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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