The Management of Postoperative Recurrence in Crohn ’s Disease

AbstractPurpose of ReviewAlthough the need for intestinal resection as a treatment for Crohn ’s disease (CD) has significantly decreased as the use of advanced therapies has increased in recent decades, approximately one-half of patients with CD will require intestinal resection within 10 years of diagnosis. We sought to review emerging concepts in the postoperative management of patient s with CD, including the use of novel advanced therapies, new diagnostic and/or imaging modalities, and new methods of endoscopic scoring.Recent FindingsIleocolonoscopy remains the predominant method of assessing recurrence after ileocolonic resection for CD; however, many authors have re-evaluated the traditional scoring methods for recurrence including the Rutgeerts score. Other non-invasive methods of assessment have emerged including biomarkers such as fecal calprotectin as well as intestinal ultrasound. Although anti-tumor necrosis factor alpha therapies such as infliximab and adalimumab have established evidence profiles in the postoperative management of CD, novel advanced therapies are being investigated including ustekinumab and vedolizumab.SummarySurgery remains an integral treatment modality in the longitudinal care of patients with CD, and thus, understanding emerging literature regarding the postoperative management of patients with CD including preventing and managing postoperative recurrence is critical.
Source: Current Treatment Options in Gastroenterology - Category: Gastroenterology Source Type: research