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Symptomatic therapy

In addition to treatment of the underlying inflammation, patients with inflammatory bowel disease (IBD) may require symptomatic therapy, particularly when their symptoms are not related to active inflammation. Treatment with antidiarrheal agents such as loperamine or diphenoxylate/atropine should generally be avoided in patients with active inflammation, as these drugs can precipitate toxic megacolon in individuals with significant colonic inflammation. Similarly, other agents that may have anticholinergic effects should be avoided, although antispasmodic medications may sometimes be useful for symptomatic relief. In patients with Crohn disease who have significant ileal disease or who have had an ileal resection, diarrhea may sometimes be due to bile salt malabsorption. In such patients, treatment with bile-binding resins, such as cholestyramine, may be helpful in managing the diarrhea.

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