Postoperative small bowel Crohn's disease: how to diagnose, manage and treat.

Chak Lam Ip, Ray Boyapati, Rahul Kalla

Current opinion in gastroenterology 2024 May 01

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Crohn's disease is a relapsing inflammatory condition and disease recurrence after surgery is common. Significant variation in clinical practice remains despite progress in management of postoperative Crohn's disease. In this review, we summarise current management strategies and guidelines, unmet needs, and research progress in this field. There has been real progress in risk stratifying individuals' postsurgery and tailoring therapies based on their risk; this has been incorporated into current management guidelines in the USA, UK, and Europe. Furthermore, novel noninvasive monitoring tools such as intestinal ultrasound have shown high sensitivity and specificity at detecting disease recurrence and are an attractive point-of-care test. Recent studies are also investigating multiomic biomarkers to prognosticate postoperative Crohn's disease. However, given the heterogeneity within this condition, large multicentre clinical validation across all age groups is needed for clinical translation in the future. Ongoing progress in research and the development of novel prognostic and noninvasive disease monitoring tools offers hope for personalised therapy tailored to individual recurrence risk in postoperative Crohn's disease. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Citation

Chak Lam Ip, Ray Boyapati, Rahul Kalla. Postoperative small bowel Crohn's disease: how to diagnose, manage and treat. Current opinion in gastroenterology. 2024 May 01;40(3):209-216