A.E., a 19-year-old college student, was diagnosed at the age of 13 with Crohn disease, a chronic inflammatory disease that can affect the entire gastrointestinal tract from mouth to anus. A.E.'s disease is limited to his large bowel. During a 9-month period of disease exacerbation, he took oral corticosteroids (prednisone) to reduce the inflammatory response. He experienced many of the drug's side effects, but has been in remission for 4 years. Currently, A.E.'s condition is managed on drugs that reduce inflammation by suppressing the immune response. He takes Pentasa (mesalamine) 250mg 4 caps po bid. Pentasa is of the 5-ASA (acetylsalicylic acid or aspirin) group of anti-inflammatory agents, which work topically on the inner surface of the bowel. It has an enteric coating, which dissolves in the bowel environment. He also takes 6-mercaptopurine (Purinethol) 75 mg po qd and a therapeutic vitamin with breakfast. A.E. may take acetaminophen for pain but must avoid NSAIDs, which will irritate the intestinal mucosa (inner lining) and cause a flare-up of the disease.
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