A child complains of RIF pain and diarrhea. On colonoscopy, granular transmural ulcers are seen near the ileo-cecal junction. What should be the management?

The key is A. Sulfasalazine. [Pain in RIF, diarrhea, granular transmural ulcers near the ileo-cecal junction points towards the diagnosis of Crohn’s diseas (predominantly ileo-cecal type). We know for Crohn’s disease treatment options are i) Corticosteroids ii) Immunosuppressant like azathioprine, mercaptopurine and methotrexate and iii) Biological agents like adalimumab, infliximab, vedolizumab and ustekinumab. However if the patient is child (steroid causes growth hamper) or can not tolerate corticosteroid alternate option used is 5-Aminosalicylate as Salfasalazine. As the given patient is a child answer for him is A. Salfasalazine].