Risk of surgery for Crohn's disease lower than reported in recent studies

Sep 01, 2010

A new multi-center study of 854 children with Crohn's disease shows a 5-year cumulative risk of bowel surgery is significantly lower than reported in recent studies. The findings of the study, led by Hasbro Children's Hospital, also indicate that children diagnosed between ages 13 and 16 had an increased risk of bowel surgery, and that a common treatment that begins at diagnosis, immunomodulator therapy, did not alter the risk of surgery. The study is published in the September 2010 edition of Clinical Gastroenterology and Hepatology.

Crohn's disease (CD) is a condition that involves of the . While the exact cause is unknown, the condition is often linked to an immune response problem. Treatments include medications that are directed at controlling the inflammation by targeting the immune system. A common treatment is immunomodulator therapy, an agent that balances and improves the of the body in fighting disease-causing agents, Immunomodulators can help reduce the need for corticosteroids while helping to heal fistulas (an abnormal connection between two organs).

Senior author Neal LeLeiko, MD, director of pediatric gastroenterology and nutrition at Hasbro Children's Hospital, led a multi-center observational study of patients under 16 years of age with newly diagnosed inflammatory bowel disease (IBD). All of the patients were enrolled in the Pediatric Inflammatory Bowel Disease Research Group (PIBDRG) Registry from 26 sites across the country. The goal of the study was to examine the incidence of CD-related surgery in pediatric patients and to examine the effect of starting immunomodulator therapy within 30 days of diagnosis.

LeLeiko, who is also a professor at The Warren Alpert Medical School of Brown University says, "The natural history of Crohn's disease often includes bowel surgery, with recent studies reporting surgery risks at one year after diagnosis as high as 34 percent and as high as 47 percent at five years following diagnosis. In this study, we examined the current incidence of bowel surgery." With an increase in the use of immunomodulators as a common therapy at the time of diagnosis in recent years, the researchers also examined its impact.

In terms of the risk of surgery, LeLeiko says, "We have identified older age at diagnosis and greater disease severity to be associated with an increased risk for bowel surgery, along with certain types of disease. The findings, however, indicate that other studies suggest an almost two times greater incidence of surgery than what we found in our study."

The researchers also found that children diagnosed between the ages of 13 and 16 were at greater risk for surgery, however they found no evidence that the early use of immunomodulators is a factor in 5-year surgical outcomes. They also found no link between gender, race or family history of as factors that would increase the risk of surgery.

LeLeiko concludes, "Our study findings indicate that changing disease behavior over time influences the risk of surgery, and treatments focused on early intervention to alter the natural course of the disease will need to be assessed in studies that ideally involve randomized controlled trials."

Explore further: Filipino tests negative for Middle East virus

add to favorites email to friend print save as pdf

Related Stories

Early onset gene for inflammatory bowel diseases identified

Sep 02, 2008

A study of Crohn's disease and ulcerative colitis in children has identified a gene that influences whether children get these diseases early in life, and points to a potential new target for treatment. The findings of the ...

Crohn's disease surgeries make steady advances

Nov 18, 2008

Thousands of Americans suffering from the chronic inflammatory bowel condition known as Crohn's disease are leading longer, healthier lives due to innovative new surgeries, according to experts at NewYork-Presbyterian Hospital/Weill ...

Recommended for you

Filipino tests negative for Middle East virus

10 hours ago

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

US orders farms to report pig virus infections

Apr 18, 2014

The U.S. government is starting a new program to help monitor and possibly control the spread of a virus that has killed millions of pigs since showing up in the country last year.

Foreigner dies of MERS in Saudi

Apr 18, 2014

A foreigner has died after she contracted MERS in the Saudi capital, the health ministry said on announced Friday, bringing the nationwide death toll to 73.

Vietnam battles fatal measles outbreak

Apr 18, 2014

Vietnam is scrambling to contain a deadly outbreak of measles that has killed more than 100 people, mostly young children, and infected thousands more this year, the government said Friday.

New clues on tissue scarring in scleroderma

Apr 18, 2014

A discovery by Northwestern Medicine scientists could lead to potential new treatments for breaking the cycle of tissue scarring in people with scleroderma.

User comments : 0

More news stories

Filipino tests negative for Middle East virus

A Filipino nurse who tested positive for the Middle East virus has been found free of infection in a subsequent examination after he returned home, Philippine health officials said Saturday.

Study says we're over the hill at 24

(Medical Xpress)—It's a hard pill to swallow, but if you're over 24 years of age you've already reached your peak in terms of your cognitive motor performance, according to a new Simon Fraser University study.

NASA's space station Robonaut finally getting legs

Robonaut, the first out-of-this-world humanoid, is finally getting its space legs. For three years, Robonaut has had to manage from the waist up. This new pair of legs means the experimental robot—now stuck ...

Ex-Apple chief plans mobile phone for India

Former Apple chief executive John Sculley, whose marketing skills helped bring the personal computer to desktops worldwide, says he plans to launch a mobile phone in India to exploit its still largely untapped ...

Egypt archaeologists find ancient writer's tomb

Egypt's minister of antiquities says a team of Spanish archaeologists has discovered two tombs in the southern part of the country, one of them belonging to a writer and containing a trove of artifacts including reed pens ...

Airbnb rental site raises $450 mn

Online lodging listings website Airbnb inked a $450 million funding deal with investors led by TPG, a source close to the matter said Friday.