Treatment of postoperative Crohn's disease.

Details

Serval ID
serval:BIB_6905C68DD550
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Treatment of postoperative Crohn's disease.
Journal
Digestion
Author(s)
Froehlich F., Juillerat P., Felley C., Mottet C., Vader J.P., Burnand B., Michetti P., Gonvers J.J.
ISSN
0012-2823
Publication state
Published
Issued date
2005
Peer-reviewed
Oui
Volume
71
Number
1
Pages
49-53
Language
english
Notes
Publication types: Journal Article ; Review - Publication Status: ppublish
Abstract
At 1 year after a first resection, up to 80% of patients show an endoscopic recurrence, 10-20% have clinical relapse, and 5% have surgical recurrence. Smoking is one of the most important risk factors for postoperative recurrence. Preoperative disease activity and the severity of endoscopic lesions in the neoterminal ileum within the first postoperative year are predictors of symptomatic recurrence. Mesalamine is generally the first-line treatment used in the postoperative setting but still provokes considerable controversy as to its efficacy, in spite of the results of a meta-analysis. Immunosuppressive treatment (azathioprine, 6-MP) is based on scant evidence but is currently used as a second-line treatment in postsurgical patients at high risk for recurrence, with symptoms or with early endoscopic lesions in the neoterminal ileum. Nitroimidazole antibiotics (metronidazole, ornidazole) are also effective in the control of active Crohn's disease in the postoperative setting. Given their known toxicity, they may be used as a third-line treatment as initial short-term prevention therapy rather than for long-term use. Conventional corticosteroids, budesonide or probiotics have no proven role in postoperative prophylaxis. Infliximab has not as yet been studied for use in the prevention of relapse after surgery.
Keywords
Anti-Inflammatory Agents, Non-Steroidal, Crohn Disease, Drug Therapy, Combination, Humans, Immunosuppressive Agents, Postoperative Care, Recurrence
Pubmed
Web of science
Create date
25/01/2008 15:58
Last modification date
20/08/2019 14:24
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