Management of Low Risk (Mild Severity) Crohns Disease 

Asymptomatic or Incidentally Discovered on Endoscopy 

 • Any high-risk features? If none continue periodic surveillance 

 • Fecal calprotectin, CRP every 6 months for 1 year, periodically thereafter 

 • Repeat colonoscopy in 6 —12 months, periodically thereafter 

Mild Disease Activity 

 • Budesonide 9mg/d induction for 8 weeks 

 • 5 ASA (sulfasalazine) for isolated colonic disease 

 • Short course of prednisone 

 • Maintenance options: observation alone, immunomodulators, 5 ASA, repeat course of budesonide 

 • Limited data on safety/efficacy on low dose (3-6mg) budesonide maintenance 

 • If budesonide needed 2x in one year: treat as high risk disease 



Gregory Brennan MD @GregoryTBrennan



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