Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Impact of endoscopic monitoring on postoperative recurrence of Crohn’s disease

February's issue Colorectal Disease investigates the impact of endoscopic monitoring and treatment step-up on postoperative recurrence of Crohn’s disease.

News image

About 80% of patients with Crohn’s disease require surgery, of whom 70% will require a further operation.

Recurrence occurs at the anastomosis.

Although often recommended, the impact of postoperative colonoscopy and treatment adjustment is unknown.

Dr De Cruz and colleagues reviewed patients with a bowel resection over a 10-year period.

The team compared the patients between those who did and did not have a postoperative colonoscopy within 1 year of surgery, and those who did or did not have a step-up in drug therapy.

Of 222 patients operated on, 136 were studied.

24% had a step-up of drug therapy
Colorectal Disease

The doctors noted that of 70 patients with and 66 without postoperative colonoscopy, clinical recurrence occurred in 49% and 48%, and further surgery in 9% and 5%.

The team noted that 89% of colonoscoped patients had a decision based on the colonoscopic findings.

Of these, 24% had a step-up of drug therapy, aminosalicylates, thiopurine, methotrexate, and 76% had no step-up in drug therapy.

The researchers found that in colonoscoped patients clinical recurrence occurred in 9 of 15 patients with, and 23 of 47 without step-up and surgical recurrence in 2 of 15 and 4 of 47.

Dr Cruz's team concluded, "Clinical recurrence occurs in a majority of patients soon after surgery."

"In this cohort, there was no clinical benefit from colonoscopy or increased drug therapy within 1 year after operation."
 
"However, the response to the endoscopic findings was not standardized and immunosuppressive therapy was uncommon. Standardizing timing of colonoscopy and drug therapy, including more intense therapy, may improve outcome, although this remains to be proven." 

Colorectal Dis 2013: 15(2): 187-197
25 February 2013

Go to top of page Email this page Email this page to a colleague

 19 April 2015

Advanced search
 17 April 2015 
MELD score and colorectal resection
 17 April 2015 
Synchronous colorectal advanced neoplasia
 17 April 2015 
PNPLA3 polymorphisms and NAFLD risk
 16 April 2015 
Bleeding risk in colonic diverticulosis
 16 April 2015 
Minority use of high-volume hospitals for colorectal cancer
 16 April 2015 
Sleep and IBD
 15 April 2015 
Treatment of hepatocellular carcinoma
 15 April 2015 
Score predicts malignant bile duct obstruction
 15 April 2015 
Increased risk of Barrett esophagus
 14 April 2015 
Improving colorectal cancer screening uptake
 14 April 2015 
Colorectal cancer presenting under the age of 50
 14 April 2015 
Functional constipation vs constipation predominant IBS
 13 April 2015 
Fecal transplant for C. difficile
 13 April 2015 
CRP and acute diverticulitis
 13 April 2015 
Immune based treatments for HCC
 10 April 2015 
Hypnotherapy for IBS
 10 April 2015 
Adjuvant therapy after rectal cancer
 10 April 2015 
Viral outcomes in HCV infection
 09 April 2015 
Male IBD patients wishing to conceive
 09 April 2015 
Screening programs based on the fecal immunochemical test
 09 April 2015 
Management of esophageal food impaction
 08 April 2015 
Nonceliac gluten sensitivity
 08 April 2015 
Ambulatory hemorrhoidal surgery
 08 April 2015 
Iron fortification and gut inflammation
 07 April 2015 
Endoscopic managements of GI bleeds
 07 April 2015 
Interventions for eosinophilic esophagitis
 07 April 2015 
Treatment of Hep C virus
 06 April 2015 
Treatment for rectal cancer
 06 April 2015 
Risk stratifying Barrett's esophagus
 06 April 2015 
Cost-effectiveness of HCV
 03 April 2015 
Predicting advanced cancer in Barrett's
 03 April 2015 
Vitamin D deficiency and Hep B outcomes
 03 April 2015 
Hepatocellular carcinoma surveillance in cirrhosis
 02 April 2015 
Physical activity and NAFLD
 02 April 2015 
Genetic risk for Crohn's disease
 02 April 2015 
EUS for detection of pancreatic neuroendocrine tumors
 01 April 2015 
Obeticholic acid in primary biliary cirrhosis
 01 April 2015 
Analysis of liver fibrosis
 01 April 2015 
Mortality rates for upper GI bleeds
 31 March 2015 
Placement of nasoenteral feeding tubes
 31 March 2015 
HCV-HIV co-infection combination therapy
 31 March 2015 
Hepatic fat and gallbladder polyps
 30 March 2015 
Treatment of pediatric IBD
 30 March 2015 
Minimally invasive approach in colorectal procedures
 30 March 2015 
Prevalence of IBD in USA residents of Indian ancestry
 27 March 2015 
Screening for fecal incontinence
 27 March 2015 
Deep remission in Crohn's disease
 27 March 2015 
Sexual functioning in IBD
 26 March 2015 
Antimicrobial therapy in cirrhosis with spontaneous bacterial peritonitis
 26 March 2015 
Metformin as a chemopreventive agent for Barrett's
 26 March 2015 
Survival of untreated hepatocellular carcinoma
 25 March 2015 
Cytomegalovirus and IBD
 25 March 2015 
Genetics and Crohn's disease
 25 March 2015 
Mortality in Barrett’s–related T1 esophageal adenocarcinoma
 24 March 2015 
Prevention of colorectal cancer after screening
 24 March 2015 
Functional GI disorders and body mass index
 24 March 2015 
Quality of life in children with fecal incontinence
 23 March 2015 
Fibrosis in NAFLD vs NASH
 23 March 2015 
The unmasking of Whipple's disease
 23 March 2015 
Predicting the quality of colon cancer care

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us