Crohn's disease: management – NICE guideline

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This National Institute for Health and Care Excellence (NICE) guideline covers the management of Crohn’s disease in children, young people and adults. It aims to reduce people’s symptoms and maintain or improve their quality of life.

There are currently at least 115,000 people in the UK with Crohn's disease. The causes of Crohn's disease are widely debated. Smoking and genetic predisposition are two important factors that are likely to play a role.

This guideline includes recommendations on:

  • patient information and support
  • inducing remission
  • maintaining remission, including after surgery
  • surgery
  • monitoring for osteopenia and assessing fracture risk
  • conception and pregnancy.

This update provides guidance on the combined use of TNF‑alpha inhibitor biologics (infliximab or adalimumab) together with an immunosuppressant medication, compared with biologic medication given alone.

Considerations specific to children and young people

Up to a third of patients with Crohn's disease are diagnosed before the age of 21 but there is a lack of studies on treatment for children and young people. Paediatric practice is often based on extrapolation from adult studies and in this guideline all recommendations relate to adults, children and young people unless otherwise specified. Inducing and maintaining remission as well as optimising nutritional status and growth, and minimising psychological concerns and possible side effects of treatment are fundamental to best practice for all people with Crohn's disease, whatever their age.

You can read the guideline on NICE's website.