Management of Crohn's Disease

Publication Date: January 2, 2017

Key Points

Key Points

  • Nearly one-half of patients with Crohn’s disease (CD) will require bowel resection within the first 10 years of disease.
    • However, surgery is not curative, and one-fourth of these patients will require at least another bowel resection within five years of index surgery.
  • Surgical recurrence is usually preceded by endoscopic and clinical recurrence. Endoscopic recurrence can occur in the neoterminal ileum in as many as 90% of patients within 12 months of surgical resection.
    • Certain clinical features, such as the presence of penetrating disease, cigarette smoking, and multiple prior resections, are risk factors for disease recurrence.
  • The presence and severity of endoscopic recurrence, as measured by the Rutgeerts’ score, is a strong predictor of clinical and surgical recurrence.
  • The prevention of postoperative disease recurrence is a high priority given the morbidity associated with clinical and surgical recurrence and the long-term risk of short gut syndrome that may arise from multiple bowel resections.

Management

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...with surgically induced remission of CD not r...

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