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Com Guidelines each medicine taken that should be discussed ideally prior to conception. ffprhc. pdf (accessed Oct 2010)). Medical treatment during pregnancy In active disease during pregnancy the Food and Drug Administration (FDA) pregnancy categories, ABCDX (see table) reﬂect a cautious approach. The drug description notice always emphasises risks and side effects. Food and drug administration (FDA) categories A B C Controlled studies show no risk No evidence of risk in humans Risk cannot be ruled out, animal studies showed adverse effects on fetus Positive evidence of risk in humans, risk/ benefit ratio should be considered Contraindicated D X The greatest risk to mother and fetus during pregnancy is active disease, and not the medication used to treat it.
In addition, arthritis, iritis and painful skin complications require analgesia in many patients. Most analgesics are relatively ineffective and have the potential to worsen underlying disease. Where possible, treatment is of the underlying cause (including corticosteroids and if appropriate, treatment of associated irritable bowel syndrome). Where non-speciﬁc pain relief is needed, an opioid that has less effect on motility, such as tramadol, may help. Patients with active and quiescent IBD often report symptoms of fatigue.
Although marginally less effective than prednisolone, its side-effect proﬁle is substantially better (EL1b). Failure to wean corticosteroids is common, and should be regarded as a treatment failure necessitating further intervention. 2 for a detailed discussion of evidence, treatment strategies, and uncertainties that need to be addressed). uk/ (accessed Oct 2010)). 5 for details). < Anti-TNF therapy is effective in maintaining remission in Crohn’s disease (EL1a, RG A), although long-term data are lacking.