Senior Scholars Program

Title

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

UMMS Affiliation

Department of Surgery; School of Medicine; Senior Scholars Program

Faculty Mentor

Karim Alavi

Publication Date

2017-11-01

Document Type

Article

Disciplines

Digestive System Diseases | Gastroenterology | Health Services Administration | Medical Education | Surgery | Surgical Procedures, Operative

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.

DOI of Published Version

10.1016/j.amjsurg.2017.04.016

Source

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

Journal/Book/Conference Title

American journal of surgery

Comments

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.

Related Resources

Link to Article in PubMed

PubMed ID

28666580

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