What is the initial treatment of choice for inflammatory bowel disease?

Sulfasalazine is the initial treatment of choice for inflammatory bowel disease (IBD), specifically for conditions such as ulcerative colitis and Crohn's disease. It is a 5-aminosalicylic acid (5-ASA) compound that reduces inflammation in the gastrointestinal tract. By acting topically on the colonic mucosa, sulfasalazine effectively decreases symptoms such as diarrhea and rectal bleeding while also inducing and maintaining remission.

For patients with IBD, sulfasalazine is often preferred because of its proven efficacy in controlling symptoms and its ability to minimize flare-ups. It has been used for decades and remains a cornerstone in the management of mild to moderate cases.

The other options listed do not serve as the first-line treatment for IBD. Ondansetron, primarily used to treat nausea and vomiting, does not address the underlying inflammatory processes. Metronidazole is an antibiotic that may be used in cases of bacterial overgrowth or specific complications but is not a standard initial therapy for IBD. Azathioprine, an immunosuppressive medication, may be considered for long-term maintenance therapy or in patients who are refractory to other treatments, but it is not typically the first drug administered at diagnosis. Thus, sul