MEDICINAL PROPHYLAXIS OF RECURRENCE OF CR OHNS-DISEASE IN THE NEOTERMINAL ILEUM AFTER ILEAL RESECTION

Citation
S. Vermiere et P. Rutgeerts, MEDICINAL PROPHYLAXIS OF RECURRENCE OF CR OHNS-DISEASE IN THE NEOTERMINAL ILEUM AFTER ILEAL RESECTION, Zentralblatt fur Chirurgie, 123(4), 1998, pp. 352-356
Citations number
23
Language
TEDESCO
art.tipo
Article
Categorie Soggetti
Surgery
Journal title
ISSN journal
0044-409X
Volume
123
Issue
4
Year of publication
1998
Pages
352 - 356
Database
ISI
SICI code
0044-409X(1998)123:4<352:MPOROC>2.0.ZU;2-3
Abstract
Crohn's recurrence is the appearance of objective signs defined define d radiologically, endoscopically or pathologically of Crohn's disease in the bowel of a patient who has previously had a resection of all ma croscopically diseased tissue. New lesions can be visualized endoscopi cally within weeks to months after ileal resection and ileocolonic ana stomosis in the neoterminal ileum. The evolution of these lesions mimi cs the natural history of ileal Crohn's disease at the onset. If we ar e able to prevent recurrence of early lesions we would probably interr upt the natural course of the disease. The drugs tested until today in clude different 5-ASA formulations, metronidazole and budesonide. 5-AS A seems to have a limited protective effect. High dose metronidazole s tarted immediately after surgery decreases endoscopic and symptomatic recurrence rates but is associated with a lot of side effects. Budeson ide 6 mg/day o.m. reduces endoscopic recurrence after one year only in patients operated upon for inflammatory activity. Studies with immuno suppression for recurrence prevention are currently underway. Thus, to day 5-ASA-formulations are recommended as general pharm aco-prophylaxi s.