Tratamento farmacológico e não farmacológico da doença de Crohn: uma revisão.

Abstract

Crohn's disease is a chronic inflammatory bowel disease that can affect several segments of the gastrointestinal tract, from the mouth to the anus, where the intestine may have several healthy segments. It affects both sexes and ages, being more common among individuals of 20 to 40 years. It is known that genetic, immunological and environmental factors are involved in its pathogenesis. The most common clinical manifestations are fever, diarrhea and abdominal pain. The DC also presents extra intestinal manifestations, in which the most affected organs are the skin, eyes, liver and joints, also presenting several types of complications. For the diagnosis of CD, laboratory evaluations, endoscopy, imaging tests and histopathological findings are required together with physical examination. There are a variety of treatments, both pharmacological and non-pharmacological, however, have no curative action. The objective of the present study was to conduct a comprehensive review of the pharmacological and non-pharmacological treatment of Crohn's disease, addressing also the pathogenesis of the disease, clinical manifestations, complications and diagnosis. This is a systematic bibliographical research, where the search of the material was carried out through the databases Medline, Pubmed, Lilacs, Scielo, Google Academic and national and international health committees, including bibliographical references between the years 2010 to 2018. The study demonstrated that Crohn's Disease has been growing worldwide, and a study on this disease is increasingly important. Its pathogenesis is not yet fully understood. Considering its variety of symptoms and clinical characteristics, the diagnosis still becomes challenging, requiring a set of procedures to reach this pathology. The drugs used depend on the severity of the disease, in which they were effective for some patients, but in other cases, they were more effective when used in combination. However, many drugs have a variety of adverse effects. Nutritional therapy, such as enteral and parenteral nutrition, as well as probiotic therapy, have also demonstrated efficacy in treatment, however, more studies and a greater number of patients are needed to prove this effect. In severely ill patients, treatment is required by surgical procedures. In view of the above, the pharmacist becomes an essential health professional in DC pharmacotherapy, since it can improve patients' quality of life through the correct use of medications, facilitating their adherence, allowing patients to use best way possible.