Crohn’s disease is an incurable disease, therefore recurrence after surgical resection is likely. Which of the following statement(s) regarding the recurrence of Crohn’s disease is/are accurate?
- Endoscopic evidence of recurrence is present in less than 50% of patients at five years
- Radiographic or endoscopic evidence of recurrence is frequently not accompanied by symptoms
- Clinical recurrence of Crohn’s disease is seen in 20% of patients at two years, and 40–50% at four years after surgery
- Reoperation for Crohn’s disease is necessary in the majority of patients by five years
- No solid evidence demonstrating prolongation of remission can be seen with corticosteroids, sulfasalazine, or antibiotics
Medicine
b. Radiographic or endoscopic evidence of recurrence is frequently not accompanied by symptoms
c. Clinical recurrence of Crohn’s disease is seen in 20% of patients at two years, and 40–50% at four years after surgery
e. No solid evidence demonstrating prolongation of remission can be seen with corticosteroids, sulfasalazine, or antibiotics
The majority of patients with Crohn’s disease will recur. If recurrence is defined as alterations detected endoscopically, then 70% will recur within one year of surgery, and 85% within three years. However, in most of these patients clinical symptoms will not accompany the endoscopic or radiographic evidence of disease. A clinical recurrence (return of symptoms) confirmed as Crohn’s disease radiologically, endoscopically, or surgically, affects 20% of patients at two years, and 40–50% at four years after surgery. Reoperation becomes necessary in about 30% of the patients by five years. These statistics give impetus to maintain remission and prevent recurrence. Although it is common practice to stem recurrence with sulfsalazine, 5-ASA preparations, antibiotics, and possibly azathioprine, none of these (possibly excepting azathioprine) have definitely been proven effective.
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