| Theme | The frontline of Crohn's disease treatment | |
|---|---|---|
| Title | Choices of medical treatments in patients with postoperative Crohn's disease | |
| Publish Date | 2016/03 | |
| Author | Makoto Naganuma | Division of Gastroenterology and Hepatology, School of Medicine, Keio University |
| Author | Haruhiko Ogata | Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University |
| Author | Takanori Kanai | Division of Gastroenterology and Hepatology, School of Medicine, Keio University |
| [ Summary ] | Crohn's disease (CD) has frequent clinical and endoscopic recurrence after intestinal resection. The severity of endoscopic changes or levels of fecal calprotectin are associated with long-term prognosis of CD. A recent study indicated that an early endoscopy and step-up in treatment for recurrence are better than conventional medications for postoperative CD patients. 5-ASA, metronidazole, and elemental diets may be effective in preventing postoperative recurrences；however, several studies have shown that the use of anti-TNF-α agents improved prognosis for postoperative CD patients. Thus, anti-TNF-α agents should be considered for use in postoperative CD patients with a high risk of recurrence, such as patients with perforating disease and/or previous intestinal resection. | |