الفهرس 
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Abstract
The inflammatory bowel diseases (lBD), crohn’s disease and ulcerative colitis are inflammatory disorders of the gastrointestinal tract, characterized by recurrent periods of inflammation and tissue destruction (Anton and Shanahan, 1998). The clinical Course is influenced by genetic, environmental factors, and the immune system. Recent insights benefiting from advances in genetic engineering and molecular biology have contributed to clinical care in terms of actual or potential therapies (Anderss and Friedman, 1999). The vast majority of patients with lBD experience chronic symptoms punctuated by periodic exacerbations requiring adjustments in medical or surgery. True emergenices are fortunately uncommon but have been associated with high rates of morbidity and mortality. Patients presenting with fulminant colitis, toxic megacolon, or perforation require prompt identification as well as intensive medical therapy and monitoring by surgeons experienced in the care of such patients (Roy, 1997). lBD, particularly DC is a premalignant condition, because these patients are at increased risk of colorectal carcinoma (Sigel and Goldblum, 1998). The major categories of therapy used in the management of lBD, conventional corticosteroids, although mainstay of the acute treatment of lBD for many years, have many drawbacks including a variety of side effects particularly with chronic use. Budesonide appear to be relatively safe and least moderately effective in inducing remission in active distal DC and CD (Robinson, 1997). lmmunomodulating agents, methotrexate, and antibiotics.