A Review on the Management of Postoperative Crohn's Disease

Postoperative Crohn's disease recurrence often precedes the emergence of clinical symptomatology and requires detection and management strategies for early objective recurrence. A multidisciplinary approach to optimize patients for surgery via nutrition, smoking cessation, and immunosuppression management may not only prevent postoperative complications but also future Crohn's disease recurrence. Postoperatively, a strategy to provide pharmacologic prophylaxis prior to the detection of objective recurrence and/or intensive monitoring via fecal calprotectin and endoscopy may alter the natural history of the disease and prevent a future surgery for complicated Crohn's disease. In this review, the management of perioperative and postoperative Crohn's disease is outlined for providers on the multidisciplinary team caring for these patients.