Current trends and challenges in the postoperative medical management of Crohn's disease: A systematic review.

Abstract:

BACKGROUND:Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the postoperative medical management of Crohn's disease. DATA SOURCES:A systematic literature review of medications administered following respective therapy for Crohn's disease was performed from 1979 through 2016. Twenty-six prospective articles provided directed guidelines for recommendations and these were graded based on the level of evidence. CONCLUSIONS:The postoperative management of Crohn's disease faces multiple challenges. Current indicated medications in this setting include: antibiotics, aminosalicylates, immunomodulators, and biologics. Each drug has inherent risks and benefits, and the optimal regimen is still unknown. Initiating therapy in a prophylactic fashion compared to endoscopic findings, or escalating therapy versus treating with the most potent drug first is debated. Although a definitive consensus on postoperative treatment is necessary, aggressive and early endoluminal surveillance is paramount in the treatment of these complicated patients.

journal_name

Am J Surg

authors

Schlussel AT,Cherng NB,Alavi K

doi

10.1016/j.amjsurg.2017.04.016

subject

Has Abstract

pub_date

2017-11-01 00:00:00

pages

931-937

issue

5

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(17)30018-1

journal_volume

214

pub_type

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