Medical Management Following Surgical Therapy in Inflammatory Bowel Disease: Evidence from Cochrane Reviews.

Abstract

Although medical therapy for inflammatory bowel disease (IBD) has greatly improved over the past 2 decades, surgery continues to be an integral part of the management of ulcerative colitis (UC) and Crohn’s disease (CD). This article reviews data from Cochrane reviews relevant to the medical management of IBD in surgical patients including treatment and prevention of pouchitis in UC patients with an ileal pouch-anal anastomosis, the risk of postoperative infectious complications from medical therapies, infertility after IBD surgery, and prevention of recurrence after bowel resection for CD. A summary of the overall certainty of evidence was assessed using Grading of Recommendations Assessment (GRADE; Table 1), and a summary of the results of these reviews is provided in Table 2. Pouchitis is an chronic inflammatory disease that may occur in the ileal pouch after proctocolectomy in patients undergoing...