Postoperative maintenance therapy for inflammatory bowel disease

TY - JOUR

T1 - Postoperative maintenance therapy for inflammatory bowel disease

AU - Orlando, A.

AU - Cottone, Mario

AU - Modesto, Irene

PY - 2006

Y1 - 2006

N2 - . Curr Opin Gastroenterol. 2006 Jul;22(4):377-81. Postoperative maintenance therapy for inflammatory bowel disease. Cottone M, Orlando A, Modesto I. Department of General Medicine, Pneumology and Nutrition Clinic, Palermo University, Palermo, Italy. PURPOSE OF REVIEW: This review will highlight the knowledge gained from studies published in the year 2005 on maintenance treatment after surgery for inflammatory bowel diseases. RECENT FINDINGS: In Crohn's disease the role of smoking in increasing the risk of relapse and recurrence after surgery is confirmed. Ornidazole seems effective in reducing endoscopic recurrence and clinical relapse after surgery. Probiotics do not appear to be effective in preventing endoscopic recurrence and clinical relapse: a controlled placebo trial showed that Lactobacillus johnsonii is not effective in preventing endoscopic recurrence. A retrospective study suggested that enteral nutrition after surgery may reduce the clinical relapse. Pathophysiological studies underlined the value of probiotics in pouchitis. SUMMARY: In Crohn's disease postoperative maintenance treatment is disappointing. Giving up smoking is still the only effective measure. Mesalamine remains the drug that has been widely studied with large trials and meta-analysis. Encouraging results come from small trials on antibiotics. Azathioprine and 6-mercaptopurine must be evaluated in better designed controlled trials. There is no evidence in favour of probiotics as an effective therapy to prevent recurrence. Enteral nutrition after surgery is a candidate new therapy, but further controlled trials are needed. Pathophysiological studies confirm the beneficial role of probiotics in pouchitis.

AB - . Curr Opin Gastroenterol. 2006 Jul;22(4):377-81. Postoperative maintenance therapy for inflammatory bowel disease. Cottone M, Orlando A, Modesto I. Department of General Medicine, Pneumology and Nutrition Clinic, Palermo University, Palermo, Italy. PURPOSE OF REVIEW: This review will highlight the knowledge gained from studies published in the year 2005 on maintenance treatment after surgery for inflammatory bowel diseases. RECENT FINDINGS: In Crohn's disease the role of smoking in increasing the risk of relapse and recurrence after surgery is confirmed. Ornidazole seems effective in reducing endoscopic recurrence and clinical relapse after surgery. Probiotics do not appear to be effective in preventing endoscopic recurrence and clinical relapse: a controlled placebo trial showed that Lactobacillus johnsonii is not effective in preventing endoscopic recurrence. A retrospective study suggested that enteral nutrition after surgery may reduce the clinical relapse. Pathophysiological studies underlined the value of probiotics in pouchitis. SUMMARY: In Crohn's disease postoperative maintenance treatment is disappointing. Giving up smoking is still the only effective measure. Mesalamine remains the drug that has been widely studied with large trials and meta-analysis. Encouraging results come from small trials on antibiotics. Azathioprine and 6-mercaptopurine must be evaluated in better designed controlled trials. There is no evidence in favour of probiotics as an effective therapy to prevent recurrence. Enteral nutrition after surgery is a candidate new therapy, but further controlled trials are needed. Pathophysiological studies confirm the beneficial role of probiotics in pouchitis.

KW - crohn.post-operative.

UR - http://hdl.handle.net/10447/20935

UR - https://journals.lww.com/co-gastroenterology/toc/2006/07000

M3 - Article

VL - 22

SP - 377

EP - 381

JO - Current Opinion in Gastroenterology

JF - Current Opinion in Gastroenterology

SN - 0267-1379

ER -