Start

UGI disease

Ileitis

Ileocolitis/colitis

Perianal disease

Fistulizing disease^*

Mild to moderate

Extended release
Budesonide^†

Mild to moderate

Extended release
Budesonide

Mild to moderate

Immunomodulator
Anti–TNF- agents
Ustekinumab
Vedolizumab

Mild to moderate

Immunomodulator
Anti–TNF- agents
Antibiotics^**

Mild to moderate

Immunomodulator
Anti–TNF- agents
Antibiotics

Moderate to severe

Corticosteroids induction
Immunomodulator: Anti–TNF- agents, vedolizumab, tofacitinib, natalizumab, ustekinumab
Supportive therapy for induction (NPO, TPN)

Refractory to medical therapy or perforation surgery

End

Moderate to severe

Temporary diversion surgery
Supportive therapy for induction (NPO, TPN)

Persistent fistula

Temporary diversion surgery
Supportive therapy for induction (NPO, TPN)

^*Abscess should be excluded before initiating medical therapy.

^†Proximal colon disease involvement.

^**Perianal location.