Antagonist: Crohn's disease recurrence can be prevented after ileal resection

Abstract

Recurrence of Crohn's disease after ileal resection cannot yet be prevented. Stopping smoking may decrease recurrence rate but prospective studies are lacking. Aminosalicylates reduce the risk of clinical recurrence after resection of exclusively small bowel disease, but their prophylactic efficacy in most patients with Crohn's is marginal. Nitroimidazole antibiotics, budesonide, and 6-mercaptopurine have been shown to reduce postoperative endoscopic recurrence rates, but none has yet been shown to have sufficient effect on the clinical relapse rate to be recommended routinely for long term prophylaxis. There is a need for further trials of immunomodulatory agents, antibiotics, and probiotics for postoperative prophylaxis of Crohn's disease.