A Review of Postoperative Crohn ’ s Disease

While surgical resection remains a mainstay of the treatment of Crohn’s disease (CD), postoperative recurrence of disease is common. The ideal management of patients after surgery is unclear and varies widely in clinical practice. Both patients and clinicians must weigh the risks and benefits of treatment in reaching a decision. Those at low risk of postoperative recurrence may not need any therapy while those at moderate risk of disease recurrence may be treated with immunomodulator therapy. Patients with the highest risk for recurrence should ideally be treated with biologic therapy. Regardless of risk, all patients should undergo ileocolonoscopic surveillance at 6–12 months after surgery. This review will outline the current evidence for various medical therapies in the prevention of postsurgical recurrence and outline a management algorithm of these patients based on risk stratification.