Approximately 25% to 35% of patients with Crohn’s disease (CD) who undergo surgery require repeat surgery. Active smoking, multiple prior surgeries, and penetrating or perianal disease are risk factors for recurrence of CD after surgical resection. Early initiation of prophylactic therapy is effective in decreasing the risk of recurrence. Active colonoscopic surveillance for the early detection of endoscopic recurrence within 6 to 12 months of surgery is recommended. In symptomatic patients without evidence of endoscopic recurrence, noninflammatory causes should be sought.
Key points
- •
Approximately 25% to 35% of patients require repeat surgery after initial resection for Crohn’s disease.
- •
Smoking, multiple prior surgeries, and penetrating or perianal disease are risk factors associated with disease recurrence.
- •
Early initiation of anti–tumor necrosis factor agents and immunomodulators within 4 to 8 weeks of surgery is consistently effective in decreasing risk of recurrence of Crohn’s disease, whereas the benefit of mesalamine is uncertain.
- •
Regardless of initial approach to prevention of recurrence of Crohn’s disease, active colonoscopic surveillance for early detection of endoscopic recurrence within 6 to 12 months of surgery is recommended.
- •
In the absence of endoscopic recurrence, noninflammatory causes should be sought for gastrointestinal symptoms such as bile acid malabsorption and small intestinal bacterial overgrowth.
Related posts:
Crohn’s Disease
Intestinal and Nonintestinal Cancer Risks for Patients with Crohn’s Disease
Sexuality, Fertility, and Pregnancy in Crohn’s Disease
Targeting Specific Immunologic Pathways in Crohn’s Disease
Janus Kinase Antagonists and Other Novel Small Molecules for the Treatment of Crohn’s Disease
Interdisciplinary Management of Perianal Crohn’s Disease
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
