cell transplantation are additional exciting regimens that are being explored. Although some of these approaches provide marked improvement in these parameters, others are unproven or fraught with adverse effects and complications. Still, control of ulcerative colitis and Crohn's is improving with more changes likely to come.