What are the treatment principles for inflammatory bowel disease?

IBD treatment uses a step-up or top-down approach based on disease severity. Mild disease: 5-ASA compounds (UC) or budesonide (CD). Moderate-severe: corticosteroids for induction, immunomodulators (azathioprine, methotrexate) or biologics (anti-TNF, vedolizumab, ustekinumab) for maintenance. Treat-to-target approach aims for clinical remission plus mucosal healing. Surgery reserved for refractory disease or complications.