Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada, .
Saudi J Gastroenterol. 2014 Mar-Apr;20(2):81-101. doi: 10.4103/1319-3767.129473.
Over the past two decades, several advances have been made in the management of patients with inflammatory bowel disease (IBD) from both evaluative and therapeutic perspectives. This review discusses the medical advancements that have recently been made as the standard of care for managing patients with ulcerative colitis (UC) and Crohn's Disease (CD) and to identify the challenges associated with implementing their use in clinical practice. A comprehensive literature search of the major databases (PubMed and Embase) was conducted for all recent scientific papers (1990-2013) giving the recent updates on the management of IBD and the data were extracted. The reported advancements in managing IBD range from diagnostic and evaluative tools, such as genetic tests, biochemical surrogate markers of activity, endoscopic techniques, and radiological modalities, to therapeutic advances, which encompass medical, endoscopic, and surgical interventions. There are limited studies addressing the cost-effectiveness and the impact that these advances have had on medical practice. The majority of the advances developed for managing IBD, while considered instrumental by some IBD experts in improving patient care, have questionable applications due to constraints of cost, lack of availability, and most importantly, insufficient evidence that supports their role in improving important long-term health-related outcomes.
在过去的二十年中，在评估和治疗的角度来看，炎症性肠病（IBD）患者的管理方面已经取得了一些进展。本综述讨论了最近在溃疡性结肠炎（UC）和克罗恩病（CD）的管理标准方面取得的医学进展，并确定了在临床实践中实施这些进展所面临的挑战。对主要数据库（PubMed 和 Embase）进行了全面的文献检索，以获取所有最近的科学论文（1990-2013 年），提供了 IBD 管理的最新更新数据。管理 IBD 的报告进展范围从诊断和评估工具，如遗传测试、活动的生化替代标志物、内镜技术和放射学模式，到治疗进展，包括医疗、内镜和手术干预。有一些有限的研究探讨了这些进展的成本效益和对医疗实践的影响。虽然一些 IBD 专家认为，大多数为管理 IBD 而开发的进展对于改善患者护理是有帮助的，但由于成本、缺乏可用性的限制，最重要的是，缺乏支持其在改善重要长期健康相关结果方面的作用的证据，这些进展的应用存在疑问。
