Post-operative Crohn's disease: Current and emerging management techniques

Abstract

Numerous treatment options for Crohn’s disease (CD) have been developed since infliximab was approved in 1998. Treatment practices for CD have also evolved: therapeutic drug monitoring and a treat-to-target approach have replaced symptom control. Despite a decline in surgery rates in Canada and elsewhere in the world, bowel resection is still required for patients with refractory, fistulizing or fibrostenosing CD. Unfortunately, postoperative recurrence (POR) is common; endoscopic recurrence affected 70–90% of patients at the five-year point. However, it is important to note that variations in recurrence were observed between randomized clinical trials (RCTs), referral centre studies and population-based studies. This article will provide an overview of the current monitoring strategies and therapies for CD patients who have undergone a bowel resection.