[Postoperative recurrence of Crohn's disease, and its prevention].
Crohn's disease is a chronic, progressive disabling condition ultimately leading to stricturing and/or penetrating complications. The need for surgery may be as high as 70% in patients with severe active disease or complications. However, relapse may develop in a significant proportion of the patients after surgery leading to frequent re-operations. Despite emerging data, postoperative prevention is still controversial. After careful evaluation of the individual risk a tailored therapy should be considered. In patients with small risk for relapse mesalazine or in selected cases no-treatment may be an option. In patients with a moderate-to-high risk azathioprine should be considered together with metronidazole in the three months. Follow-up ileocolonoscopy 6-12 months after the surgery is helpful in the determination of endoscopic severity and may assist in the optimization of the therapy. In most severe cases anti-TNF agents may be appropriate for postoperative prevention and therapy.
Lakatos
László
L
Csolnoky Ferenc Megyei Kórház, Belgyógyászati Centrum, Veszprém, Kórház u. 1. 8200. lakatos.laszlo@vmkorhaz.hu
Lakatos
Péter László
PL
D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use; D003113:Colonoscopy; D003424:Crohn Disease / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control* / Q000601:surgery*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D019804:Mesalamine / Q000627:therapeutic use; D008795:Metronidazole / Q000627:therapeutic use; D011184:Postoperative Period; D012008:Recurrence; D012307:Risk Factors
D000890:Anti-Infective Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D008795:Metronidazole; D019804:Mesalamine; D001379:Azathioprine