A child complains of RIF pain and diarrhea. On colonoscopy, granular transmural ulcers are seen
near the ileo-cecal junction. What should be the management?
The best choice from the options given would be A, but it is not the best choice for Crohns in general, here is a summary of the management based on NICE recommendations:
Induce remission > steriod, if steroid contraindicated/unwanted> ASA(much less effective) +/- azathioprine or mercaptopurine or methotrexate. If refractory> biologics.
Maintaining remission: (1st-line) azathiprone or mercaptopurine, (2nd-line) methotrexate
Antibiotics: add metronidazole or ciprofloxacin for peri-anal disease (limited efficacy)
Anti-diarrheals: must be avoided during exacerbations as increase risk of toxic megacolon