Which type of treatment is advisable in the prevention of recurrence after surgery in Crohnʼs disease?

Abstract

P revention of recurrence after intestinal resection is a major goal in Crohn’s disease (CD) treatment. After complete resection of all the affected gut, endoscopic lesions reappear in 70%–90% of patients 1 year after surgery while, 10%–20% of patients have symptoms. Within 3 years 90% of those with endoscopic recurrence at 1 year are symptomatic. Some factors such as site and extent of disease, presence of perforating disease, smoking habit, and age of the patient can influence recurrence time, as well as the severity of symptoms. For patients who smoke, cessation significantly reduces postoperative recurrence. Several controlled trials have evaluated the role of medical therapy in CD recurrence prevention. A reduction in recurrence rates or in the severity of recurrence has been observed with aminosalicylates, nitroimidazole antibiotics, and immunosuppressive drugs.