Materiały źródłowe

• #1 Crohn disease Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/crohn-disease

  There is no known way to prevent Crohn disease, however, people can usually manage the condition with medication, diet, and lifestyle changes. […] Eating a diet rich in fruit and vegetables can also help ease symptoms. […] Eating fruits and vegetables, lowering fat, and eliminating sugar may reduce the risk of developing Crohn disease. […] Certain foods may also reduce symptoms and make recurrences of the disease less likely.

• #1 Inflammatory Bowel Disease (IBD): Lifestyle factors may aid prevention

  https://www.medicalnewstoday.com/articles/ibd-prevention-lifestyle-factors-inflammatory-bowel-disease-cases

  A recent study found that adherence to specific lifestyle factors may successfully prevent many inflammatory bowel disease cases. […] Their analysis showed that low modifiable risk scores could prevent almost 43% of Crohns disease cases and over 44% of ulcerative colitis cases. They further estimated that following a healthy lifestyle could prevent about 61% of Crohns disease cases and about 42% of ulcerative colitis cases. […] If our findings are true, this suggests that choosing low-risk or healthy dietary and lifestyle habits may be an effective strategy to prevent CD and UC.

• #1 Crohn’s Disease: What It Is, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/9357-crohns-disease

  You cant prevent Crohns disease, but you can ease symptoms and reduce flare-ups by: […] Stopping smoking. Quitting smoking is the best thing you can do to reduce your risk of flare-ups and complications. […] Avoiding medications that can trigger flare-ups. Taking certain medicines can increase your risk of flare-ups. […] Avoiding foods that may trigger unwanted symptoms. […] Eating foods that work for you with meals spread out. […] Caring for your mental health. Getting enough rest and exercising regularly improve your overall well-being, which makes life with Crohns more manageable.

• #1 Role of diet in prevention versus treatment of Crohn’s disease and ulcerative colitis | Frontline Gastroenterology

  https://fg.bmj.com/content/15/3/247

  From these data, there are clear differences between CD and UC, but results are often inconsistent in finding associations. […] Protective dietary factors included docosahexaenoic acid (DHA), dairy, total fibre, specifically from fruit or grains or both, polyphenols in wine, grapes and certain herbs, dietary potassium and zinc. […] While not specified as a MED, another cohort assessed a healthy lifestyle score (HLS), which considered comparable dietary factors, high in fruit, vegetables, nuts and fish and low in red meat, and also the lifestyle factors body weight, smoking and physical activity. […] These data indicate non-dietary lifestyle modifiers likely play a role in IBD development. […] The general message that features of a MED that is heavily plant based, moderate in fish and dairy and low in meat and UPF is pleasingly in line with healthy eating guidelines and assurance that these default dietary recommendations are likely to reduce risk of CD development.

• #1

  https://www.prevention.com/health/health-conditions/a26024642/crohns-disease-symptoms-causes-treatments/

  How to prevent Crohns disease: Again, smoking and eating too little fiber are associated with an increased risk for Crohns disease. So if you smoke, stop. Also, try to eat at least 24 grams of fiber per day. (You’ll find tips for hitting that daily mark here.) Some research has found this amount can cut your risk for Crohns by up to 40 percent. […] Otherwise, theres not much you can do to shield yourself from Crohns. The underlying causes of the disease arent well-understood, and likely involve a combination of different genetic, biological, and environmental factors.

• #1 Role of diet in prevention versus treatment of Crohn’s disease and ulcerative colitis | Frontline Gastroenterology

  https://fg.bmj.com/content/15/3/247

  While dietary associations for UC development are less apparent, with the exception of red meat consumption increasing risk, it is judicious to recommend the same for those at risk of UC. […] The first dietary intervention to induce remission was exclusive enteral nutrition (EEN) for CD, but it is difficult to maintaining beyond 68 weeks. […] Efficacy data for EEN, which replaces food with liquid nutritional supplements for 68 weeks, are strongest for paediatric patients with CD, with a Cochrane review showing 83% remission rates. […] Consensus guidelines recommend EEN as first-line therapy to induce remission in children with active luminal CD. […] The rationale of the diet is that it excludes dietary components implicated in the development of CD from epidemiology and animal studies, including animal fats, red meat, gluten, dairy, maltodextrin and UPF.

• #1 Role of diet in prevention versus treatment of Crohn’s disease and ulcerative colitis | Frontline Gastroenterology

  https://fg.bmj.com/content/15/3/247

  Diet is a modifiable risk factor for disease course and data over the past decade have emerged to indicate its role in Crohns disease (CD) and ulcerative colitis (UC). […] The key understanding is that causative factors in disease development do not always proceed to an opportunity to change disease course, once established. […] We appraise the literature for how our dietary recommendations should be shaped to prevent disease development and if or how that differs for CD and UC induction therapy and maintenance therapy. […] In UC, principles of healthy eating are likely to play a role in all states of disease. […] Conversely, data linking dietary factors to CD prevention and treatment are paradoxical with the highest quality evidence for CD treatment being exclusive enteral nutrition, a lactose, gluten and fibre-free diet comprising solely of ultraprocessed food—all dietary factors that are not associated or inversely associated with CD prevention.

• #1 Crohn’s Disease Prevention – Klarity Health Library

  https://my.klarity.health/crohns-disease-prevention/

  Many people with Crohns disease have found gluten to be a trigger for flare-ups, studies have shown that 65.6% of patients that avoided gluten found improvement in gastrointestinal symptoms. […] Those with Crohns disease are advised to reduce alcohol intake as alcohol can cause damage to the gastrointestinal tract and worsen the existing symptoms. […] Nonsteroidal anti-inflammatory drugs, commonly referred to as NSAIDs can have an adverse effect on Crohns disease. […] Research indicates that smoking can make symptoms of Crohns Disease worse. […] Crohns disease is a lifelong inflammatory condition that is not entirely preventable but can be managed with a combination of medical and habitual interventions. Reforming your diet by adding fiber and nutritious foods can reduce the severity of symptoms. Furthermore, avoiding certain items such as alcohol, medications, and nicotine can reduce the frequency of flare-ups and manage this condition.

• #1 6 Ways to Prevent a Crohn’s Flare-Up

  https://www.webmd.com/ibd-crohns-disease/crohns-disease/crohns-disease-prevent-flares

  Stress causes an uptick in inflammation, and people with Crohns and other irritable bowel diseases have more flares when theyre under stress. […] Regular exercise may improve your bodys immune response and reduce inflammation. That, in turn, could reduce flares. […] To help you figure out which foods may not be right for you, start a food journal. Write down what you eat and how it makes you feel. If a certain food brings on symptoms, eliminate it from your diet.

• #1 Can You Prevent Inflammatory Bowel Disease? | Mass General Brigham

  https://www.massgeneralbrigham.org/en/about/newsroom/articles/prevent-inflammatory-bowel-disease

  Theres no known way to prevent IBD. But there may be things you can do to help reduce your risk. […] To help reduce your risk of developing IBD: Avoid processed food and additives. Eat a Mediterranean-style diet rich in fruits and vegetables. Get enough sleep. Limit exposure to antibiotics. Dont smoke. Reduce stress and anxiety. Breastfeeding during infancy has been shown to reduce risk of IBD in children. Studies also have shown that people who exercise regularly may have a lower risk of developing IBD.

• #1 Crohn’s Disease: Symptoms, Causes, and Treatment

  https://www.health.com/condition/crohns-disease-overview

  There’s no way to prevent Crohn’s disease. But you can take steps to reduce your risk of flares. Some lifestyle changes that may help include: […] Pay special attention to your diet: You may find that soft, bland foods are easy to digest. Spicy or high-fiber foods can be rough on your GI tract. Also, limit dairy, greasy foods, or foods that cause gas. A food journal can keep track of what foods worsen your symptoms. […] Try complementary and alternative therapies: These include acupuncture, massage, or Tai Chi. They may help alleviate pain. Reducing pain can improve your overall quality of life. Some may even boost immunity. […] Manage your stress: Meditation, yoga, or deep breathing can help prevent a flare. They may also help your disease feel less overwhelming. […] Quit smoking: Quitting smoking may prevent flares. You’ll also reduce your risk of surgery. […] Limit caffeine and alcohol: Both may worsen symptoms. It’s best to track if you have flares after consuming caffeine or alcohol. […] You can take steps to prevent flares. Avoiding foods that irritate your GI tract, reducing stress, and quitting smoking may help with the pain.

• #1 6 Ways to Prevent a Crohn’s Flare-Up

  https://www.webmd.com/ibd-crohns-disease/crohns-disease/crohns-disease-prevent-flares

  Your Crohns disease is ever-present, unfortunately, and so is the possibility of a flare-up. What can you do? While nothing offers guaranteed protection against a return of symptoms, you can take steps to make flares less likely. […] Medications that modify the way your immune system operates help prevent inflammation. But they only work when you take them. If you skip doses, thats an invitation for symptoms to return. So stick with the instructions your doctor gave you and take your medication as prescribed, even when you feel fine. […] The American College of Gastroenterologists strongly recommends against the use of NSAIDs by people with Crohns disease. If you have arthritis or another condition that causes frequent pain, talk to your doctor about your options. […] Smoking kicks Crohns disease activity into overdrive and makes the disease progress faster. Not only does smoking increase the odds that youll need surgery, it also makes flares more frequent. After you stop smoking, the number of flares you have should drop. You also may need fewer Crohns disease medications if you quit smoking.

• #1 Risk Stratification for Prevention of Recurrence of Postoperative Crohn’s Disease – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/november-2017/risk-stratification-for-prevention-of-recurrence-of-postoperative-crohns-disease/

  Abstract: Although there have been significant advances in medical therapies to treat Crohn’s disease, an estimated 50% of patients will require surgery within the first decade of disease duration. […] To prevent disease recurrence, many physicians use postoperative prophylactic therapy. […] Randomized, controlled trials, although limited in number, have demonstrated that a prophylactic postoperative strategy is effective at reducing recurrence (both clinical and endoscopic) in high-risk patients. […] Future studies must be conducted to establish a gold standard as to who should receive postoperative prophylaxis and which therapies and time course are ideal. […] Given the rates of postoperative Crohn’s disease recurrence, various medical strategies have been considered for postsurgical disease prevention.

• #1 Prophylaxis of Crohn’s disease recurrence: A surgeon’s perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7511563/

  Medical therapy—immunosuppressive modulators and biologic agents—have been associated with decreased need for operation in the short-term, without definitive long-term evidence. […] In addition to antibiotics and immunomodulators, several studies have demonstrated anti-tumor necrosis factor to be efficacious in reducing POR in CD, with a more pronounced effect noted in anti-TNF naïve patients. […] The unsolved dilemma is who is going to benefit the most from an expensive and potentially morbid therapy. […] Patients were categorized as high or low-risk then randomized for 6 vs 18-month initial colonoscopy following surgery. High-risk patients were treated with either thiopurine or and all patients were treated with 3 months of metronidazole. […] The initial step in postoperative CD management is risk stratification. Early postoperative endoscopy for high-risk patients with intensification of medical therapy is associated with 18% lower rate of endoscopic recurrence. […] While there is no concrete evidence that smoking decreased therapeutic response to biologic therapy, there is a two times increased risk of POR recurrence in active smokers either incapable or unwilling to stop.

• #1 Prevention of post-operative recurrence of Crohn’s disease

  https://www.wjgnet.com/1007-9327/full/v20/i5/1147.htm

  Prevention of post-operative recurrence of Crohns disease. […] A number of medical therapies have been shown to reduce this risk in clinical trials. Metronidazole, thiopurines and anti-tumour necrosis factors (TNFs) are all effective in reducing the risk of endoscopic or clinical recurrence of CD. […] Patients who are high risk for post-operative recurrence should be considered for early medical prophylaxis with an anti-TNF. […] Clinical recurrence rates are variable, and methods to stratify patients into high and low risk populations combined with prophylaxis tailored to endoscopic recurrence would be an effective strategy in treating these patients. […] Multiple risk factors have been identified for postoperative recurrence. Risk stratifying patients based on these factors can thus help decide which patients to treat aggressively.

• #1

  https://link.springer.com/article/10.1007/s11894-999-0006-6

  Postoperative recurrence of Crohns disease is often inevitable. Certain risk factors such as smoking, young age, and a perforating disease behavior have been identified. Patients with an enhanced risk profile should be treated with mesalamine or with azathioprine, the latter of which has higher success rates. […] An endoscopic evaluation of the neoterminal ileum performed 6 to 12 months after surgery provides important prognostic information regarding the further clinical course of the disease and can be used as a guide to optimize medical therapy. […] Oral budesonide for prevention of postsurgical recurrence in Crohn’s disease. […] Maintenance and prophylactic therapy for Crohn’s disease. […] Prophylactic mesalamine treatment decreases postoperative recurrence of Crohn’s disease. […] Mesalamine in the prevention of endoscopic recurrence after intestinal resection for Crohn’s disease.

• #1

  https://journals.lww.com/10.1097/MEG.0000000000001729

  Prevention and management of postoperative recurrence (POR) is a controversial field in Crohns disease. […] Most respondents (60%) considered starting postoperative immunoprophylaxis in nave patients if one or more known risk factors were present. […] In case of fistulizing phenotype, perianal disease, or concomitant colonic involvement, the majority of physicians reported to start an immediate prophylaxis in 85, 98 and 88% of patients, respectively. […] The high rate of early prophylaxis with expensive biologics despite missing solid evidence highlights the need for more randomized trials.

• #1 Postoperative prophylaxis in Crohn’s disease after intestinal resection: a retrospective analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5558283/

  Up to 80% of patients with Crohn’s disease (CD) may require surgery at some point in their lives, and it is estimated that as many as 40% may require several surgeries. […] It has been suggested that prophylactic medication decreases the rate of clinical and endoscopic recurrence following intestinal resection. […] The efficacy of several agents has been studied, including mesalazine, thiopurines, anti-tumour necrosis factor (TNF)- drugs, such as infliximab and adalimumab, and 5-imidazole antibiotics, including metronidazole and ornidazole. […] A cost-effectiveness analysis reported that thiopurine drugs had the most favourable incremental cost-effectiveness ratio (ICER) in the prevention of clinical recurrence of postoperative CD up to 1 year, and mesalazine the most favourable ICER at 5 years.

• #1 Interventions for prevention of post-operative recurrence of Crohn’s disease | Cochrane

  https://www.cochrane.org/CD006873/IBD_interventions-for-prevention-of-post-operative-recurrence-of-crohns-disease

  The use of nitroimidazole antibiotics appeared to reduce the risk of clinical (RR 0.23; 95%CI 0.09 to 0.57, NNT=4) and endoscopic (RR 0.44; 95%CI 0.26 to 0.74, NNT = 4) recurrence relative to placebo. […] Mesalamine therapy was associated with a significantly reduced risk of clinical recurrence (RR 0.76; 95% CI 0.62 to 0.94, NNT = 12), and severe endoscopic recurrence (RR 0.50; 95% CI 0.29 to 0.84, NNT = 8) when compared to placebo. […] Azathioprine/6MP was also associated with a significantly reduced risk of clinical recurrence (RR 0.59; 95% CI 0.38 to 0.92, NNT = 7), and severe endoscopic recurrence (RR 0.64; 95% CI 0.44 to 0.92, NNT = 4), when compared to placebo.

• #1 Crohn’s Disease: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/1201/p661.html

  All patients with Crohn’s disease should be counseled on smoking avoidance or cessation. […] Smoking cessation reduces complications experienced by patients with Crohn’s disease, and all patients should be counseled not to smoke and offered cessation assistance. […] Maximizing prevention measures is essential in caring for these patients. […] Preventive measures can mitigate these complications. Patients with Crohn’s disease are at increased risk of cancer, osteoporosis, anemia, nutritional deficiencies, depression, infection, and thrombotic events. […] After surgical resection, prophylactic therapy should be considered to prevent recurrence. Current data show that anti-TNF agents are most effective. […] Nitroimidazole antibiotics (metronidazole), mesalamine, and thiopurines are also useful in preventing postoperative recurrence.

• #1 Management of Crohn’s disease after surgical resection – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-crohns-disease-after-surgical-resection/

  Strategies to reduce disease recurrence in Crohn’s disease patients who have achieved remission following bowel resection. […] 1. In patients with surgically induced remission of Crohn’s disease, AGA suggests early pharmacological prophylaxis over endoscopy-guided pharmacological treatment. […] 2. In patients with surgically induced remission of Crohn’s disease, AGA suggests using anti-tumor necrosis factor (anti-TNF) therapy and/or thiopurines over other agents. […] 3. In patients with surgically induced remission of Crohn’s disease, AGA suggests against using mesalamine (or other 5-aminosalicylates), budesonide or probiotics. […] 4. In patients with surgically induced remission of Crohn’s disease receiving pharmacological prophylaxis, AGA suggests postoperative endoscopic monitoring at 6 to 12 months after surgical resection over no monitoring.

• #1 Management and Prevention of Postoperative Crohn’s Disease – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/march-2011-2/management-and-prevention-of-postoperative-crohns-disease/

  For these patients, I initiate postoperative anti-TNF treatment after surgery and perform a colonoscopy within 1 year. […] Addressing recurrences promptly is especially important in high-risk patients, as these individuals often develop complications if their disease is left unchecked. […] Typically, I perform a colonoscopy 6–12 months after surgery to check for CD recurrence, and some physicians are starting to perform colonoscopy as early as 3 months following surgery. […] In the future, clinicians may be able to perform noninvasive ultrasound and reliably detect recurrences; for now, however, the gold standard is to perform a colonoscopy and visually examine the mucosa at and above the site where the surgery was performed. […] First, we need studies comparing different preventative strategies.

• #1 Management of Crohn’s disease after surgical resection – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-crohns-disease-after-surgical-resection/

  5. In patients with surgically induced remission of Crohn’s disease not receiving pharmacological prophylaxis, AGA recommends postoperative endoscopic monitoring at 6 to 12 months after surgical resection over no monitoring. […] 6. In patients with surgically induced remission of Crohn’s disease with asymptomatic endoscopic recurrence, AGA suggests initiating or optimizing anti-TNF and/or thiopurine therapy over continued monitoring alone.

• #1 Prophylaxis of Crohn’s disease recurrence: A surgeon’s perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7511563/

  Management of inflammatory bowel disease has evolved extensively in the last three decades. […] Only if we manage these complex patients in the context of a multidisciplinary team we will be able to obtain outstanding outcomes, specifically with high and sustained remission rates for these patients. […] In a case-controlled comparative analysis, 138 patients were divided between wide-lumen stapled side-to-side and hand-sewn end-to-end anastomoses. Clinical recurrence was noted in 24% of side-to-side anastomoses and 57% of end-to-end anastomoses with a cumulative surgical recurrence rate of 11% and 20% at 5 years (P = .017). The authors concluded that the side-to-side anastomosis created a wider diameter lumen that reduced clinical recurrence by limiting fecal stasis and reducing recurrence secondary to ischemia.

• #1 Targeting Disease Prediction and Prevention: the New Frontier in IBD

  https://reports.mountsinai.org/article/gi2023-04-targeting-ibd-prediction-and-prevention

  Mount Sinai researchers have found strong evidence that before the first symptoms of Crohns disease and ulcerative colitis occur, theres a preclinical phase in which immune and inflammatory pathways are already altered. By targeting and treating the early pathogenic events that promote IBD development, they believe, disease onset could be prevented or impeded. […] In other words, by targeting and treating the early pathogenic events that promote IBD development, disease onset could be prevented or impeded, and a true opportunity to change its course revealed. […] Being able to identify in the blood or stool those dysregulated pathways through biomarkers, such as proteomics, metabolomics, gut microbiome, and antimicrobial antibodies, will lead to the development of prediction models and prevention strategies. […] If were going to find a way to prevent Crohns disease and ulcerative colitis, it will require the global GI community actively embracing this new paradigm of prediction and prevention, declares Dr. Colombel. We are making great progress, but so much work remains.

• #1 Takeda and EU Innovative Health Initiative launch Crohn’s disease prevention study – PMLiVE

  https://pmlive.com/pharma_news/takeda-and-eu-innovative-health-initiative-launch-crohns-disease-prevention-study/

  Takeda and the EUs Innovative Health Initiative have announced a 38m project aimed at improving early intervention in Crohns disease. […] The first-of-its-kind INTERCEPT study will use biomarkers to intercept the diseases development in high-risk individuals, with the goal of preventing the symptoms ever developing. […] INTERCEPT will aim to verify and clinically validate a panel of biomarkers and build a blood risk score that can identify those at a high risk of developing Crohns disease within five years after initial evaluation. […] The project will recruit 10,000 healthy first-degree relatives of Crohns disease patients from seven European countries, and the 80 individuals at the highest risk of developing the condition will participate in a trial aimed at preventing full-blown disease development through an established and effective medical treatment.

• #1 Prevention in Inflammatory Bowel Disease: An Updated Review – Practical Gastro

  https://practicalgastro.com/2020/03/13/prevention-in-inflammatory-bowel-disease-an-updated-review/

  Patients with inflammatory bowel disease (IBD) are subject to complications from the disease itself and also from the immunosuppressive therapies used for treatment. […] To optimize the care of patients with IBD, providers need to consider primary, secondary and tertiary prevention. Primary prevention is employed to prevent a disease or complication from developing, such as immunizations. […] Therefore, adherence to vaccination guidelines of inactivated vaccines can reduce these infectious complications. Annual influenza vaccination is indicated in all patients with IBD, pneumococcal vaccination series is indicated in all immunosuppressed patients with IBD and herpes zoster vaccination is indicated in all patients with IBD 50 years of age. […] Another method of primary prevention in IBD patients is sunscreen use to prevent skin cancer. Patients with IBD have increased risks of both non-melanoma (NMSC) and melanoma skin cancer.

• #1 Prevention in Inflammatory Bowel Disease: An Updated Review – Practical Gastro

  https://practicalgastro.com/2020/03/13/prevention-in-inflammatory-bowel-disease-an-updated-review/

  Therefore, this is a potentially preventable complication of therapy through broad-spectrum sunscreen use. […] Finally, weight bearing exercise and calcium/ vitamin D supplementation, when appropriate, can prevent downstream osteoporotic fracture in these patients who may require recurrent courses of corticosteroids during their lifetimes with IBD. […] Secondary prevention is defined as detecting a disease early to prevent disability; such as through screening programs. […] Therefore, a dermatology skin screening program is recommended in all patients with IBD. […] Therefore, patients with longstanding colonic inflammation should undergo routine colonoscopy starting at 8-10 years of colonic disease duration, with subsequent colonoscopy intervals based on the results (often every 1-3 years).

• #1 Prevention in Inflammatory Bowel Disease: An Updated Review – Practical Gastro

  https://practicalgastro.com/2020/03/13/prevention-in-inflammatory-bowel-disease-an-updated-review/

  Tertiary prevention refers to utilization of measures to reduce the impact of long-term disease and disability. […] Therefore, by intervening early and treating inflammation, with a goal of mucosal healing, we can potentially prevent these morbid and potentially life-threatening, complications of IBD. […] Therefore, by optimizing therapies to improve mucosal healing, we may be able to impact the long-term disability associated with irreversible bowel damage in IBD. […] Through this partnership, an individualized plan for preventive medicine can be developed for each patient with IBD. This proactive approach of addressing primary, secondary and tertiary prevention in IBD patients can ultimately help to reduce infectious, malignant and long-term disease-related complications.

• #1 Role of diet in prevention versus treatment of Crohn’s disease and ulcerative colitis | Frontline Gastroenterology

  https://fg.bmj.com/content/15/3/247

  Multiple epidemiological studies uphold the idea that a healthy diet modelled on the MED, being mostly plant-based with limits on red meat and UPF, is likely beneficial for disease prevention, at least for CD. […] Less apparent for UC, similar healthy eating principles should be the default messaging, potentially with an emphasis on less red meat.

• #1 Postoperative prophylaxis in Crohn’s disease after intestinal resection: a retrospective analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5558283/

  The American College of Gastroenterology recommends that metronidazole, mesalazine, thiopurines or infliximab should be considered. […] The European Crohn’s and Colitis Organisation recommends prophylactic treatment after small intestinal resection, and favours thiopurines over 5-aminosalicylates or imidazole antibiotics, but the British Society of Gastroenterology does not endorse this view. […] In our study, combination therapy with anti-TNF- and immunomodulator therapy was well tolerated, efficacious (efficacy appeared durable for patients with postoperative CD) and superior to monotherapy with either thiopurines or anti-TNF- drugs. […] Our data suggest that there may be merit in the use of combination therapy in carefully selected postoperative patients whose care has been individualised via a multidisciplinary team meeting format. Prospective, controlled studies are therefore required to further assess the efficacy and safety of combination therapy for postoperative prophylaxis in CD.

• #1 Prevention – Helmsley Charitable Trust

  https://helmsleytrust.org/our-focus-areas/crohns-disease/crohns-disease-prevention/

  Helmsley believes the best way to help a person with Crohns disease is to ensure that the condition never develops in the first place or, once diagnosed, that disease progression, or any complications, are delayed for as long as possible. […] A greater understanding of its natural history and causes will lead to the development of effective interventions to prevent the onset and progression of Crohns disease. […] We support international research initiatives that will improve our understanding of the environmental component of Crohns disease to uncover further its root causes and to identify how the disease develops. Studying what factors are driving the global increase in Crohns disease could provide important new insights for prevention. […] Our goal is to identify dietary interventions that can improve the course of the disease, which could have both immediate and lasting benefits for disease management.

• #1

  https://esmed.org/MRA/mra/article/view/3928

  The Probiotic VSL#3 Has Anti-inflammatory Effects and Could Reduce Endoscopic Recurrence After Surgery for Crohns Disease. […] Combination of antibiotic and probiotic treatment is efficacious in prophylaxis of post-operative recurrence of Crohns disease: A randomized controlled study VS mesalamine. […] The Genetics of Postoperative Recurrence in Crohn Disease: A Systematic Review, Meta-analysis, and Framework for Future Work.

• #1 Prevention of post-operative recurrence of Crohn’s disease

  https://www.wjgnet.com/1007-9327/full/v20/i5/1147.htm

  The use of mesalamine in the postoperative setting is appealing given its favorable safety profile, ease of administration, and relatively lower costs to anti-TNFs. […] Azathioprine and 6-mercaptopurine are efficacious in maintenance of CD and have been extensively studied in the post-operative setting. […] Most recently anti-TNF therapeutic antibodies have been studied in the prevention of post-operative prophylaxis. […] Manipulation of the bacterial flora is an attractive mode of preventing postoperative recurrence, as specific bacteria including bacteroides, fusobacteria and E. coli have been found in increased amount in the neo-terminal ileum. […] The goal of therapy for post-operative prophylaxis is to decrease clinical recurrence. […] Stratifying patients according to risk of symptomatic recurrence and tailoring therapy is the ideal and most cost effective way to treat patients, however these questions have not been fully answered.

• #1

  https://link.springer.com/article/10.1007/s11894-023-00911-7

  Despite advances in therapeutics, a significant portion of patients with Crohns disease still require surgical management. […] High-risk patients benefit most from medical prophylaxis, including anti-TNF with or without immunomodulator therapy to prevent recurrence. […] Recent advances in the prediction, prevention, and monitoring algorithms of postoperative Crohns disease may be leading to a reduction in postoperative recurrence. […] Ongoing trials will help determine optimal monitoring and management strategies for this at-risk population. […] New biologics such as vedolizumab and ustekinumab have emerging evidence in the use of prophylaxis, especially with recent REPREVIO trial data. […] Large, multicenter prospective study showing that prophylactic biologics help prevent POR in both high-risk and low-risk patients. […] First RCT demonstrating that vedolizumab is effective and safe in the prevention of POR of Crohn’s disease. […] Ustekinumab is more effective than azathioprine to prevent endoscopic postoperative recurrence in Crohns disease.

• #1

  https://esmed.org/MRA/mra/article/view/3928

  Historically up to 80% of Crohns disease patients required at least one surgical resection in their lifetime. […] However, surgery continues to be necessary for many. […] Therefore, new approaches are required. Predicting which patients will develop recurrence using genetic and microbiome markers is one approach. […] Choosing surgical techniques that reduce recurrence rates is another and finally dietary approaches to manipulate the microbiome to reduce recurrence are another potential avenue. […] The aim is to be able to reduce recurrence rates whilst accurately predicting which patients will have disease recurrence with the ultimate goal of a more personalised preventive approach. […] The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

• #1 INTERCEPT: Pioneering the future of Crohn’s disease prevention — EFCCA

  https://www.efcca.org/news/intercept-pioneering-future-crohns-disease-prevention

  EFCCA is partnering in the groundbreaking INTERCEPT project! This multi-million Euro research initiative, funded by the Innovative Health Initiative Joint Undertaking (IHI JU), marks a significant milestone in the fight against Crohns disease. By harnessing the power of predictive biomarkers, the project aims to shift Crohns from an incurable condition to one that can be effectively managed or even prevented. […] INTERCEPT is Europes first-ever trial using biomarkers to prevent the onset of Crohns disease before symptoms develop. […] The goal is to validate a panel of biomarkers and develop a blood risk score to identify individuals at high risk of developing Crohns disease within five years. […] By detecting and addressing the disease in its earliest stages, INTERCEPT has the potential to revolutionise IBD care and significantly improve patient outcomes. […] EFCCAs commitment to improving the quality of life for those affected by IBD aligns seamlessly with INTERCEPTs mission to transform the future of Crohns disease care.

• #2 How To Prevent Crohn’s Disease

  https://www.health.com/crohns-disease-prevention-7097735

  Crohn’s disease may not be entirely preventable, but lifestyle changes can help you reduce symptoms and the frequency of flare-ups. […] While you may not be able to prevent Crohn’s disease, there are steps you can take to reduce your symptoms and the frequency of your flares. […] If you participate in activities that may increase your risk of the condition, it may be a good time to make healthy lifestyle changes that can decrease symptoms and your frequency of experiencing flares. […] Here are some things that you may want to try to prevent flares and reduce symptoms: […] If you smoke cigarettes, one of the best things you can do for your health is to quit. […] You may find it helpful to make nutritional changes, especially if you eat a diet that is high in fat. […] Quitting tobacco and eating anti-inflammatory foods can greatly improve symptoms. […] If you receive a diagnosis for Crohn’s disease, it’s a good idea to also ask your provider how to prevent flares from happening. […] While the condition cannot be prevented, you can reduce your symptoms and frequency of flares by following your treatment plan and making lifestyle changes.

• #2 Can You Prevent Inflammatory Bowel Disease? | Mass General Brigham

  https://www.massgeneralbrigham.org/en/about/newsroom/articles/prevent-inflammatory-bowel-disease

  Theres no known way to prevent IBD. But there may be things you can do to help reduce your risk. […] To help reduce your risk of developing IBD: Avoid processed food and additives. Eat a Mediterranean-style diet rich in fruits and vegetables. Get enough sleep. Limit exposure to antibiotics. Dont smoke. Reduce stress and anxiety. Breastfeeding during infancy has been shown to reduce risk of IBD in children. Studies also have shown that people who exercise regularly may have a lower risk of developing IBD.

• #2 Crohn’s Disease: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/1201/p661.html

  All patients with Crohn’s disease should be counseled on smoking avoidance or cessation. […] Smoking cessation reduces complications experienced by patients with Crohn’s disease, and all patients should be counseled not to smoke and offered cessation assistance. […] Maximizing prevention measures is essential in caring for these patients. […] Preventive measures can mitigate these complications. Patients with Crohn’s disease are at increased risk of cancer, osteoporosis, anemia, nutritional deficiencies, depression, infection, and thrombotic events. […] After surgical resection, prophylactic therapy should be considered to prevent recurrence. Current data show that anti-TNF agents are most effective. […] Nitroimidazole antibiotics (metronidazole), mesalamine, and thiopurines are also useful in preventing postoperative recurrence.

• #2 Crohn disease Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/condition/crohn-disease

  There is no known way to prevent Crohn disease, however, people can usually manage the condition with medication, diet, and lifestyle changes. […] Eating a diet rich in fruit and vegetables can also help ease symptoms. […] Eating fruits and vegetables, lowering fat, and eliminating sugar may reduce the risk of developing Crohn disease. […] Certain foods may also reduce symptoms and make recurrences of the disease less likely.

• #2 Role of diet in prevention versus treatment of Crohn’s disease and ulcerative colitis | Frontline Gastroenterology

  https://fg.bmj.com/content/15/3/247

  From these data, there are clear differences between CD and UC, but results are often inconsistent in finding associations. […] Protective dietary factors included docosahexaenoic acid (DHA), dairy, total fibre, specifically from fruit or grains or both, polyphenols in wine, grapes and certain herbs, dietary potassium and zinc. […] While not specified as a MED, another cohort assessed a healthy lifestyle score (HLS), which considered comparable dietary factors, high in fruit, vegetables, nuts and fish and low in red meat, and also the lifestyle factors body weight, smoking and physical activity. […] These data indicate non-dietary lifestyle modifiers likely play a role in IBD development. […] The general message that features of a MED that is heavily plant based, moderate in fish and dairy and low in meat and UPF is pleasingly in line with healthy eating guidelines and assurance that these default dietary recommendations are likely to reduce risk of CD development.

• #2 Role of diet in prevention versus treatment of Crohn’s disease and ulcerative colitis | Frontline Gastroenterology

  https://fg.bmj.com/content/15/3/247

  Multiple epidemiological studies uphold the idea that a healthy diet modelled on the MED, being mostly plant-based with limits on red meat and UPF, is likely beneficial for disease prevention, at least for CD. […] Less apparent for UC, similar healthy eating principles should be the default messaging, potentially with an emphasis on less red meat.

• #2 Crohn’s disease 101: Causes, symptoms & treatment – Oshi Health

  https://oshihealth.com/crohns-disease/

  You can also take actions to minimize the chance of flare-ups and complications. A team of GI specialists can identify what lifestyle modifications make the most sense for you, but some of the most common target your diet, mental health, and smoking habits. […] If you don’t smoke, don’t start. If you already smoke, know that current smokers are more likely to develop Crohn’s. For those who already have Crohn’s disease, smoking can increase the risk of hospitalization. […] To manage living with a chronic GI condition, many patients find it useful to work with a gut-brain specialist. Typically, these specialists focus on addressing emotions and feelings that stem from having Crohn’s disease. […] Stress is one of the most prevalent risk factors for experiencing more severe Crohn’s flare-ups. Before you panic (or stress), it’s important to know that stress management techniques can play a huge role in preventing Crohn’s flare-ups. […] The good news is that with a proper diagnosis, there are many treatments available to control your immune system and symptoms so you can live well. While Crohn’s disease is a lifelong condition, lifestyle and dietary modifications can reduce flare-ups.

• #2 Crohn’s Disease – Symptoms, Causes, Complications & Prevention PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact Nu

  https://www.pacehospital.com/crohn-s-disease-symptoms-types-causes-complications-prevention

  Crohn’s disease cannot be prevented; however, the following might lessen flare-ups and ease symptoms: […] Quit smoking […] Daily yoga for stress management […] Avoid intake of painkillers […] Consumption of a low-fat diet […] Regular exercise.

• #2 Crohn’s Disease: Symptoms, Causes, and Treatment

  https://www.health.com/condition/crohns-disease-overview

  There’s no way to prevent Crohn’s disease. But you can take steps to reduce your risk of flares. Some lifestyle changes that may help include: […] Pay special attention to your diet: You may find that soft, bland foods are easy to digest. Spicy or high-fiber foods can be rough on your GI tract. Also, limit dairy, greasy foods, or foods that cause gas. A food journal can keep track of what foods worsen your symptoms. […] Try complementary and alternative therapies: These include acupuncture, massage, or Tai Chi. They may help alleviate pain. Reducing pain can improve your overall quality of life. Some may even boost immunity. […] Manage your stress: Meditation, yoga, or deep breathing can help prevent a flare. They may also help your disease feel less overwhelming. […] Quit smoking: Quitting smoking may prevent flares. You’ll also reduce your risk of surgery. […] Limit caffeine and alcohol: Both may worsen symptoms. It’s best to track if you have flares after consuming caffeine or alcohol. […] You can take steps to prevent flares. Avoiding foods that irritate your GI tract, reducing stress, and quitting smoking may help with the pain.

• #2 Crohn’s Disease Prevention – Klarity Health Library

  https://my.klarity.health/crohns-disease-prevention/

  Many people with Crohns disease have found gluten to be a trigger for flare-ups, studies have shown that 65.6% of patients that avoided gluten found improvement in gastrointestinal symptoms. […] Those with Crohns disease are advised to reduce alcohol intake as alcohol can cause damage to the gastrointestinal tract and worsen the existing symptoms. […] Nonsteroidal anti-inflammatory drugs, commonly referred to as NSAIDs can have an adverse effect on Crohns disease. […] Research indicates that smoking can make symptoms of Crohns Disease worse. […] Crohns disease is a lifelong inflammatory condition that is not entirely preventable but can be managed with a combination of medical and habitual interventions. Reforming your diet by adding fiber and nutritious foods can reduce the severity of symptoms. Furthermore, avoiding certain items such as alcohol, medications, and nicotine can reduce the frequency of flare-ups and manage this condition.

• #2 Prophylaxis of Crohn’s disease recurrence: A surgeon’s perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7511563/

  Medical therapy—immunosuppressive modulators and biologic agents—have been associated with decreased need for operation in the short-term, without definitive long-term evidence. […] In addition to antibiotics and immunomodulators, several studies have demonstrated anti-tumor necrosis factor to be efficacious in reducing POR in CD, with a more pronounced effect noted in anti-TNF naïve patients. […] The unsolved dilemma is who is going to benefit the most from an expensive and potentially morbid therapy. […] Patients were categorized as high or low-risk then randomized for 6 vs 18-month initial colonoscopy following surgery. High-risk patients were treated with either thiopurine or and all patients were treated with 3 months of metronidazole. […] The initial step in postoperative CD management is risk stratification. Early postoperative endoscopy for high-risk patients with intensification of medical therapy is associated with 18% lower rate of endoscopic recurrence. […] While there is no concrete evidence that smoking decreased therapeutic response to biologic therapy, there is a two times increased risk of POR recurrence in active smokers either incapable or unwilling to stop.

• #2 Prevention of post-operative recurrence of Crohn’s disease

  https://www.wjgnet.com/1007-9327/full/v20/i5/1147.htm

  Prevention of post-operative recurrence of Crohns disease. […] A number of medical therapies have been shown to reduce this risk in clinical trials. Metronidazole, thiopurines and anti-tumour necrosis factors (TNFs) are all effective in reducing the risk of endoscopic or clinical recurrence of CD. […] Patients who are high risk for post-operative recurrence should be considered for early medical prophylaxis with an anti-TNF. […] Clinical recurrence rates are variable, and methods to stratify patients into high and low risk populations combined with prophylaxis tailored to endoscopic recurrence would be an effective strategy in treating these patients. […] Multiple risk factors have been identified for postoperative recurrence. Risk stratifying patients based on these factors can thus help decide which patients to treat aggressively.

• #2 Risk Stratification for Prevention of Recurrence of Postoperative Crohn’s Disease – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/november-2017/risk-stratification-for-prevention-of-recurrence-of-postoperative-crohns-disease/

  Early studies focused on 5-aminosalicylic acids (5-ASAs) and showed superiority over placebo in the prevention of postoperative recurrence. […] Multiple randomized, controlled trials evaluating 5-ASAs have also been performed, with a meta-analysis finding a 13% reduction in risk of postoperative recurrence. […] However, a more recent multicenter, double-blind, randomized, controlled trial showed no difference in clinical or endoscopic remission in patients treated with 5-ASAs postoperatively compared to placebo. […] Budesonide has been studied for postoperative prevention in 2 prospective trials. […] Antibiotics have also been studied in postoperative prophylaxis. […] Given the side-effect profile and the lack of evidence supporting long-term efficacy, the role of antibiotics in postoperative prophylaxis remains unclear.

• #2 Risk Stratification for Prevention of Recurrence of Postoperative Crohn’s Disease – Gastroenterology & Hepatology

  https://www.gastroenterologyandhepatology.net/archives/november-2017/risk-stratification-for-prevention-of-recurrence-of-postoperative-crohns-disease/

  Multiple studies have investigated the effectiveness of a variety of probiotic species in postoperative disease prevention. […] On the contrary, thiopurines have shown superior efficacy to placebo, 5-ASAs, and antibiotics in preventing postoperative clinical recurrence. […] With the advent of biologic therapies, the clinical course of postoperative Crohn’s disease has changed dramatically. […] The first use of a biologic agent to prevent postoperative recurrence was reported in 2006. […] A technical review of postsurgical treatment strategies revealed superiority of a prophylactic strategy over an endoscopy-guided treatment strategy with a low quality of evidence. […] With this in mind, the AGA has made a conditional recommendation to manage postoperative Crohn’s disease patients with prophylactic pharmacologic therapy over endoscopic monitoring, favoring the use of anti–tumor necrosis factor agents or thiopurines over 5-ASAs, corticosteroids, or probiotics. […] Although overall small in numbers, well-designed trials have demonstrated the safety and efficacy of post-operative prophylactic strategies in preventing recurrence.

• #2 Management of Crohn’s disease after surgical resection – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-crohns-disease-after-surgical-resection/

  Strategies to reduce disease recurrence in Crohn’s disease patients who have achieved remission following bowel resection. […] 1. In patients with surgically induced remission of Crohn’s disease, AGA suggests early pharmacological prophylaxis over endoscopy-guided pharmacological treatment. […] 2. In patients with surgically induced remission of Crohn’s disease, AGA suggests using anti-tumor necrosis factor (anti-TNF) therapy and/or thiopurines over other agents. […] 3. In patients with surgically induced remission of Crohn’s disease, AGA suggests against using mesalamine (or other 5-aminosalicylates), budesonide or probiotics. […] 4. In patients with surgically induced remission of Crohn’s disease receiving pharmacological prophylaxis, AGA suggests postoperative endoscopic monitoring at 6 to 12 months after surgical resection over no monitoring.

• #2 Management of Crohn’s disease after surgical resection – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-crohns-disease-after-surgical-resection/

  5. In patients with surgically induced remission of Crohn’s disease not receiving pharmacological prophylaxis, AGA recommends postoperative endoscopic monitoring at 6 to 12 months after surgical resection over no monitoring. […] 6. In patients with surgically induced remission of Crohn’s disease with asymptomatic endoscopic recurrence, AGA suggests initiating or optimizing anti-TNF and/or thiopurine therapy over continued monitoring alone.

• #2 Mechanisms to prevent Crohn’s disease unveiled | ScienceDaily

  https://www.sciencedaily.com/releases/2020/03/200326144445.htm

  In a series of four studies published today, inflammatory bowel disease (IBD) researchers describe the identification of predictive tools and a new understanding of environmental factors that trigger IBD. […] „Early identification of individuals at high risk for disease development could allow for close monitoring and interventions to delay, attenuate, or even halt disease initiation. This is highly relevant as we seek to predict and prevent IBD, which continues to sharply increase in numbers across the globe,” says Jean-Frederic Colombel, MD, Professor of Medicine (Gastroenterology) at the Icahn School of Medicine at Mount Sinai and Co-Director of Mount Sinai’s Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center. „In the absence of a cure, our clinical strategy will center on aggressive and innovative mechanisms to predict and prevent the disease,” says Dr. Colombel.

• #2 Mechanisms to prevent Crohn’s disease unveiled | ScienceDaily

  https://www.sciencedaily.com/releases/2020/03/200326144445.htm

  „The data suggests strongly that achieving deep remission early in the course of Crohn’s disease can lead to disease modification with a significant decrease in long-term complications. The implication is that we can play a big role in slowing the disease progression if we catch and treat Crohn’s early, highlighting the relevance of prediction and prevention in treating Crohn’s,” says lead author Ryan Ungaro, MD, MS, Assistant Professor of Medicine (Gastroenterology) at the Icahn School of Medicine at Mount Sinai and a member of Mount Sinai’s Feinstein IBD Clinical Center. […] „The study suggests that biological processes are activated many years before Crohn’s, opening the possibility of developing targeted strategies that could work to prevent or delay disease onset. […] „If we can identify these factors, we could alter them as a preventative measure for those at high risk of developing IBD.”

• #2 Takeda backs biomarker trial for Crohn’s prevention | pharmaphorum

  https://pharmaphorum.com/news/takeda-backs-biomarker-trial-crohns-prevention

  A pioneering clinical trial backed by the EU and drugmaker Takeda will look for biomarkers that could be used to identify people at risk of developing Crohn’s disease in the hope of intervening early on to prevent symptoms ever developing. […] The INTERCEPT study is being funded to the tune of 38 million (nearly $40 million) over the next five years and is described as „the first-ever prevention and disease interception trial using biomarkers with the goal of transforming Crohn’s,” a common form of inflammatory bowel disease. […] INTERCEPT will recruit 10,000 healthy first-degree relatives of individuals with Crohn’s disease from seven European countries to validate biomarkers and risk score. Of these, 80 people at the highest risk of going on to develop symptomatic Crohn’s will take part in a trial to see if full-blown disease can be prevented with treatment. […] „Biomarkers are key to future research and have the potential to revolutionise the treatment landscape for IBD,” remarked Awny Farajallah, Takeda’s chief medical officer.

• #2 Landmark International Trial Seeks to Intercept and Prevent Crohn Disease Using Biomarkers

  https://www.patientcareonline.com/view/landmark-international-trial-seeks-to-intercept-and-prevent-crohn-disease-using-biomarkers

  The INTERCEPT project aims to build a blood risk score that can identify individuals with a high risk of developing Crohn disease within 5 years of initial evaluation. […] The focus of the INTERCEPT trial will be to verify and clinically validate a panel of investigational biomarkers and to create a blood risk score that can identify individuals at high risk for developing Crohns disease before symptomatic onset, specifically within 5 years after an initial evaluation, according to the IHI statement. […] INTERCEPT is setting its sights on a future where Crohns Disease is highly manageable or even avoidable, the announcement stated. […] INTERCEPT will recruit 10,000 healthy first-degree relatives of CD patients from 7 European countries to further validate the identified biomarkers and the risk score. Of these participants, 80 individuals at the highest risk will participate in a prevention trial using an established and highly effective medical treatment aimed at halting disease progression.

• #2 Prevention in Inflammatory Bowel Disease: An Updated Review – Practical Gastro

  https://practicalgastro.com/2020/03/13/prevention-in-inflammatory-bowel-disease-an-updated-review/

  Tertiary prevention refers to utilization of measures to reduce the impact of long-term disease and disability. […] Therefore, by intervening early and treating inflammation, with a goal of mucosal healing, we can potentially prevent these morbid and potentially life-threatening, complications of IBD. […] Therefore, by optimizing therapies to improve mucosal healing, we may be able to impact the long-term disability associated with irreversible bowel damage in IBD. […] Through this partnership, an individualized plan for preventive medicine can be developed for each patient with IBD. This proactive approach of addressing primary, secondary and tertiary prevention in IBD patients can ultimately help to reduce infectious, malignant and long-term disease-related complications.

• #2 Crohn’s disease

  https://www.nhs.uk/conditions/crohns-disease/

  There’s currently no cure for Crohn’s disease. But there are treatments that can help you stay without symptoms for long periods (in remission). […] Treatments to prevent or treat flare-ups include: medicines to reduce inflammation in your gut, such as steroids, mesalazine or sulfasalazine […] have vaccinations such as the flu vaccine and pneumococcal vaccine if you take medicines that affect your immune system but check that the vaccine is suitable for you, as some types (live vaccines) may not be recommended. […] do not smoke, as it can increase the risk of flare-ups.

• #2 Prevention in Inflammatory Bowel Disease: An Updated Review – Practical Gastro

  https://practicalgastro.com/2020/03/13/prevention-in-inflammatory-bowel-disease-an-updated-review/

  Therefore, this is a potentially preventable complication of therapy through broad-spectrum sunscreen use. […] Finally, weight bearing exercise and calcium/ vitamin D supplementation, when appropriate, can prevent downstream osteoporotic fracture in these patients who may require recurrent courses of corticosteroids during their lifetimes with IBD. […] Secondary prevention is defined as detecting a disease early to prevent disability; such as through screening programs. […] Therefore, a dermatology skin screening program is recommended in all patients with IBD. […] Therefore, patients with longstanding colonic inflammation should undergo routine colonoscopy starting at 8-10 years of colonic disease duration, with subsequent colonoscopy intervals based on the results (often every 1-3 years).

• #2 Crohn’s Disease – Delaware Chronic Disease Coalition

  https://dechronicdiseasecoalition.org/?page_id=778

  There is no known prevention for Crohns Disease, but there are steps that can be taken to reduce the risk of a flare-up, manage symptoms, and reduce discomfort. […] Quit smoking. Smoking is the number-one preventable risk factor for Crohns disease.

• #2 Prevention – Helmsley Charitable Trust

  https://helmsleytrust.org/our-focus-areas/crohns-disease/crohns-disease-prevention/

  Preventing any disease is difficult, but Helmsley is heavily invested in supporting the research and development of preventive strategies for Crohns disease. The challenge is significant, but the potential reward is great. By understanding how the disease develops and by developing safe and effective strategies for intervention, we can focus on efforts to prevent onset, recurrence, or progression, and reduce complications of the disease.

• #2

  https://esmed.org/MRA/mra/article/view/3928

  Historically up to 80% of Crohns disease patients required at least one surgical resection in their lifetime. […] However, surgery continues to be necessary for many. […] Therefore, new approaches are required. Predicting which patients will develop recurrence using genetic and microbiome markers is one approach. […] Choosing surgical techniques that reduce recurrence rates is another and finally dietary approaches to manipulate the microbiome to reduce recurrence are another potential avenue. […] The aim is to be able to reduce recurrence rates whilst accurately predicting which patients will have disease recurrence with the ultimate goal of a more personalised preventive approach. […] The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

• #2

  https://esmed.org/MRA/mra/article/view/3928

  The Probiotic VSL#3 Has Anti-inflammatory Effects and Could Reduce Endoscopic Recurrence After Surgery for Crohns Disease. […] Combination of antibiotic and probiotic treatment is efficacious in prophylaxis of post-operative recurrence of Crohns disease: A randomized controlled study VS mesalamine. […] The Genetics of Postoperative Recurrence in Crohn Disease: A Systematic Review, Meta-analysis, and Framework for Future Work.

• #2 Disease prevention trials in IBD: feasibility to future outlook | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-024-00984-3

  Therapeutic advances in inflammatory bowel disease (IBD) have been universally directed towards patients with established disease to control inflammation, ameliorate symptoms and hinder disease progression, but preventing IBD development or delaying its onset are highly attractive. […] This Comment discusses the emerging approaches and future promises of interventional disease prevention trials in IBD.

• #2 Takeda and EU Innovative Health Initiative launch Crohn’s disease prevention study – PMLiVE

  https://pmlive.com/pharma_news/takeda-and-eu-innovative-health-initiative-launch-crohns-disease-prevention-study/

  Farajallah said: At Takeda, we are excited to join forces with the Innovative Health Initiative with the aim of transforming the treatment of Crohns disease. […] In intercepting Crohns disease, we face complex scientific challenges that no one organisation can address alone. Our collaboration will unite public and private sector expertise and resources to more efficiently advance Crohns research and potentially benefit IBD patients.

• #3 Postoperative prophylaxis in Crohn’s disease after intestinal resection: a retrospective analysis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5558283/

  Up to 80% of patients with Crohn’s disease (CD) may require surgery at some point in their lives, and it is estimated that as many as 40% may require several surgeries. […] It has been suggested that prophylactic medication decreases the rate of clinical and endoscopic recurrence following intestinal resection. […] The efficacy of several agents has been studied, including mesalazine, thiopurines, anti-tumour necrosis factor (TNF)- drugs, such as infliximab and adalimumab, and 5-imidazole antibiotics, including metronidazole and ornidazole. […] A cost-effectiveness analysis reported that thiopurine drugs had the most favourable incremental cost-effectiveness ratio (ICER) in the prevention of clinical recurrence of postoperative CD up to 1 year, and mesalazine the most favourable ICER at 5 years.

• #3 Prophylaxis of Crohn’s disease recurrence: A surgeon’s perspective

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7511563/

  Medical therapy—immunosuppressive modulators and biologic agents—have been associated with decreased need for operation in the short-term, without definitive long-term evidence. […] In addition to antibiotics and immunomodulators, several studies have demonstrated anti-tumor necrosis factor to be efficacious in reducing POR in CD, with a more pronounced effect noted in anti-TNF naïve patients. […] The unsolved dilemma is who is going to benefit the most from an expensive and potentially morbid therapy. […] Patients were categorized as high or low-risk then randomized for 6 vs 18-month initial colonoscopy following surgery. High-risk patients were treated with either thiopurine or and all patients were treated with 3 months of metronidazole. […] The initial step in postoperative CD management is risk stratification. Early postoperative endoscopy for high-risk patients with intensification of medical therapy is associated with 18% lower rate of endoscopic recurrence. […] While there is no concrete evidence that smoking decreased therapeutic response to biologic therapy, there is a two times increased risk of POR recurrence in active smokers either incapable or unwilling to stop.

• #3

  https://link.springer.com/article/10.1007/s11894-023-00911-7

  Despite advances in therapeutics, a significant portion of patients with Crohns disease still require surgical management. […] High-risk patients benefit most from medical prophylaxis, including anti-TNF with or without immunomodulator therapy to prevent recurrence. […] Recent advances in the prediction, prevention, and monitoring algorithms of postoperative Crohns disease may be leading to a reduction in postoperative recurrence. […] Ongoing trials will help determine optimal monitoring and management strategies for this at-risk population. […] New biologics such as vedolizumab and ustekinumab have emerging evidence in the use of prophylaxis, especially with recent REPREVIO trial data. […] Large, multicenter prospective study showing that prophylactic biologics help prevent POR in both high-risk and low-risk patients. […] First RCT demonstrating that vedolizumab is effective and safe in the prevention of POR of Crohn’s disease. […] Ustekinumab is more effective than azathioprine to prevent endoscopic postoperative recurrence in Crohns disease.

• #3 Management of Crohn’s disease after surgical resection – American Gastroenterological AssociationAGA Logo_Horizontal

  https://gastro.org/clinical-guidance/management-of-crohns-disease-after-surgical-resection/

  5. In patients with surgically induced remission of Crohn’s disease not receiving pharmacological prophylaxis, AGA recommends postoperative endoscopic monitoring at 6 to 12 months after surgical resection over no monitoring. […] 6. In patients with surgically induced remission of Crohn’s disease with asymptomatic endoscopic recurrence, AGA suggests initiating or optimizing anti-TNF and/or thiopurine therapy over continued monitoring alone.

• #3 INTERCEPT: Pioneering the future of Crohn’s disease prevention — EFCCA

  https://www.efcca.org/news/intercept-pioneering-future-crohns-disease-prevention

  EFCCA is partnering in the groundbreaking INTERCEPT project! This multi-million Euro research initiative, funded by the Innovative Health Initiative Joint Undertaking (IHI JU), marks a significant milestone in the fight against Crohns disease. By harnessing the power of predictive biomarkers, the project aims to shift Crohns from an incurable condition to one that can be effectively managed or even prevented. […] INTERCEPT is Europes first-ever trial using biomarkers to prevent the onset of Crohns disease before symptoms develop. […] The goal is to validate a panel of biomarkers and develop a blood risk score to identify individuals at high risk of developing Crohns disease within five years. […] By detecting and addressing the disease in its earliest stages, INTERCEPT has the potential to revolutionise IBD care and significantly improve patient outcomes. […] EFCCAs commitment to improving the quality of life for those affected by IBD aligns seamlessly with INTERCEPTs mission to transform the future of Crohns disease care.

• #3 Is Prevention Achievable in Inflammatory Bowel Disease? – Helmsley Charitable Trust

  https://helmsleytrust.org/news-and-insights/is-prevention-achievable-in-inflammatory-bowel-disease/

  The preclinical phase of Crohns disease is what happens before the first symptoms occur and the diagnosis is made. […] If this preclinical period can be diagnosed, different prediction tools could be offered to individuals at risk for developing IBD, with the goal of eventually offering prevention strategies. […] Importantly, can we interfere with those events? […] The ultimate goal of our studies is to build a predictive tool that can be applied to people at risk of Crohns disease, such as first-degree relatives of patients with Crohns disease, and then to start the first prevention trial. […] So, what we are learning in the preclinical phase may be very useful for new therapeutics in later phases as well. […] Thanks to support from Helmsley, the goal is now to combine data from multiple cohorts and create a large collaborative consortium on prediction and prevention of Crohns disease.

• #4 6 Ways to Prevent a Crohn’s Flare-Up

  https://www.webmd.com/ibd-crohns-disease/crohns-disease/crohns-disease-prevent-flares

  Your Crohns disease is ever-present, unfortunately, and so is the possibility of a flare-up. What can you do? While nothing offers guaranteed protection against a return of symptoms, you can take steps to make flares less likely. […] Medications that modify the way your immune system operates help prevent inflammation. But they only work when you take them. If you skip doses, thats an invitation for symptoms to return. So stick with the instructions your doctor gave you and take your medication as prescribed, even when you feel fine. […] The American College of Gastroenterologists strongly recommends against the use of NSAIDs by people with Crohns disease. If you have arthritis or another condition that causes frequent pain, talk to your doctor about your options. […] Smoking kicks Crohns disease activity into overdrive and makes the disease progress faster. Not only does smoking increase the odds that youll need surgery, it also makes flares more frequent. After you stop smoking, the number of flares you have should drop. You also may need fewer Crohns disease medications if you quit smoking.

• #5 Crohn’s Disease – Delaware Chronic Disease Coalition

  https://dechronicdiseasecoalition.org/?page_id=778

  There is no known prevention for Crohns Disease, but there are steps that can be taken to reduce the risk of a flare-up, manage symptoms, and reduce discomfort. […] Quit smoking. Smoking is the number-one preventable risk factor for Crohns disease.

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