What is the role of budesonide in Crohn's disease?

• A. For maintenance long-term therapy
• B. For mild-to-moderate ileocecal Crohn's with less systemic effects
• C. As an antibiotic
• D. Not used in Crohn's disease

Answer: (B)

Budesonide is a locally acting glucocorticoid whose high first-pass metabolism gives much lower systemic exposure than other steroids. This makes it useful for inducing remission in mild-to-moderate Crohn’s disease, especially when the disease is limited to the ileocecal region, because you can dampen intestinal inflammation with fewer systemic steroid-related side effects. It is not used for long-term maintenance therapy, since evidence for durable control with budesonide is limited and relapse is common after tapering or stopping. It is not an antibiotic, and it’s not the choice for broad, systemic Crohn’s management.