← Master Index· Section 5 · Gastrointestinal Disorders · Chapter 26

Inflammatory Bowel Disease

IBDUC vs CDBiologicsTNF-α

30-Second Snapshot

What it is:Inflammatory bowel disease is really two different diseases wearing one name. Ulcerative colitis (UC)is mucosal inflammation confined to the colon and rectum, always continuous, always starting at the rectum and working proximally. Crohn's disease (CD)is transmural inflammation that can hit anywhere from mouth to anus, classically the terminal ileum, and it skips around leaving normal bowel between diseased segments.

The core problem:In a genetically susceptible person, the gut microbiome triggers an immune response that never turns off. TNF-α is the shared final pathway driving inflammation in both diseases, which is why anti-TNF therapy works across both. The details of which cytokines dominate (Th1/Th17 in CD, Th2 in UC) explain why some newer biologics work better in one disease than the other.

What you do about it:Match the drug to three variables: which disease, how severe, and how much bowel is involved. Then think in two phases: induction(get them into remission) and maintenance(keep them there). Most drugs that induce remission also maintain it. Corticosteroids are the huge exception: great for induction, useless and harmful for maintenance.

Worth knowing

Think of therapy as a ladder keyed to location + severity, not a single algorithm. Distal/proctitis UC gets treated topically (rectal therapy) even when extensive UC at the same severity gets systemic therapy. Mild-to-moderate disease starts with 5-ASA or budesonide; moderate-to-severe skips straight to systemic steroids for induction plus a biologic or immunomodulator for durable control. If you remember nothing else: steroids induce, they never maintain.

Ulcerative Colitis vs Crohn's Disease

This comparison is tested constantly because the two diseases really do behave, look, and get treated differently once you get past "chronic GI inflammation."

FeatureUlcerative ColitisCrohn's Disease
LocationRectum first, extends proximally through the colon onlyAnywhere mouth to anus; terminal ileum and cecum classic
DistributionContinuousDiscontinuous / skip lesions
DepthMucosa and submucosa onlyTransmural (full thickness)
Classic lesionCrypt abscess (very common)Granuloma, linear clefts, cobblestone appearance (all common)
Malaise / feverUncommonCommon
Abdominal pain / massUnusual / absentCommon
Fistulas, stricturesRareCommon
Rectal bleedingCommon (bloody diarrhea is classic)Common but can be non-bloody
Major complicationsToxic megacolon, colonic perforation, colorectal cancerStrictures with obstruction, fistulas, abscesses, nutritional deficiency
SmokingProtective (unusual!)Worsens frequency and severity
NSAIDsMay trigger flaresMay trigger flares
Serologyp-ANCA positiveAnti-Saccharomyces cerevisiaeantibodies (ASCA) positive
The distractor to know cold

Everyone assumes "bloody diarrhea = UC only." Wrong: CD can absolutely present with hematochezia too, it's just more classic and more consistentin UC. What actually separates them cleanly is distribution(continuous vs skip lesions) and depth(mucosal vs transmural), not bleeding pattern alone.

Grading severity

UC severity is graded by stool frequency plus systemic signs, and this grading is what determines whether you reach for topical 5-ASA or an ICU bed.

SeverityStools/dayOther findings
Mild(~2/3 of patients)<4, ± bloodNo systemic disturbance, ESR <30 mm/h
Moderate>4Minimal systemic disturbance
Severe>6, with bloodFever, tachycardia, anemia, or ESR >30 mm/h
Fulminant>10, continuous bleedingToxicity, abdominal tenderness, transfusion requirement, colonic dilation

CD disease activity is tracked with composite indices like the Crohn's Disease Activity Index (CDAI), built from 7-day stool count, abdominal pain ratings, general well-being, antidiarrheal use, body weight, hematocrit, and presence of an abdominal mass, plus the shorter Harvey-Bradshaw Index. UC has its own composite scores (Mayo score, Ulcerative Colitis Activity Index) combining stool frequency, rectal bleeding, endoscopic appearance, and physician global assessment. You won't need to memorize the point cutoffs, just recognize these are the tools used to track response and define remission objectively instead of by gut feeling.

Pathophysiology - Why the Drugs Work

Every drug class in this chapter targets a specific step in the same broken pathway: susceptible genetics, a triggering microbial/environmental exposure, and an immune response that can't stand down.

The setup

No single cause has been pinned down, but four ingredients keep showing up together: genetics(first-degree relatives have up to a 20-foldincreased risk, extending even to second- and third-degree relatives), infectious/microbial triggers(mycobacteria, certain E. coli, Listeria, and other organisms implicated), environmental factors, and an abnormal innate immune response. The prevailing model is that gut microflora acts as the environmental trigger that lights up inflammation in someone who was already genetically loaded for it.

Which cytokines, and why it matters for drug choice

DiseaseDominant cytokine patternKey players
Crohn's diseaseTh1 / Th17↑ IFN-γ, IL-12, IL-17A, IL-22
Ulcerative colitisTh2Different cytokine skew, p-ANCA positivity common
BothShared final pathwayTNF-α elevated in mucosa and intestinal lumen of both diseases
The unlock

Read the drug classes straight off the immunology. Anti-TNF agents(infliximab, adalimumab, certolizumab, golimumab) neutralize the cytokine shared by both diseases, which is why they work in UC and CD. Anti-IL-12/23 and anti-IL-23 agents(ustekinumab, risankizumab, mirikizumab, guselkumab) target the Th1/Th17 axis that's especially active in CD. Anti-integrin agents(vedolizumab, natalizumab) don't touch cytokines at all, they physically block leukocytes from adhering to gut endothelium and migrating in, which is why they're "gut-selective" with a different safety profile. 5-ASA compoundsact topically within the bowel lumen with an unclear but locally anti-inflammatory mechanism (inhibiting leukocyte motility, interfering with cytokine production) and are barely absorbed systemically, so they work best where they can physically contact inflamed mucosa.

Antineutrophil cytoplasmic antibodies (p-ANCA) show up in a high percentage of UC patients and less often in CD; patients with CD typically carry antibodies to Saccharomyces cerevisiae(ASCA), reflecting an abnormal immune reaction to intestinal organisms. Smoking is protective in UC but worsens CD, one of the genuinely strange asymmetries in this disease pair, and nobody fully understands why. NSAIDs can trigger disease occurrence or flares in both.

Local complications explain the anatomy-specific drug strategy

Because UC is mucosal and confined to the colon, its local complications are things like hemorrhoids, anal fissures, perirectal abscesses, and (in a minority) toxic megacolon, occurring in up to 7.9%of hospitalized UC patients. Because CD is transmural and can occur anywhere, its complications are structural: small bowel strictureswith obstruction, and fistula formation, which happens far more often than in UC since a full-thickness inflamed tract can burrow through to adjacent structures. This is the anatomic reason CD needs surgeons involved earlier and more often for drainage/resection of fistulizing disease, while UC surgery is more often a colectomy for disease control.

Clinical Presentation

Both diseases run a relapsing-remitting course: bouts of active illness separated by intervals of quiet, sometimes for years.

Ulcerative ColitisCrohn's Disease
SymptomsAbdominal cramping, frequent BMs often with blood, weight loss, fever/tachycardia if severeMalaise, fever, abdominal pain, frequent BMs, hematochezia, fistula, weight loss/malnutrition
ExamHemorrhoids, anal fissures, perirectal abscesses may be presentAbdominal mass and tenderness, perianal fissure or fistula
Labs↓ Hgb/Hct, ↑ ESR/CRP/fecal calprotectin, leukocytosis + hypoalbuminemia if severe, (+) p-ANCA↑ WBC/ESR/CRP/fecal calprotectin, (+) ASCA

Extraintestinal manifestations - shared across both diseases

Toxic megacolon red flags

High fever, tachycardia, distended abdomen, elevated WBC, and a dilated colon on imaging. This is a UC emergency (up to 7.9% of hospitalized UC patients) that needs aggressive supportive care, IV steroids, and early surgical consultation, not another round of outpatient mesalamine.

Diagnosis

Diagnosis is clinical plus objective confirmation: history, exam, labs, imaging, and endoscopy with biopsy. No single test rules IBD in or out.

Labs that matter

Imaging and endoscopy

CT, ultrasound, MRI, and endoscopy (colonoscopy, sigmoidoscopy, capsule endoscopy) localize and characterize disease, and biopsy confirms histology (crypt abscesses favor UC; granulomas favor CD).

How fecal calprotectin actually gets used

It's cheap, noninvasive, and correlates with mucosal inflammation, which makes it a great tool for triage ("does this patient need a scope") and for monitoring a known IBD patient's trend without repeat colonoscopy. A normal fecal calprotectin makes active IBD unlikely; a rising one in a quiet patient is an early flag before symptoms fully declare themselves.

Two inflammatory biomarkers specific to intestinal inflammation

Your course material flags fecal calprotectinand fecal lactoferrinspecifically as the two biomarkers that reflect intestinal (not just systemic) inflammation, as opposed to ESR/CRP which rise with inflammation anywhere in the body. Know that distinction, it's an easy short-answer trap.

Treatment: Goals, Framework, and Algorithms

Goals:resolve the acute inflammatory process, resolve complications like fistulas or abscesses, control extraintestinal manifestations like arthritis, achieve and maintain remission, and reserve surgery for palliation or cure when medical therapy fails. Modern practice targets objective endpoints, mucosal healing and endoscopic remission, not just "the patient feels better" (the treat-to-targetapproach).

Induction vs maintenance is the whole game

Ask two questions for every drug: (1) can it induce remission, (2) can it maintain it?Corticosteroids (oral or IV) are excellent inducers and terrible maintainers, they have no role in long-term control and should always be tapered off over 2-4 weeks once remission is reached. Biologics, thiopurines, methotrexate, and 5-ASA (in UC) generally do both. Cyclosporine and IV corticosteroids are induction/rescue-only tools.

Nonpharmacologic groundwork

Ulcerative colitis algorithm

Two variables drive the choice: extent(proctitis/distal vs extensive) and severity(mild, moderate, severe, fulminant).

Severity / extentInductionMaintenance
Proctitis (mild-mod)Rectal 5-ASA ± rectal corticosteroidRectal 5-ASA
Left-sided (mild-mod)Rectal + oral 5-ASA ± oral budesonide MMXOral 5-ASA
Extensive (mild-mod)Oral 5-ASA 2-3 g/day ± oral budesonide MMX 9 mg/dayOral 5-ASA ≥2 g/day
Moderate-to-severeOral systemic corticosteroid ± anti-TNF (adalimumab, golimumab, infliximab+thiopurine preferred if treatment-naive), vedolizumab, tofacitinib/upadacitinib, or ustekinumab/guselkumab/mirikizumab/risankizumabContinue the successful induction agent (except corticosteroid, methotrexate, cyclosporine, which never maintain)
Severe/fulminant, hospitalizedIV methylprednisolone 40-60 mg/day or hydrocortisone; if no response in 3-5 days, IV cyclosporine 2-4 mg/kg/day or infliximabTransition survivors to thiopurine or vedolizumab (if induced with cyclosporine) or continue TNF-inhibitor/immunomodulator (if induced with infliximab)
Rules worth memorizing from the algorithm

Topical mesalamine (enema/suppository) beats oralmesalamine or topical steroids for distal disease. Budesonide MMX is preferred over systemic corticosteroids when it's an option for moderate disease. When induction with corticosteroids works, hand off to a thiopurinefor maintenance since steroids can't do that job. Fulminant UC failing IV steroids gets 3-5 days, not weeks, before escalating to cyclosporine or infliximab. And critically: avoid switching a failed originator anti-TNF to its own biosimilar, switch to a different agent instead.

Crohn's disease algorithm

Severity / locationInductionMaintenance
MildSulfasalazine 3-6 g/day (marginal efficacy; newer mesalamine derivatives even less effective in CD)Consider treating as moderate-to-severe; 5-ASA agents are not preferred long-term
Small bowel (ileal/ascending colonic)Budesonide CIR 9 mg/day, preferred first-line for this distributionCan continue budesonide up to ~4 months; not indefinite
Perianal diseaseMetronidazole up to 10-20 mg/kg/day ± infliximabAnti-TNF-based maintenance
ModeratePrednisone + infliximab, adalimumab, certolizumab, or vedolizumab ± methotrexate/azathioprine/mercaptopurine. Consider infliximab pre-surgery as a last optionTaper prednisone after 2-4 weeks; continue the biologic ± immunomodulator
SevereHydrocortisone 100 mg IV every 6-8 h; add azathioprine/mercaptopurine/methotrexate if not already on board; switch to natalizumab or vedolizumab if no response to anti-TNF + immunomodulatorConsider anti-TNF trough monitoring; ustekinumab as a last-line option
The TNF-inhibitor + thiopurine combo

Combining an anti-TNF agent with a thiopurine has become the preferred approach for moderate-to-severe CD, not because either alone is weak, but because the thiopurine reduces immunogenicity (antibody formation against the biologic), extending how long the biologic keeps working. This combination principle shows up again under therapy failure below.

Newer agents your course material adds beyond the classic handbook algorithm, now used across both diseases in moderate-to-severe disease unresponsive to first-line biologics: risankizumab, mirikizumab, and guselkumab(anti-IL-23), and upadacitinib(JAK inhibitor, CD-approved) alongside tofacitinib (UC-approved) and the S1P modulators ozanimod/estrasimod (UC-approved).

Dosing Table

DrugInitial / InductionUsual / Maintenance
5-Aminosalicylates (mainly UC)
Sulfasalazine (Azulfidine)500 mg-1 g4-6 g/day (CD: 3-6 g/day)
Mesalamine (Asacol HD, Delzicol, Lialda, Pentasa, Apriso)1.2-2 g/day1.5-4.8 g/day (varies by formulation)
Mesalamine suppository (Canasa)1 g1 g daily to 3x weekly
Mesalamine enema (Rowasa)4 g4 g daily to 3x weekly
Olsalazine (Dipentum)1.5 g/day1.5-3 g/day
Balsalazide (Colazal)2.25 g/day2.25-6.75 g/day
Corticosteroids
Budesonide MMX (Uceris) - UC9 mg PO once dailyUp to 8 weeks, then taper
Budesonide CIR (Entocort EC) - CD9 mg PO once dailyUp to 8 weeks, then 6 mg/day up to 3 months
Budesonide rectal foam (Uceris)2 mg BID2 mg daily
Prednisone40-60 mg/dayTaper over 2-4 weeks; no maintenance role
Methylprednisolone / hydrocortisone (severe/toxic megacolon)40-60 mg/day IV or hydrocortisone 100 mg IV q6-8hInduction only
Immunomodulators / immunosuppressants
Azathioprine (Imuran, Azasan)50-100 mg initial1-2.5 mg/kg/day
Mercaptopurine (Purinethol, Purixan)50-100 mg initial0.75-2.5 mg/kg/day
Methotrexate15-25 mg IM/SC weeklySame, weekly (CD only)
Cyclosporine (rescue, severe UC)2-4 mg/kg/day IV2-8 mg/kg/day oral if transitioned
Anti-TNF-α (UC and CD except golimumab = UC only)
Infliximab (Remicade + biosimilars)5 mg/kg IV weeks 0, 2, 65-10 mg/kg IV every 8 weeks
Adalimumab (Humira + biosimilars)160 mg SC day 1, 80 mg day 1540 mg SC every 2 weeks from day 29
Certolizumab pegol (Cimzia) - CD only400 mg SC weeks 0, 2, 4400 mg SC every 4 weeks
Golimumab (Simponi) - UC only200 mg SC wk 0, 100 mg wk 2100 mg SC every 4 weeks
Anti-integrin
Vedolizumab (Entyvio) - UC and CD300 mg IV weeks 0, 2, 6300 mg IV every 8 weeks
Natalizumab (Tysabri) - CD, refractory only300 mg IV300 mg IV every 4 weeks
Anti-IL-12/23 and anti-IL-23
Ustekinumab (Stelara) - UC and CDWeight-based IV: <55 kg 260 mg, 55-85 kg 390 mg, >85 kg 520 mg90 mg SC every 8 weeks
Risankizumab (Skyrizi) - UC1200 mg IV weeks 0, 4, 8180-360 mg SC wk 12, then every 8 weeks
Risankizumab (Skyrizi) - CD600 mg IV weeks 0, 4, 8180-360 mg SC wk 12, then every 8 weeks
Mirikizumab (Omvoh) - UC300 mg IV weeks 0, 4, 8200 mg SC wk 12, then every 4 weeks
Mirikizumab (Omvoh) - CD900 mg IV weeks 0, 4, 8300 mg SC wk 12, then every 4 weeks
Guselkumab (Tremfya) - UC and CD400 mg SC/IV weeks 0, 4, 8100 mg SC every 8 weeks from wk 16
JAK inhibitors
Tofacitinib (Xeljanz) - UC10 mg PO BID for 8 weeks (max 16 weeks)5 mg PO BID
Upadacitinib (Rinvoq) - UC and CDPer product labelingPer product labeling
S1P receptor modulators - UC only
Ozanimod (Zeposia)0.23 mg daily days 1-4, 0.46 mg daily days 5-70.92 mg daily from day 8
Estrasimod (Velsipity)Per product labelingPer product labeling

Upadacitinib and estrasimod doses are intentionally left as "per product labeling" here; neither source material gave exact mg values, and this deck won't guess at biologic/small-molecule dosing.

Drug Class Detail

5-ASA agents - sulfasalazine vs mesalamine vs olsalazine/balsalazide

Sulfasalazineis a prodrug: a sulfonamide antibiotic (sulfapyridine) chemically bonded to mesalamine (5-ASA). Gut bacteria cleave the azo bond in the colon, releasing active mesalamine locally while the sulfapyridine moiety gets absorbed and causes most of the adverse effects (dose-related nausea, dyspepsia, headache, fatigue, plus rare but serious toxic epidermal necrolysis/SJS, pancreatitis, hepatitis, bone marrow suppression, interstitial nephritis, hemolytic anemia). Because it contains a sulfa moiety, it's contraindicated with true sulfa allergy.

Olsalazine and balsalazideuse the same diazo-bond strategy (two mesalamine molecules, or mesalamine plus an inert carrier) to deliver drug to the colon without the sulfa component, so they dodge the sulfa-allergy issue. Olsalazine's signature side effect is secretory diarrhea from the unabsorbed diazo compound in the small bowel.

Mesalamineformulations (Asacol HD, Delzicol, Lialda, Pentasa, Apriso) use pH-dependent or delayed/controlled-release coatings instead of a diazo bond, releasing the same active moiety at different points along the GI tract depending on formulation, which is why formulation choice matters for ileal vs colonic disease. Generally the best-tolerated of the group; rare but real risks include interstitial nephritis, pancreatitis, pericarditis, myocarditis, pneumonitis, and hypersensitivity.

Don't forget the folate

Sulfasalazine inhibits folic acid absorption. Every patient on it needs oral folic acid supplementation, and it's an easy add-on to miss when you're focused on the GI symptoms.

Efficacy note:5-ASA agents work reasonably well in UC but have marginal-to-minimal efficacy in CD, and are not preferred for CD maintenance. This asymmetry trips people up because it's the same drug class treated very differently by disease.

Corticosteroids - MMX vs CIR, and why they're induction-only

Two targeted budesonide formulations exploit different release chemistry to hit different bowel segments: budesonide MMX (Multi-Matrix System, Uceris)is a pH-dependent tablet that delays release until the colon, used for mild-to-moderate UC. Budesonide CIR (Controlled Ileal Release, Entocort EC)is a controlled-release capsule that delivers drug to the terminal ileum, used for mild-to-moderate ileal/right-sided CD. Both undergo extensive first-pass hepatic metabolism via CYP3A4, giving low systemic bioavailability and fewer steroid-type side effects than systemic corticosteroids, but still real drug interaction potential with CYP3A4 inhibitors.

Systemic corticosteroids (prednisone 40-60 mg/day, or IV methylprednisolone/hydrocortisone for severe/fulminant disease) are used for moderate-to-severe active disease unresponsive to aminosalicylates, or when faster symptom control is needed. Adverse effects with any systemic use: hyperglycemia, hypertension, osteoporosis, acne, fluid retention, electrolyte disturbances, myopathy, muscle wasting, increased appetite, psychosis, infection risk, and adrenocortical suppression.

The rule that gets tested every time

Corticosteroids have zero role in maintenancefor either UC or CD, they don't alter the long-term disease course and chronic use just accumulates toxicity. Always taper gradually over 2-4 weeks after remission, never stop abruptly (adrenal insufficiency/crisis risk), and always have a maintenance plan (5-ASA, thiopurine, biologic) ready before you start the taper.

Thiopurines, methotrexate, cyclosporine - the "conventional" immunomodulators

Azathioprineand its active metabolite mercaptopurineimpair purine biosynthesis, halting DNA synthesis and inhibiting proliferation of activated immune cells. They're used for long-term maintenance in both diseases, generally reserved for patients who fail 5-ASA or are steroid-refractory/steroid-dependent, and they are not used to induce remissionin moderate-to-severe CD, only to maintain steroid-induced remission.

TPMT before you dose

Efficacy and toxicity of thiopurines hinge on thiopurine methyltransferase (TPMT)activity (or NUDT15 phenotype). Rapid TPMT activityshunts metabolism toward 6-methylmercaptopurine (hepatotoxic, less effective) with lower 6-thioguanine (6-TGN). Normal activitygives a normal 6-TGN level. Intermediate activityraises 6-TGN, consider a 50% dose reduction. Minimal/poor activityproduces the highest 6-TGN and real bone marrow suppression risk, thiopurines are not recommendedhere. Therapeutic 6-TGN concentrations run 230-450 pmol per 8×10⁸ erythrocytes, though routine monitoring isn't available everywhere. Also watch the classic interaction: allopurinolblocks thiopurine metabolism and can precipitate severe toxicity.

Methotrexateis a folic acid analogue that inhibits dihydrofolate reductase, blocking purine and thymidine synthesis. Dosed 15-25 mg IM or SC once weekly (never daily, that's a fatal dosing error), it's an option for CD(not established for UC), reduces steroid dependency, and may substitute for thiopurines. Check a baseline pregnancy test before starting given its known effects on the fetus, and supplement folic acid to offset deficiency. Watch for bone marrow suppression, pancreatitis, pneumonitis/pulmonary fibrosis, hepatitis, GI upset, and CNS symptoms like fatigue and headache.

Cyclosporineinhibits calcineurin, blocking IL-2 and other stimulatory cytokine gene expression. Its role is narrow: short-term rescue in acute severe UCfailing IV corticosteroids, to avoid colectomy, dosed as a continuous IV infusion (2-4 mg/kg/day). It has little efficacy in CD. Not a maintenance drug, patients get bridged to a thiopurine or vedolizumab once stabilized.

Biologics - anti-TNF, anti-integrin, anti-IL-12/23, and the biosimilar trap

Anti-TNF agents(infliximab, adalimumab, certolizumab, golimumab) bind and neutralize TNF-α, useful for moderate-to-severe active disease and for steroid-dependent or fistulizing disease, as both induction and maintenance. Infliximab is chimeric (part mouse, part human), adalimumab and golimumab are fully human, certolizumab is a humanized, pegylated Fab fragment. Chimeric agents carry more immunogenicity risk than fully human ones. Golimumab is not approved for CD in the US, UC only. All carry a boxed warning for increased risk of infections and malignancies; require TB testing and viral serology screening before starting; and can trigger infusion reactions (infliximab especially) or injection-site reactions.

Anti-integrin agentswork completely differently: vedolizumabblocks α4β7 integrin, preventing lymphocyte adhesion and migration specifically into gut tissue (gut-selective), approved for moderate-to-severe UC and CD, and notably not associated with PMLthe way natalizumab is. Natalizumabblocks integrins more broadly (not gut-selective) and carries a real risk of progressive multifocal leukoencephalopathy (PML), so it's reserved for CD unresponsive to other therapies, with brain MRI and mental status monitoring built into follow-up.

Anti-IL-12/23 and anti-IL-23-selective agents(ustekinumab targets the shared p40 subunit of IL-12 and IL-23; risankizumab, mirikizumab, and guselkumab selectively target IL-23's p19 subunit) block cytokines that drive Th1/Th17 activation of lymphocytes, approved across moderate-to-severe UC and CD. Watch for rare posterior reversible encephalopathy syndrome (PRES) with ustekinumab, and avoid live vaccines (especially BCG, 1 year before/after) with this whole class.

Not all biosimilars are interchangeable

Biosimilars are not automatically swappable with each other or with the reference product. For infliximab, none of the current biosimilars (Inflectra, Avsola, Ixifi, Renflexis) are FDA-designated interchangeable with Remicade. For adalimumab, some are interchangeable (Cyltezo, Abrilada) while others (Amjevita, Hadlima) are not. Golimumab and certolizumab currently have no biosimilars. Always check the FDA Purple Bookbefore substituting, and remember the algorithm rule: if a patient fails an originator anti-TNF, don't just switch them to that same drug's biosimilar.

JAK inhibitors and S1P modulators - the newer oral small molecules

Tofacitinib(UC) and upadacitinib(UC and CD) inhibit Janus kinase signaling, blunting the intracellular signal transduction that activates the inflammatory response, given orally instead of by infusion or injection. Tofacitinib's monitoring burden is substantial and reflects real safety signals seen in trials: screen for baseline TB, don't start if lymphocytes <500/mm³, ANC <1000/mm³, or hemoglobin <9 g/dL, monitor lipids and LFTs every 4-8 weeks, watch for infection, thrombosis, lymphoma, and GI perforation (reported with the XR formulation), and check for drug interactions with CYP3A4/2C19 inhibitors. Avoid live vaccines with this class as well.

Ozanimodand estrasimodactivate sphingosine-1-phosphate (S1P) receptors, which traps lymphocytes in lymph nodes and blocks their movement to sites of gut injury, an oral, non-immunosuppressive-feeling mechanism that still carries real cardiac and ophthalmic monitoring requirements. Before starting ozanimod: baseline ECG, WBC, LFTs, ophthalmic exam, and varicella zoster antibody testing. It's contraindicated with a recent history (within 6 months) of MI, unstable angina, stroke/TIA, decompensated heart failure, Mobitz II or third-degree AV block, sick sinus syndrome, or with concomitant MAOI use, and requires effective contraception during and for 3 months after use in women of childbearing age given fetal risk. Watch for macular edema, changes in vision, heart rate/blood pressure changes, and respiratory symptoms.

This entire oral small-molecule group shares one theme: convenience of a pill instead of an infusion, traded for a monitoring checklist that's arguably heavier than some of the biologics.

Complications, Special Situations, and Therapy Failure

Toxic megacolon

Requires general supportive care, consideration of early surgery, and drug therapy together, not sequentially. Aggressive fluid and electrolyte correction for dehydration; blood transfusion if significant blood loss occurred; high-dose IV steroids(e.g., hydrocortisone 100 mg every 8 hours) to knock down acute inflammation; and broad-spectrum antimicrobialscovering gram-negative bacilli and intestinal anaerobes as preemptive therapy if perforation occurs or is suspected.

Fistulizing and perianal Crohn's

Fistulas are common in CD because the inflammation is transmural. Simple perianal fistulas can respond to metronidazole, sometimes combined with infliximab for more complex or refractory fistulizing disease.

Surgery

Extraintestinal manifestation management

Therapeutic drug monitoring and anti-TNF therapy failure

Guidelines recommend reactive TDMfor anti-TNF agents (check trough level and antidrug antibodies when a patient is losing response) rather than routine trough checks on everyone, and routine TPMT testingbefore starting thiopurines to guide dosing.

Failure patternLabsWhat it meansWhat to do
Mechanistic failureAdequate trough, no antibodiesDrug level is fine, the mechanism just isn't controlling this patient's diseaseSwitch to a different drug classentirely; staying within the same class won't help
Non-immune-mediated PK failureSubtherapeutic trough, no antibodiesDrug is being cleared too fast, not being rejectedIncrease dose or shorten the interval
Immune-mediated PK failureLow/undetectable trough, high antidrug antibody titersThe immune system is neutralizing the drugSwitch to another drug within the same class(a different anti-TNF, not the same one's biosimilar)
Why combination therapy shows up so often

Pairing an anti-TNF with a thiopurine reduces the odds of immune-mediated PK failure by lowering antidrug antibody formation, which is the mechanistic reason combo therapy extends how long a biologic keeps working. It's not just "more immunosuppression is better," it's targeting a specific failure mode.

Monitoring - What, When, Why

Drug(s)Watch forMonitoring parameters
SulfasalazineN/V, headache, rash, anemia, pneumonitis, hepatotoxicity, nephritis, thrombocytopenia, lymphomaFolate level, CBC, LFTs, SCr/BUN. Increase dose slowly over 1-2 weeks
MesalamineN/V, headache, GI disturbancesGenerally minimal; watch renal function
CorticosteroidsHyperglycemia, dyslipidemia, osteoporosis, hypertension, acne, edema, infection, myopathy, psychosisBP, fasting lipid panel, glucose, vitamin D, bone density. Avoid long-term use or switch to budesonide
Azathioprine / MercaptopurineBone marrow suppression, pancreatitis, lymphoma, liver dysfunction, rash, arthralgiaCBC, SCr/BUN, LFTs, TPMT/NUDT15 genotype-phenotype; may monitor 6-TGN
MethotrexateBone marrow suppression, pancreatitis, pneumonitis/pulmonary fibrosis, hepatitisCBC, SCr/BUN, LFTs, baseline pregnancy test, chest x-ray
Infliximab / Adalimumab / Certolizumab / GolimumabInfusion reactions (infliximab), infection, heart failure, optic neuritis, demyelination, injection site reactionBP/HR with infliximab, neurologic exam/mental status, trough concentrations (infliximab), antidrug antibodies (all), baseline negative PPD and viral serologies
Natalizumab / VedolizumabInfusion reactions, PML (natalizumab only, not vedolizumab)Brain MRI and mental status if natalizumab
UstekinumabInfections, skin cancers, rare PRESS/S of infection, annual skin exam, avoid live vaccines
TofacitinibInfection, thrombosis, lymphoma, elevated cholesterol/CK/LFTs, cytopeniasS/S infection or thrombosis, baseline TB screen, lipids and LFTs every 4-8 weeks, avoid live vaccines
OzanimodInfection, bradyarrhythmia, hepatotoxicity, macular edema, fetal riskBaseline ECG, WBC, LFTs, ophthalmic exam, VZV antibody testing, effective contraception

Patient Counseling - What You'll Actually Say

  • On sulfasalazine:"This medication can lower your folate, so you'll take a folic acid supplement alongside it. If you have a sulfa allergy, tell me now, this drug contains a sulfa component."
  • On budesonide (MMX or CIR):"Don't stop this suddenly once you've been on it a while. Your body's own steroid production slows down, and stopping abruptly can make you seriously sick. We'll taper it together."
  • On thiopurines:"Before we start, we're going to run a blood test to check an enzyme called TPMT. It tells us how you'll process this drug, so we can pick the right starting dose instead of guessing."
  • On methotrexate:"This is a once-weekly dose, not a daily one. Taking it daily by mistake can be dangerous. We'll also check a pregnancy test before starting, and you'll need reliable contraception while on it."
  • On biologics generally:"Before you start, we need to test you for tuberculosis and a couple of viral infections, because these medications lower part of your immune defense. And no live vaccines while you're on it, only inactivated ones."
  • On infliximab infusions:"Some people react during or shortly after the infusion, itching, flushing, chest tightness. Tell the infusion nurse immediately if you notice anything, they can slow the infusion or treat it."
  • On switching biologics:"If this drug stops working, we may switch you to a different one. That switch isn't automatic, so we'll check drug levels and antibody levels first to figure out exactly why it stopped working before picking the next step."
  • On NSAIDs:"Try to avoid ibuprofen, naproxen, and similar over-the-counter pain relievers. They can actually trigger a flare of your IBD, even though they seem unrelated. Acetaminophen is a safer choice for pain."
  • On smoking (UC vs CD):"I know this sounds backwards, but smoking can actually worsen Crohn's specifically, quitting is genuinely part of your treatment plan for Crohn's. For ulcerative colitis, the relationship runs the other way, which is not a reason to start smoking."
  • On symptom tracking:"Keep a rough log of how many bowel movements you're having each day and whether there's blood. That number is one of the biggest things we use to tell if you're flaring or improving."

High-Yield Recall Sheet

  • UC:mucosal, continuous, rectum-first, colon-only. CD:transmural, skip lesions, mouth to anus, terminal ileum classic.
  • TNF-αis elevated in both diseases, the shared target that makes anti-TNF agents work across UC and CD.
  • Smoking:protective in UC, worsens CD. NSAIDs can flare both.
  • Toxic megacolon:up to 7.9% of hospitalized UC patients; fever, tachycardia, distended/dilated colon, elevated WBC.
  • Severity by stool count (UC):mild <4/day, moderate >4/day, severe >6/day + systemic signs, fulminant >10/day + toxicity.
  • Fecal calprotectin and fecal lactoferrinare the two intestine-specific inflammatory biomarkers, distinct from systemic ESR/CRP.
  • p-ANCA leans UC, ASCA leans CD(neither diagnostic alone).
  • Steroids induce, never maintain.Always taper over 2-4 weeks; no long-term role in either disease.
  • Budesonide MMX= UC (colon-targeted). Budesonide CIR= CD (ileum-targeted).
  • Topical rectal 5-ASA beats oral 5-ASA or topical steroidsfor distal/proctitis disease.
  • 5-ASA works in UC, has marginal-to-minimal efficacy in CD.
  • TPMT activitybefore thiopurines: minimal activity → don't use (bone marrow suppression risk); intermediate → consider 50% dose reduction. Watch the allopurinolinteraction.
  • Methotrexateis weekly, not daily; CD only, not UC; check pregnancy test first.
  • Cyclosporine:rescue for severe UC only, little efficacy in CD.
  • Golimumab is UC-onlyin the US, not approved for CD.
  • Vedolizumab is gut-selective and not linked to PML; natalizumab is not gut-selective and does carry PML risk.
  • Not all biosimilars are interchangeable.Check the FDA Purple Book; don't switch a failed originator to its own biosimilar.
  • Three failure patterns for biologics:mechanistic (switch class), non-immune PK (increase dose/frequency), immune-mediated PK (switch within class, high antidrug antibodies + low trough).
  • Anti-TNF + thiopurine comboreduces immunogenicity and extends how long the biologic keeps working.
  • UC colectomy is curative; CD surgery is not(high recurrence since disease can appear anywhere else in the GI tract).