PREVENTING POSTOPERATIVE RECURRENCE OF CROHNS-DISEASE

Background and methods Risk factors for recurrence of Crohn's disease and the evidence for progress in reducing recurrence following resecti on were reviewed. A Medline based literature review was carried out. R esults and conclusion Only smoking has been confirmed as a significant adverse risk factor for recurrence. Evidence for differing recurrence rates in fibrostenosing disease and perforating disease is inconclusi ve, but such a classification along with the endoscopic findings of re currence may have a place in the analysis of therapeutic trials. Minim al resectional surgery with clearing of only macroscopic disease seems to be justified, with no clear benefits from different anastomotic te chniques. Recent trials offer encouraging evidence of the usefulness o f 5-aminosalicylic acid, particularly higher-dose regimens started ear ly after resection, although the long-term benefits are uncertain. The oral steroid, budesonide, offers a potent treatment with minimal side -effects, but evidence of its prevention of recurrence is presently we ak.