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Postoperative Surveillance and Management of Crohn’s Disease

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Pediatric Inflammatory Bowel Disease

Abstract

Postoperative recurrent Crohn’s disease is quite common and clinically silent at onset, requiring ileocolonoscopy for diagnosis and surveillance. Patients with a history of penetrating disease, multiple bowel resections, and/or who smoke cigarettes after surgery are at highest risk for disease recurrence. Antibiotics, aminosalicylates, and immunomodulators have been shown to modestly reduce the risk of clinical and endoscopic disease recurrence. In contrast, anti-tumor necrosis therapy is effective at suppressing disease recurrence and may have the potential to change the natural course of disease after surgery. In this chapter, the management of postoperative Crohn’s disease is summarized, and a suggested approach to treatment is provided.

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Financial Disclosures

Dr. Barrie – none

Dr. Regueiro – Abbvie, Janssen, UCB, Shire, Takeda

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Authors and Affiliations

  1. Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, 200 Lothrop Street, C-Wing, Mezzanine, Pittsburgh, PA, 15213, USA

    Arthur M. Barrie III MD, PhD & Miguel Regueiro MD

Authors
  1. Arthur M. Barrie III MD, PhD
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  2. Miguel Regueiro MD
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Correspondence to Miguel Regueiro MD .

Editor information

Editors and Affiliations

  1. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Petar Mamula

  2. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Andrew B. Grossman

  3. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Robert N. Baldassano

  4. Division of GI, Hepatology & Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Judith R. Kelsen

  5. Division of Pediatric Gastroenterology & Nutrition, University of South Carolina School of Medicine - Greenville, Greenville, South Carolina, USA

    Jonathan E. Markowitz

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Barrie, A.M., Regueiro, M. (2017). Postoperative Surveillance and Management of Crohn’s Disease. In: Mamula, P., Grossman, A., Baldassano, R., Kelsen, J., Markowitz, J. (eds) Pediatric Inflammatory Bowel Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-49215-5_43

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  • DOI: https://doi.org/10.1007/978-3-319-49215-5_43

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-49215-5

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