Current trends and challenges in the postoperative medical management of Crohn's disease: A systematic review
Faculty AdvisorKarim Alavi
Document TypeJournal Article
KeywordsDigestive System Diseases
Health Services Administration
Surgical Procedures, Operative
MetadataShow full item record
AbstractBACKGROUND: 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.
Am J Surg. 2017 Nov;214(5):931-937. doi: 10.1016/j.amjsurg.2017.04.016. Epub 2017 Jun 6. Link to article on publisher's site
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/49330
Nicole B. Cherng participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School.