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hospitalization required Maintenance of Remission: Immunomodulators (azathioprine, 6-MP, methotrexate) for steroid-dependent or frequently-relapsing disease Biologic monotherapy or combination therapy (biologic + immunomodulator) for moderate-to-severe disease Step-up or top-down approach based on disease severity, patient risk factors, and prior therapy Biologic Therapy Targets: TNF-: Infliximab (IV), adalimumab (SC), certolizumab pegol (SC) IL-12/23: Ustekinumab (IV induction, SC maintenance) Integrin: Vedolizumab (IV) IL-23: Risankizumab (IV induction, SC maintenance) JAK inhibition: Upadacitinib (oral) Surgical Management Surgery is indicated in approximately 7080% of patients with Crohns disease over their lifetime, per StatPearls

BPC-157 further decreases oxidative damage and calms inflammatory mediators for smoother, less reactive skin

Peptides can influence the microbiome through several mechanisms, including antimicrobial activity, selective modulation of bacterial populations, and strengthening of epithelial defenses

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