Patients with severe to fulminant Crohn's disease who require hospitalization represent a critical subset with urgent management needs. This protocol addresses this specific presentation — marked by high fevers, peritoneal signs, and evidence of severe mucosal disease — where an escalated, structured approach is essential.
For patients hospitalized with severe to fulminant disease, anti-TNF therapy — including infliximab, which can be administered in the inpatient setting — is part of the management strategy for this population.
Response of severely active inflammatory Crohn's disease to TNF inhibition.
For hospitalized patients presenting with severe to fulminant CD, intravenous corticosteroids may be used to control inflammatory burden while evaluating steroid-sparing treatment options.
Individuals with severe/fulminant disease have persistent symptoms despite the introduction of conventional corticosteroids and/or advanced therapies or present with high fevers, evidence of intestinal obstruction, significant peritoneal signs such as involuntary guarding or rebound tenderness, cachexia, or evidence of an abscess usually requiring hospitalization.
Anti-TNF agents are effective for severely active CD and infliximab may be administered in the inpatient setting for patients with severe to fulminant disease.
DOI: 10.14309/ajg.0000000000003465
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