| Theme |
How Do You Choose Treatment Strategies for IBD Patients with a Critical Situation? |
| Title |
Crohn's Disease : Surgical Indication and Therapeutic Strategy after Surgery |
| Author |
Shojiro Yamamoto |
Division of Gastroenterology and Hematology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki |
| Author |
Tadashi Miike |
Division of Gastroenterology and Hematology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki |
| Author |
Kanna Hashimoto |
Division of Gastroenterology and Hematology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki |
| Author |
Hiroo Abe |
Division of Gastroenterology and Hematology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki |
| Author |
Yoshihiro Tahara |
Division of Gastroenterology and Hematology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki |
| Author |
Kazuya Shimoda |
Division of Gastroenterology and Hematology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki |
| [ Summary ] |
Crohn's disease is a chronic progressive inflammatory disease that often requires surgical operation during its clinical course. Surgical operation indications for Crohn's disease are as follows : perforation, abscess, hemorrhage, intestinal obstruction, stenosis, fistula, medical treatment resistance, and cancer. Medical treatment is still one of the therapeutic options for such conditions. After surgery, remission maintenance therapy with 5‒aminosalicylic acid, immunomodulatory drugs, biologics, and elementary diet are required based on the risk factors of recurrence. Imaging analysis, including endoscopic examination, should be planned to assess the disease status and to choose the optimal therapy. The relapse rate after surgery in Crohn's disease is not low, and sometimes reoperation is required. Proper medical remission maintenance therapy is important avoid reoperation. |