Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology practice recommendations for medical management and monitoring of inflammatory bowel disease in Asia

J Gastroenterol Hepatol. 2021 Mar;36(3):637-645. doi: 10.1111/jgh.15185. Epub 2020 Jul 29.


Inflammatory bowel disease (IBD) has increased in incidence and prevalence in Asian countries since the end of the 20th century. Moreover, differences in the cause, phenotypes, and natural history of IBD between the East and West have been recognized. Therefore, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have established recommendations on medical management of IBD in Asia. Initially, the committee members drafted 40 recommendations, which were then assessed according to Grading of Recommendations Assessment, Development and Evaluation. Eight statements were rejected as this indicated that consensus had not been reached. The recommendations encompass pretreatment evaluation; medical management of active IBD; medical management of IBD in remission; management of IBD during the periconception period and pregnancy; surveillance strategies for colitis-associated cancer; monitoring side effects of thiopurines and methotrexate; and infections in IBD.

Keywords: Clostridium difficile; Crohn's disease; biologics; chronic ulcerative colitis; cytomegalovirus; inflammatory bowel disease; intestinal tuberculosis.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adrenal Cortex Hormones / therapeutic use
  • Aminosalicylic Acid / adverse effects
  • Aminosalicylic Acid / therapeutic use
  • Asia
  • Azathioprine / adverse effects
  • Azathioprine / therapeutic use
  • Colitis, Ulcerative / diagnosis*
  • Colitis, Ulcerative / therapy*
  • Crohn Disease / diagnosis*
  • Crohn Disease / therapy*
  • Diagnosis, Differential
  • Female
  • Gastroenterology / organization & administration*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Methotrexate / adverse effects
  • Methotrexate / therapeutic use
  • Monitoring, Physiologic*
  • Pacific Islands
  • Practice Guidelines as Topic*
  • Pregnancy
  • Remission Induction
  • Societies, Medical / organization & administration*
  • Tuberculosis, Gastrointestinal


  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Aminosalicylic Acid
  • Azathioprine
  • Methotrexate