Selection of treatment regimens depends on disease severity, disease location, and disease-associated complications. Various guidelines recommend that approaches be sequential - initially to induce clinical remission, and then to maintain remissions. Initial evidence of improvement should be seen within 2 to 4 weeks and maximal improvement should be seen in 12 to 16 weeks 3 . The classic approach to therapy in Crohn's disease has been a "step-up" approach starting with the least toxic agents for mild disease, and increasingly more aggressive treatment for more severe disease, or patients who have not responded to less toxic agents. More recently the field has been moving toward a "top-down" approach (early aggressive management) which might decrease exposure to anti-inflammatory agents and increase exposure to agents that enhance mucosal healing that might prevent future complications 4 .
Approach from Moor Monkton Village. Approximately half a mile River Nidd rightbank . Park in car Park P1 - Go overcattle grid and after 200 yards the track bends to the right. At this point gostraight forward onto the grass and follow the car tracks. After 400 yardsthere is a gated compound which holds 4 cars.. Parking also on left hand side of track anywhere on grass (beware of cows causing damage to vehicles!) Pegs 1 to 8 on Ouse are also closer from this car park. Approximately 1000 yards River Ouse right bank. Car Park P2 - Through Laund House Farm yard and park on grass as per map. Take care whendriving through farm yard. Car park P3 - Approach towards Moor Monkton village up ChurchLane then turn right down Red House Lane. Limited Parking at end of lane adjacent to barrier. Fishing allowed up until 11pm on this venue from 16th June to 31 October.