Prevent postoperative recurrence of paediatric Crohn’s disease by risk-based treatment and early monitoring

Abstract

The course of Crohn’s disease (CD) is especially aggressive in paediatric CD, with surgical resection of intestinal macroscopic lesions often being necessary, Unfortunately, surgery is not curative, and most patients experience postoperative disease recurrence within years of undergoing the initial surgery. Paediatric CD patients have a higher lifelong risk of repeated surgical interventions than adults, and preventing disease recurrence is of utmost importance to ensure growth and quality of life. Prevention generally involves prophylactic drugs (e.g. anti-TNFα, thiopurines, metronidazole), as well as early and regular monitoring (with fecal calprotectin levels and ileocolonoscopy), with step-up therapy as needed.