Review of Current Medical and Surgical Therapy for Inflammatory Bowel Disease

Inflammatory bowel disease, comprised of Crohn's disease (CD) and ulcerative colitis (UC), is a chronic, immune-mediated disorder of the gastrointestinal tract. The therapeutic landscape for IBD has expanded significantly in the last 2 decades with the introduction of biological agents and small-molecule therapies that target specific inflammatory pathways. This review provides an overview of current medical and surgical treatment options for IBD, emphasizing mechanisms of action, clinical efficacy, and safety profiles. Biological therapies, including TNF-α inhibitors, integrin blockers, and interleukin inhibitors, have improved rates of clinical remission and mucosal healing in patients with moderate-to-severe disease. Small-molecule agents, such as Janus kinase (JAK) inhibitors and sphingosine-1-phosphate (S1P) receptor modulators, offer effective oral alternatives for patients who are refractory to or intolerant of biologics. Comparative studies among these therapies continue to guide individualized treatment approaches. This review discusses the emerging role of head-to-head trials, safety considerations, and evolving treatment algorithms that integrate new agents into clinical practice. While IBD remains incurable, current therapies offer promising long-term disease control, relief of symptoms, and improved quality of life.