Management of inflammatory bowel disease

Area of Science:

• Gastroenterology and Internal Medicine
• Diagnostic Biomarkers
• Medical Imaging

Background:

• Australia exhibits high incidence rates of inflammatory bowel disease (IBD).
• Timely diagnosis and intervention are essential for managing IBD, particularly Crohn's disease, to mitigate disability.
• Primary care physicians can utilize fecal calprotectin tests to identify patients with gastrointestinal symptoms who may have IBD.

Purpose of the Study:

• To highlight the importance of early IBD diagnosis and treatment in Australia.
• To discuss the role of fecal biomarkers and advanced imaging in IBD management.
• To review current biological drug treatments available for IBD.

Main Methods:

• Utilizing fecal calprotectin as a sensitive biomarker for initial IBD screening in primary care.
• Employing magnetic resonance imaging (MRI) and/or intestinal ultrasound to avoid radiation exposure from computed tomography (CT) scanning for disease evaluation.
• Reviewing current pharmaceutical options for IBD treatment, including biological drugs.

Main Results:

• Fecal calprotectin aids primary care physicians in identifying patients who may require endoscopy for IBD diagnosis.
• Non-ionizing radiation imaging techniques (MRI, ultrasound) are recommended over CT for regular disease monitoring.
• Five biological drugs (adalimumab, infliximab, golimumab, vedolizumab, ustekinumab) are available through the Pharmaceutical Benefits Scheme for IBD treatment.

Conclusions:

• Prompt identification and management of IBD, supported by fecal biomarkers and appropriate imaging, can alter disease progression and reduce patient disability.
• Regular re-evaluation using safe and reliable methods is key to effective IBD management.
• Advances in biological therapies offer improved disease control for selected IBD patients.